Preventing Breast Implant Rupture

While there is no guaranty that breast implants will last a lifetime, plastic surgeons have come up with different techniques to at least prolong the devices’ lifespan and lower the risk of implant rupture.

In the event of implant rupture, the only solution is a revision breast augmentation; this procedure may involve replacing the implants with new ones or removing them without any replacement.

Meanwhile, these are some of the basic rules which can help patients prevent or at least lower the risk of implant failure.

* Choosing silicone implants over the saline version

Currently available silicone breast implants are less likely to rupture than saline because they are not prone to sloshing and wrinkling which are known to affect the shell’s stability.  Another advantage is that the silicone gel does not evaporate (unlike the saline) which means the patients can maintain their breast volume unless in the event of rupture.

The latest version of silicone implants—which have a more cohesive silicone gel than the one currently used—is almost immune to implant failure.  However, these breast implants, called the gummy bear implants, are not yet approved in the US although these are already used in Europe and Canada.

* When using salinei mplants

Rippling, which can compromise the shell’s stability, can be prevented in saline implants by slightly overfilling them.  However, this should be carefully done because too much filler can cause abnormal pressure on the device.

On the other hand, underfilling saline implants only has negative results because it can cause creases, leading to weak areas in the shell.

* Avoiding high trauma to the breast

Modern breast implants are very strong although they are still subjected to the effects of physical force.  Impact from car collision, sports injuries, and accidental falls may compromise the shell’s stability or may even lead to rupture.

* Consider the implant placement

Some doctors say that submuscular implant placement (placing the device under the pec muscle) poses a slightly higher chance of shell damage than the subglandular technique (positioning the implants over the muscle).  A good compromise might be the subpectoral placement.

* Use of Keller Funnel technique

In this technique, plastic surgeons place the breastimplants in a cone-shaped device and then squeeze it so the implants are transferred into the breast pockets.  Doctors use less force in this method than if they push the devices using their fingers.

Breast Surgery—Combining Fat Grafting and Breast Implants

Breast reconstruction via implants for cancer patients who had undergone radiation therapy is often not an ideal procedure due to the high risk of complications for the reason that radiation has toxic effects on tissues, which can impede natural healing for many women.

Because breast implants are not ideal for cancer patients who had radiation therapy, tissue-based reconstruction is the only viable treatment in which their own tissue from buttocks, abdomen, or back is used to create a new breast mound.  However, the tradeoff is longer recovery and muscle weakness and scarring in the donor site.

Fortunately, doctors have found ways minimize the radiation-induced complications, making it possible to use breast implants for post-cancer patients who received radiation therapy.  The staged procedure involves injecting a person’s own fats to her breast so the area will receive a “bed of healthy tissue” in the chest wall.

A recent study published in the February issue of Plastic and Reconstructive Surgery medical journal has proven the promising advantage of combining fat grafting and implants for breast reconstruction.

The three-year study involved 16 patients who underwent the new breast reconstruction technique after receiving radiation therapy to fight off cancer cells.  Eleven respondents had mastectomy (partial or complete removal of breasts) while five had lumpectomy and other types of breast-conserving surgery.

Breast reconstruction began three to six months after the respondents received radiation therapy.

All patients have received two to three fat grafts to place healthy tissue in the chest wall, allowing it to accommodate the breast implants and to lower the risk of radiation-induced complications.

The collected fats from the donor site must be subjected to a purification method to separate biomaterials such as blood and connective tissue; in this way, the survival rate of the grafted fats will be high.

After the staged breast reconstruction, the results were highly encouraging in terms of aesthetic improvements, the researchers concluded.  Also, patient satisfaction was rated high to very high.

Meanwhile, an average follow-up of 15 months did not show any complications as all patients have experienced good healing in their tissue surrounding the breast implants.

Performing radiation therapy after breast cancer surgery significantly reduces the risk of recurrence, although the downside is that the treatment can affect the body’s healing because of its toxic effects.

While the new study revealed the promising benefits of fat grafting with breast implant for reconstruction surgery, the researchers said more comprehensive surveys and trials with longer follow-up are still needed to confirm their findings.