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On the Breast Implant Fence? Clarity on the 5 Obstacles that Make the Decision Hard

Breast augmentation is among the most popular cosmetic surgery procedures and one of the highest rated in patient satisfaction. But the decision to get breast implants is a highly personal one. There are pros and cons to weigh and lots of choices to make: the type of implants, their size, whether to combine implants with a breast lift, the best time to have the procedure. If you’re considering breast implants but are still on the fence, that’s a healthy sign. It means you’re carefully considering these factors. The best candidates for implants — and the ones who are most satisfied with the outcomes — are women who have carefully weighed the pros and cons and who have realistic expectations for what the surgery can and can’t do.

In this blog, we’ll look at five of the most common obstacles to deciding to have breast implants. By providing information on each of them, we hope to give you some clarity and help you make a decision you’ll feel good about.

1. Emotional Aspects of Plastic Surgery

Plastic surgery is a medical art that aids in personal transformation. From the surgeon’s perspective, it blends precision, the latest medical science, and the aesthetics of the human form. From the patient’s perspective, it’s a launching step to a new appearance. There’s an emotional element in that. People judge us by how we look, and they often treat us differently based on those physical perceptions. Changes that make you more look more attractive can build your self-confidence. But it can take courage to make that leap and become a new version of yourself. You’re choosing to change your appearance — to transform your body to better match your sense of who you are and who you’d like to be.

As you weigh breast implant surgery, it’s healthy to think about who you want to be, how you want to look, and how you want others to perceive you. If you’re unhappy with your appearance and feel a mismatch between how you feel about yourself and how others see you, plastic surgery can help bring your appearance into line with your ideal self-image.

It’s also healthy to have a clear understanding of what breast implants can and can’t do to transform you. Breast augmentation will increase the size of your breasts and can give them a more attractive shape. The procedure will change the form of your upper body so that you can wear different kinds of clothes. With implants, you may feel good about how you look in a low-cut dress or a swimsuit, for example. But you also need to understand what implants won’t change. They won’t fix unhealthy body-image issues or change other aspects of your appearance.

The best candidates for breast implants have a clear idea of how the surgery will change their looks. And they have the assurance that they want that change; they are ready and eager for it. They are making the change for their own benefit — to look sexier, to extend the wardrobe they look good in, to get a fresh boost of self-confidence. They don’t do it because someone else wants them to.

2. Downtime for Recovery

You’ll need some downtime for recovery after breast implant surgery — a week at home with no strenuous activities and no heavy lifting. You’ll need help with ordinary chores in those first few days: shopping for groceries, taking out the trash, even moving pots around in the kitchen. If you have young children, you won’t be able to lift or carry them yourself. After the first week, you’ll be able to gradually resume normal activities, but it will be six weeks before you are fully recovered and able to completely get back to strenuous activities and tasks that require heavy lifting.

That downtime can be an obstacle for some women. Think about when you’d be able to take that break from your daily routine, when you could get the time off from work, and who might help you at home. As with any obstacle in life, if you want to get past it, you just need to think about how and come up with a plan. Ask friends or family members if they’d be willing to help, and find out when they’re available. Figure out when you could take a week off from work and talk to your employer about it. A few quick conversations could melt this obstacle away and give you clarity on when would be the best time for the procedure.

3. Breastfeeding Plans

Another common concern about breast implants is whether they will affect your ability to breastfeed. In fact, the great majority of women who have implants are able to breastfeed without difficulty. The implants don’t affect their ability to produce or express milk at all. As with any surgical procedure, however, breast augmentation carries the risk of rare complications, and a possible problem with breastfeeding is one of these. If this is a concern for you, the best approach is to learn more. Bring it up in your consultation with the surgeon, who can share the actual experiences of patients.

Research has also looked at the effect of silicone implants on the quality of breast milk. The FDA considered this before approving silicone breast implants as safe. On its website, the FDA cites a study that tracked the levels of silicon (a measurable component in silicone) in the breast milk of women with and without silicone gel-filled implants. The women with implants did not have higher levels of silicon in their milk than did the women without implants.

We should note that it is not recommended that women have breast augmentation surgery while they are pregnant or breastfeeding. That’s partly to protect your health and the health of your developing baby, but also to ensure satisfying long-term results. It’s best to wait until your breasts have returned to a stable size and shape after childbearing and breastfeeding before planning and scheduling the surgery.

4. Potential Health Effects

Concern about the health effects of implants is probably the most common obstacle we hear about in our consultations. It makes good sense to learn about the risks of any surgical procedure before deciding to have it, and patients face the usual surgical risks from the implant procedure. These include the risks associated with anesthesia and the possibility of infection or bleeding. But implant surgery is generally considered to be safe. 

Silicone implants carry a special stigma that is largely undeserved. Some of this is based on old information and some on newer findings. Between 1992 and 2006, the FDA prevented the use of silicone breast implants while research was done to better understand their safety. That era of heightened concern still echoes in the worries of some of our patients, but it is largely an outdated concern. Once the research was completed to the FDA’s satisfaction, and no links were found between silicone implants and the medical conditions that had prompted the restriction, the FDA resumed its approval of selected silicone gel implants for use in breast augmentation.

To protect patient safety, the FDA continues to monitor outcomes and adjust its specific device approvals based on new findings. This has brought silicone implants back into the news recently. In 2019, a link was found between the use of a particular brand of textured implants and a rare form of cancer: anaplastic large-cell lymphoma (ALCL). At the FDA’s request, the manufacturer withdrew that implant from the market and it is no longer used. The media attention from this action made it seem, to the casual reader, that silicone implants had once again been found to be dangerous. But the risk was extremely low, and is even lower now, after the FDA and manufacturer responses. More than 90 percent of implants are smooth, not textured, and no connection has been found between smooth implants and ALCL. Further, the risk of ALCL in women with textured implants is very low — an estimated 1 in 30,000. That low risk is easy to avoid by choosing smooth implants, or to minimize by using FDA-approved textured implants.

It’s worth understanding three other health concerns related to breast implants before you make your decision to go ahead with the procedure.

First, implants can rupture. When a saline implant ruptures, the salt water simply leaks out and is absorbed by the body. That’s not a health concern. But it is a cosmetic issue. When the implant deflates, the affected breast is reduced to its former size. This might lead you to have the implant replaced. When a silicone implant ruptures, the gel remains in place for a time. The appearance of the breast may not change, but the tissue inside can be affected. The loose silicone can, over time, begin to cause small masses called granulomas in the breast and these can start to disperse through the body. So when a silicone implant ruptures, its best to remove it. That’s why women with silicone implants are advised to have an MRI three years after the placement procedure, then every two years after that.

The second concern is the risk of developing hardened scar tissue around the implant, a condition called capsular contracture. This is a relatively rare problem. If the scar tissue gets too thick, it can change the shape and appearance of the breast. In some cases, it can be painful. The remedy, when this happens, is to remove the implant. Once the breast has healed, the patient can consider whether to replace the implant, perhaps with one of a different type.

The third issue is with mammogram screenings for breast cancer. Implants can be placed either below or above the muscle of the chest wall. When placed below the muscle, the implants don’t interfere with normal mammogram imaging. When placed above the muscle, in the breast tissue, it is sometimes necessary to supplement X-ray screening with ultrasound or MRI imaging. If you have a family history of breast cancer or are at higher risk for another reason, you should discuss this with your plastic surgeon.

5. How Long Implants Last

Breast implants should be seen as a 10- or 15-year investment. They don’t last forever, and eventually they will need to be removed or replaced. This is another factor to consider as you make your decision. 

In 10 or 15 years, you may have a different ideal for the size of your breasts. Or your breasts may change in size or shape by then, whether through the natural process of aging or from weight fluctuations or pregnancy. In a smaller number of cases, implant rupture, capsular contracture, or another problem may make it necessary to remove or replace an implant.

As you make a commitment to have implants now, understand that you may need another procedure a few years down the road to remove or replace them.

Making the Implant Decision

How will you know you are ready for breast implants? When you’ve done your research, found answers to your questions, and understand the pros and cons of your choice. You’ll know it’s the right decision, and that now is the right time, when it feels right to you.

Choose a Practice with Experience and Skill

A big part of gaining the confidence to move ahead lies in finding a plastic surgeon you trust. Dr. Russell Hendrick, Jr., at the New Orleans Center for Aesthetics and Plastic Surgery is a board-certified plastic surgeon with extensive experience in breast enhancement procedures. Call us at (504) 533-8848 or contact us today to schedule a consultation. Dr. Henrick will take the time to answer your questions and discuss any concerns you may have.