Breast Augmentation Complications - Philadelphia

Treating Breast Implant Problems

Breast Reconstruction | Philadelphia | Bryn Mawr Dr. Noone has gained national recognition for treating patients who have been referred to him for complications of breast implants. He is widely published in the medical literature for correcting these problems. Please see references included on this page.

Breast augmentation surgery carries many of the same risks associated with other types of surgeries, such as adverse reactions to anesthesia, post-operative bleeding (hematoma), infection, swelling, fluid accumulation (seroma), redness, and pain. Complications specific to breast augmentation include:

Capsular Contracture

Capsular contracture is one of the most common problems caused by breast implants. This condition occurs when scar tissue around the implant hardens and begins to squeeze the implant. Capsular contraction can be painful and can cause hardening of the breast tissue, rippling in the skin of the breast, movement of the breast implant, and a distorted shape of the breast. When capsular contracture develops, surgery is sometimes needed to remove the scar tissue or to replace the implant.

Deflation/Rupture

Breast implants can deflate when the saline solutions leaks through an unsealed or damaged valve or through a rupture in the implant shell. Deflations can either occur immediately or over a few days and can happen at any time from months to years after surgery. Causes of deflation include, but are not limited to, damage from surgical instruments, overfilling or underfilling of the breast implant with saline solution, capsular contracture, trauma to the breast, and normal wear and tear over time. Deflated breast implants require additional surgery for removal and possible replacement of the implant.

Bottoming Out

Bottoming out occurs when the implant rides too low in the breast tissue, causing the nipple to point upwards. This condition is more common in thin patients with very little breast tissue and skin coverage. It can also occur when the implant is placed above the muscle. If bottoming out is noticeable shortly after surgery, it is most likely caused by over-dissection of the pocket (the pocket is made too big). If it occurs later on, it is most likely caused by the weight of the implant. Bottoming out can be corrected by recreating the pocket surgically.

Symmastia

Symmastia is a condition when the breast implants are too close together, meeting at the middle of the chest. This is usually a result of over-dissection of tissue in the cleaving area, which is done in hopes of creating or increasing cleavage. Symmastia is more common in thinner women, primarily because they have less tissue covering the sternum. This condition can be corrected by reattaching the fat and underlying skin tissue to the sternum, or by replacing the implants with smaller ones.

Interference with Mammography

Breast implants may interfere with the detection of breast cancer by hiding suspicious lesions in the breast during a mammogram. The implants may also cause calcium deposits around the breast which can be mistaken for cancer during a mammogram. It is important to note, however, that breast implants have not been shown to increase the risk of breast cancer.

Dissatisfaction with Results

As with any cosmetic surgery, the result may not meet with your expectations. Reasons for feeling dissatisfied may include implant size, excessive scarring, wrinkling, asymmetry, and implant displacement (shifting). These results can be minimized with pre-surgical counseling, careful surgical planning, and possible correction with additional surgery.

References:

Noone, R.B., Murphy, J.B., Spear, S.L. and Little, J.W.
A six year experience with immediate reconstruction after mastectomy for cancer.
Plast. Reconstr. Surg. 76:258-269, 1985.

Castiglione, C.L., Noone, R.B., Murphy, J.B. and Little, J.W. III
Complications after immediate breast reconstruction and their management.
Plastic Surgical Forum. Vol. X, pp. 221-222, 1987.

Noone, R.B.
Immediate Reconstruction After Breast Surgery. In Noone, R.B. Ed. Plastic and Reconstructive
Surgery of the Breast. p. 344-371.
B.C. Decker, Philadelphia, 1991.

Adjustable Implant Reconstruction. In Spear, Little, and Lippman, eds., Surgery of the Breasts:
Principles and Art. Lippincott-Raven Publishers, Chapter 24: 357-374, Philadelphia , PA 1998.

Noone, R.B.
A review of the Possible Health Implications of Silicone Breast Implants.
Cancer 79: 1747-56, 1997.

Noone, R.B.
Single Stage Breast Reconstruction with the Adjustable Implant
In Jackson, I.T. and Noone, R.B. eds.
Innovations in Plastic Surgery: The Adjustable Breast Implant. St. Louis
Quality Medical Publishing. 2004. pp.122-140

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