Allergan breast implant devices have been successfully on the market for almost 50 years. The products are available in over 60 countries and are subjected to rigorous national and international quality control standards and practices.

Among the many products manufactured by Allergan every year, silicone gel-filled breast implants are by far the most favored among both patients and surgeons. The gel-filled implants have been placed in more than 1 million women worldwide.

As a result of hundreds of thousands of clinical trials, peer-reviewed journals and published reports, silicone gel-filled breast implants have become one the most studied devices in the world. Allergan’s gel-filled implants specifically, have set themselves apart from various competitors due to their more cohesive silicone gel and their stronger outer shells.

A recent report published by the U.S. FDA has again confirmed the safety and effectiveness of silicone breast implants when used as intended, however, it is important for patients to recognize that breast implants are not made for lifelong use. Patients at some point in their lives may require a removal and replacement. Breast implants should be monitored regularly by a physician.

Allergan is committed to excellence and continues to set the industry standard for breast implant manufacturing with their strong adherence to the most stringent of safety and quality standards.

Learn more about gel-filled breast implants in Bellevue, WA.

Source: News-Medical.net

The researchers reviewed insurance claims of 2,403 obese patients and 5,597 normal weight patients who had breast procedures, including breast lifts, breast reductions and breast augmentations, between 2002 and 2006.

Just over 18 percent of the obese group had at least one complication within 30 days of surgery, compared to only 2.2 percent of non-obese patients.

It also found that obese patients were 22 times more likely to have inflammation; 13 times more likely to develop infection; and 11 times more likely to experience pain.

Breast reduction was the most common procedure for patients in the study, accounting for 80.7% of surgeries in the obese group and 63.8% in the non-obese group. Next was breast reconstruction, followed by breast augmentation and breast lift.

Individual breast procedures all had higher complication rates for obese patients, and complications were most common with breast augmentation among obese patients, with half of obese patients experiencing complications.

Complication rates for each breast surgery are as follows:

• Breast augmentation – 50.5% among obese and 4.4% among non-obese
• Breast lift – 24.1% among obese and 11.4% among non-obese
• Breast lift with augmentation – 38.9% among obese and 5.6% among non-obese
• Breast reconstruction – 29.4% among obese and 1.8% among non-obese
• Breast reduction – 14.6% among obese and 1.7% among non-obese

Preparing for Breast Surgery

Based on their findings, the researchers recommended that patients should be informed about the risk of obesity prior to breast surgery procedures.

Other ways surgeons may have patients prepare for breast surgery include getting a baseline mammogram before surgery; not smoking in advance of the surgery; and avoiding certain anti-inflammatory drugs that could increase bleeding.

After conducting an in-depth study of silicone implant safety, the FDA has confirmed that silicone gel implants “have a reasonable assurance of safety and effectiveness when used as labeled.” For consumers, this means silicone gel implant augmentations performed by a board certified plastic surgeon, and maintained as instructed, should present no extreme health issues for the patient.

The FDA’s silicone implant safety study also debunked a rumor that silicone breast implants share an association with “connective tissue disease, breast cancer, or reproductive problems.” Based on current data, the FDA said there is no detected connection.

Long-Term Silicone Implant Safety Tips

Women who are considering silicone breast implants should note that though breast implants are long-lasting, no such implant will last a lifetime. Over the course of her life, a woman who has gotten breast implants will likely need to have them replaced.

Patients will need to monitor their silicone gel implants over time and note any signs of complication to their surgeon. Some women may experience a hardening of tissue around the breast, called capsular contracture, or may have a revision or removal surgery.

Silicone implant safety monitoring also extends to visiting your doctor for screenings. Periodic MRIs can detect a “silent rupture” of the implant, which the patient may not be aware of. As an added precaution for women both with and without silicone gel implants, it is important to continue regular mammograms, as directed by your doctor.

Silicone gel implants are used not only for breast augmentation, but often as a part of breast lift surgeries, as well.

The study by Dr. Cong-Feng Wang of Meitan General Hospital in Beijing found that mammographic changes occurring after the fat transfer procedure — in which fat from other parts of the body is obtained through liposuction and transferred to the breasts — are indistinguishable from abnormalities associated with breast cancer.

Based on this “mammographic confusion,” the authors concluded that the use of fat injection for breast augmentation should be “prohibited continuously.”

Researchers looked at 48 women who underwent fat transfer, which the authors refer to as “autologous fat injection for breast augmentation.” They found eight cases (16.7 percent) with clustered microcalcifications in postoperative mammograms, and in all eight cases the microcalcifications were regarded as “highly suspicious” for breast cancer.

The abnormalities prompted surgical biopsy to remove and examine the breast area showing microcalcifications, but none of the biopsies revealed breast cancer. The calcifications appeared to be related to death of the injected fat cells.

The study’s recommendation to discontinue the procedure conflicts with a study published in the March issue of PRS journal, the official journal of the American Society of Plastic Surgeons (ASPS), which concluded that “Radiographic follow-up of breasts treated with fat grafting is not problematic and should not be a hindrance to the procedure.”

An ASPS release noted the conflicting studies and said that the results “highlight the need for caution — and for more scientific evidence on the mammographic changes occurring after fat injection.”

“Implications from this correlation found in our study include possibly improving implant volume predictions preoperatively, leading to improved efficiency, outcomes and reduced reoperation rates,” the authors wrote in the study, which was published in the Canadian Journal of Plastic Surgery.

The study examined physical characteristics and implant details of 100 breast augmentation patients each in three cities: Loma Linda, California; and Temple, Texas; and Kelowna, British Columbia, Canada. The authors also said that the patients’ BMI could potentially provide an additional data point on which to make operative planning decisions.

The authors carried out the demographic study because they found this data lacking from other breast augmentation research, despite the surgery’s continued growth in popularity. There has been a 45 percent increase in women seeking breast augmentation since 2000, according to statistics from the American Society of Plastic Surgeons.

In addition to gathering data on patient BMI and implant volume, data was also collected on height, weight, age and the number of children the patient had.

Other findings included:

• The three geographic group medians were significantly different for weight, BMI and implant volume
• BMI was lowest in the Canadian city and highest in Temple, Tex.
• Temple patients had the smallest average implant size, significantly lower than the other two cities.

The study also looked at the data for all 300 patients as one group. On average, the breast augmentation patients studied were 34 years old, 5’ 4” tall and 128 pounds.

The full text of the study is available online. Dr. Leff performs breast augmentation in Bellevue, Washington.

Fat grafting for breast augmentation has been a relatively obscure procedure, but with new studies, such as this one, the evidence is building that it could be effective and have long-term results.

During fat grafting, fat cells are harvested via liposuction from one part of the body and injected into another. It has few surgical complications and is most commonly used cosmetically for the face and hands, according to the American Society for Aesthetic Plastic Surgery (ASAPS).

The study by Boston plastic surgeon Daniel Del Vecchio, MD, and Philadelphia plastic surgeon Louis Bucky, MD, was conducted over a two-year period with 25 patients who had breast enhancement with fat grafting.

Prior to the procedure, patients were photographed and had intravenous contrast MRI and/or 3D breast imaging, followed by three weeks of expansion, such as wearing a suction bra every day. Six months after the procedure, patients were again photographed and had the other breast imaging tests.

The results showed that six months post surgery all patients had visible breast volume increase, with a mean volume increase of 250 cc per breast.

The study concluded that external pre-expansion of the breasts is an important variable in the success of the procedure, as is patient selection. Furthermore, the authors say this technique can be “performed in a time efficient manner with reproducible, long-lasting results.”

“While the procedure is gaining scientific validity and traction among plastic surgeons, it is not the same as having breast enlargement with implants,” noted a release by ASPS.

ASPS and ASAPS initially cautioned against the procedure because some of the side effects such as oil cysts, calcification and tissue scarring were difficult to distinguish mammographically between calcifications associated with breast cancer vs. those associated with fat transfer. More recently, however, radiology literature suggests that new generations of mammography equipment, especially digital mammography, are better able to distinguish cancer cells from benign ones, according to the societies. The study’s abstract is available online at plasticsurgery.org.

The authors were able to do a comparison of 92 patients who underwent breast surgery at the ASC and 92 who underwent surgery at the hospital because they had an ASC that was closed in 2005, and then breast operations were moved to a hospital.

The study analyzed anesthetic techniques; recovery room events; and the patient’s total duration of stay, pre- through post-op.

Results found that age and recovery times were similar and complications were negligible at both, but the preoperative and total facility time increased for breast operations done in the hospital setting.

“Findings support a common perception, namely, that outpatient surgery can be more efficiently performed at a dedicated outpatient center rather than at a hospital setting,” according to the study’s authors.

Reasons for the efficiency of the ASC include:

• Nurses at the ASC only prep outpatients, whereas hospital nurses may process both outpatients and critically ill patients.
• The ASC was limited to a relatively small and uniform set of cases, whereas the hospital has a more varied and complex case mix, which can cause surgery delays.
• The preoperative area in the ASC was physically closer to the OR compared with the hospital setting.

The study conclusion states that “the potential efficiency advantage of an ASC over a hospital has implications for patient and staff satisfaction, facility expense, and surgeon productivity.”

While both the ASC and hospital are safe places for plastic surgery, the ASC may have the advantage in efficiency.

According to the story published on the LATimes website, Lydia Carranza’s breast implant deflated when she was shot in the chest last summer – an incident that claimed the life of her co-worker and left her with disfiguring scars.  When a man opened fire in the dental office where she worked, Lydia was shot twice: “The bullet fragments were millimeters from her heart and her vital organs,” said Dr. Ashkan Ghavami to the LA Times.

A firearms expert speaking to the Times said the deciding factor between life and death for Lydia may have been the presence of her saline breast implant.  Of course he advises readers, “don’t go getting breast enhancements as a means to deflect a possible incoming bullet.”

Read about this on LATimes.com

It is uncommon, but a certain number of patients do experience a disruption in the ability to breast feed.  Usually, this problem is associated with the type of breast augmentation incision chosen.  If future breast feeding is a concern, you should investigate the surgical incision techniques that avoid manipulation of the nipple such as those near the armpit, breast crease, or navel.

Some surgeons will recommend sub-muscular breast implant placement as well, even though breast feeding is not necessarily compromised by sub-glandular (above the muscle) placement.

Research studies published in the late 90s regarding infant safety haven’t found any measurable risks associated with breast implants.  In the late 90s, a study was published in Plastic and Reconstructive Surgery showing that women with silicone breast implants carry no higher levels of silicone (silicon) in their breast milk than women without implants.  It isn’t known what effect would occur if a small amount of silicone were to pass through to the infant.

If you still have concerns, feel free to speak with Dr. Leff or your OB/GYN.  Whether you plan to become pregnant or not, it is best to understand all of the possible breast augmentation risks before proceeding with surgery.