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The most common problems associated with silicone gel-filled and saline-filled breast implants are those that occur in the breast or chest area, and are known as "local complications. Other local complications include implant wrinkling, asymmetry, scarring, pain, and infection at the incision site. These local complications often result in reoperation or implant removal. The following is a list of local complications and adverse outcomes that occur in one percent or more of patients at any time after breast implant surgery.

They are listed in alphabetical order—not in order of prevalence. If you experience any of the local complications listed above after breast implant surgery, you may need specific treatments, including additional surgery. Maintain an active role in your health care and inform your doctor immediately if you experience any new health issues. The most common local complications and adverse outcomes associated with breast implants — silicone gel-filled and saline-filled—are capsular contracture, reoperation, implant removal, and rupture or deflation of the implant.

Capsular Contracture Capsular contracture is the hardening of the breast area around the implant. It can occur in the tissue surrounding one or both implants. This hardening causes the tissue to tighten, which can be painful. Grades III and IV capsular contracture are considered severe, and may require reoperation or implant removal.

Capsular contracture, whether mild, moderate or severe, may occur more than once in the same implant. Photograph 1 shows Grade IV capsular contracture in the right breast of a year-old woman seven years after placement of silicone gel-filled breast implants. Photograph 1 Photo courtesy of Walter Peters, Ph.

Reoperation Breast implants are not lifetime devices. You may need to have one or more reoperations over the course of your life due to any one or combination of local complications. You may also need one or more reoperations to improve breast appearance if you are unsatisfied with the outcomes of the surgery aimed at correcting any local complications.

Removal One type of reoperation involves the surgical removal of your implants, which may or may not include implant replacement. As many as 20 percent of women who receive breast implants for breast augmentation have to have their implant removed within years.

Over the course of your life, you may need to have your implant removed due to local complications. Many women have their implants replaced, but some women do not. Women who do not have their implants replaced may have cosmetically undesirable dimpling, puckering, or sagging of the natural breast following implant removal.

Photograph 2 shows a year-old woman one year after having her silicone gel-filled breast implants removed. This is the same woman from Photograph 1. Photograph 2 Photo courtesy of Walter Peters, Ph. Rupture is a tear or hole in the outer shell of the breast implant.

When this occurs in a saline-filled breast implant, it deflates, meaning the saltwater saline solution leaks from the shell. Silicone gel is thicker than saline, so when a silicone gel-filled implant ruptures, the gel may remain in the shell or in the scar tissue that forms around the implant intracapsular rupture.

Some breast implants rupture in the first few months after surgery and some after several years. Others may rupture after 10 or more years. Some possible causes of rupture include:. FDA recommends removing both saline-filled and silicone gel-filled breast implants if they have ruptured. You and your doctor will need to decide whether or not your implant has ruptured and if you should have it replaced or removed without replacement. Silicone Gel-filled Breast Implants and Rupture When silicone gel-filled implants rupture, silicone gel may escape from the scar tissue capsule around the implant and migrate away from the breast.

This can cause lumps to form in the breast, chest wall, armpit, arm, or abdomen. When a silicone gel-filled breast implant ruptures, some women may notice decreased breast size, hard knots, uneven appearance of the breasts, pain or tenderness, tingling, swelling, numbness, burning, or changes in sensation. However, most ruptures occur without any symptoms.

Magnetic Resonance Imaging MRI is the most effective way to detect silent rupture of a silicone gel-filled breast implant. The FDA and implant manufacturers recommend that women with silicone gel-filled breast implants undergo MRI screening three years after they receive a new implant and every two years after that for early detection of a silent rupture.

The FDA recommends using MRI equipment that is specifically designed for imaging the breast for evaluating patients with suspected rupture or leakage of their silicone gel-filled implants. Saline-filled Breast Implants and Deflation Deflation occurs when the shell of a saline-filled breast implant tears or when the seal around the valve used to fill the implant is broken and liquid saline leaks out from the implant.

When saline-filled breast implants deflate, loss of size or shape of the implant can be noticed immediately, or it may progress slowly over a period of days. Photograph 3 below shows deflated saline-filled breast implants in a year-old woman.

Photograph 3 Photo courtesy of Walter Peters, Ph. It is a cancer involving cells of the immune system. BIA-ALCL is generally found next to the implant itself and is usually contained within the fibrous capsule that the body forms around the implant. Most of the breast implant patients found to have BIA-ALCL were diagnosed after they sought medical treatment for implant-related symptoms such as pain, lumps, swelling, or asymmetry that developed after their initial surgical sites had fully healed.

Some patients also received radiation therapy, chemotherapy or both. If you have breast implants, there is no need to change your routine medical care and follow-up. There are several important things to consider before deciding to undergo breast implant surgery, including understanding your own personal expectations and reasons for having the surgery.

Below are some things the FDA thinks you should consider before undergoing breast augmentation, reconstruction or revision surgery. For more detailed information about breast implants, visit www. Page Last Updated: If you need help accessing information in different file formats, see Instructions for Downloading Viewers and Players. Language Assistance Available: Skip to main page content Skip to search Skip to topics menu Skip to common links. Medical Devices.

Introduction The most common problems associated with silicone gel-filled and saline-filled breast implants are those that occur in the breast or chest area, and are known as "local complications.

Local Complications and Adverse Outcomes The following is a list of local complications and adverse outcomes that occur in one percent or more of patients at any time after breast implant surgery. The Most Common Local Complications and Adverse Outcomes The most common local complications and adverse outcomes associated with breast implants — silicone gel-filled and saline-filled—are capsular contracture, reoperation, implant removal, and rupture or deflation of the implant.

There are four grades of capsular contracture, known as Baker Grades: Some possible causes of rupture include: Breast implants are not lifetime devices; the longer you have your implants, the more likely it will be for you to have them removed. The longer you have breast implants, the more likely you are to experience local complications and adverse outcomes. The most common local complications and adverse outcomes are capsular contracture, reoperation, implant removal, and rupture or deflation of the implant.

Other complications include wrinkling, asymmetry, scarring, pain, and infection at the incision site. You should assume that you will need to have additional surgeries reoperations.

Many of the changes to your breast following implantation may be cosmetically undesirable and irreversible. If you have your implants removed but not replaced, you may experience changes to your natural breasts such as dimpling, puckering, wrinkling, breast tissue loss or other undesirable cosmetic changes. If you have breast implants, you will need to monitor your breasts for the rest of your life. If you notice any abnormal changes in your breasts, you will need to see a doctor promptly.

For early detection of silent rupture, the FDA and breast implant manufacturers recommend that women with silicone gel-filled breast implants receive MRI screenings 3 years after they receive a new implant and every 2 years after that. MRI screening for implant rupture is costly and may not be covered by your insurance. If you have breast implants, you have a low risk of developing a type of cancer called breast implant-associated anaplastic large cell lymphoma BIA-ALCL in the breast tissue surrounding the implant.

Other Resources.

Breast Implant Complications

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