Breast implants are medical devices that are considered to have a high health risk. In addition to the risks associated with breast surgery (phlebitis, hematomas, embolisms, inflammation, and infections), there are also complications associated with the implants, such as lymphomas, which are usually associated with the rejection or rupture of the prosthetic material.
Breast Implants
Most breast implants consist of a synthetic silicone elastomer containing a filler (silicone gel, saline, or hydrogel). The outer surface may be smooth or textured (macro and micro). They are used for breast reconstruction (breast cancer) or cosmetic purposes (breast augmentation).
Breast implants and cancer risks
According to the National Cancer Institute, women with breast implants have no greater risk of developing breast cancer (adenocarcinoma) than the general population. In addition, systematic breast cancer screening can be performed under the same conditions.
However, as of 2019, macro-textured breast implants and those made with polyurethane envelopes have been withdrawn from the market due to the emergence of a form of cancer, Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL). This rare disease is a non-Hodgkin lymphoma (cancer of the lymphatic system) directly related to breast implantation.
Risks associated with breast surgery
As with any surgery, there are risks associated with anesthesia. Also, thromboembolic incidents, such as venous thrombosis or hematoma (internal bleeding into breast tissue), or seroma (build-up of clear bodily fluids), are still possible in the postoperative period.
It is estimated that the gross incidence of surgical site infections SSIs (all surgeries combined) is between 2% to 4% in patients without risk factors. Although the risk of infection in breast surgery is not zero, it is still limited by surgical asepsis guidelines.
Risks associated with breast implants
Capsular contracture or capsular fibrosis is a reaction of the tissues surrounding the implant. It manifests as an inflammatory process and stiffening of breast tissue at the implant site, which can cause pain. Also, according to the Cleveland Clinic implant ruptures account for “1.1% to 17.7% at six to 10 years after primary augmentation, 2.9% to 14.7% after revision augmentation, 1.5% to 35.4% after primary breast reconstruction, and 0% to 19.6% after revision reconstruction.” In both two cases, revision surgery is required.
References
Cleveland Clinic. (2019, May 7). Addressing implant rupture and capsular contracture: Breast augmentation in modern practice. Consult QD. https://consultqd.clevelandclinic.org/addressing-implant-rupture-and-capsular-contracture
Munhoz, A. M., Clemens, M. W., & Nahabedian, M. Y. (2019). Breast implant surfaces and their impact on current practices: Where we are now and where are we going? Plastic and Reconstructive Surgery – Global Open, 7(10), e2466. https://doi.org/10.1097/GOX.0000000000002466
UC Davis PSNet Editorial Team. (2024, September 15). Surgical site infections. PSNet. https://psnet.ahrq.gov/primer/surgical-site-infections
