Breast implant (or breast prosthesis)
Cosmetic Surgery - Plastic Surgery - Aesthetic Medicine - Reconstructive Surgery
Breast implants (or breast prostheses) allow breast size to be increased during surgery for breast augmentation.
The breast implants used in France today, which are pre-filled with
silicone gel, meet specific and rigorous safety standards as the EC
(European Community) mark standard and the AFSSAPS (French Agency for
the Medical Safety of Health Products) authorization introduced in
2004.
The breast implant is made of a flexible envelope, made of sealed and
elastic silicone rubber with a smooth or rough texture (there is a
solid wall to prevent the escape of the gel to the outside). Silicone
gel consistency is somewhat fluid and is contained within that
envelope.
Improvements in shape have been added to improvement in the quality
and reliability of the products. The new generation of breast implants
have a variety of forms known as "anatomical" forms allowing individual
customization for each patient.
In France, besides the silicone gel, two types of filler envelopes for silicone elastomers are allowed:
- saline (salt water, which makes up to 70% the human body) the
difference between this and silicone gel is that this type of breast
prosthesis has a less natural consistency.
- hydrogel, an aqueous gel (water gelled with a cellulose
derivative) which secured its AFSSAPS certification in 2005, has more
natural consistency than the previous one and is also capable of being
absorbed by the body.
An independent British Commission of Enquiry study whose findings are
available on the Internet concluded in a 1998 report that there was no
evidence of the existence of health problems associated with the use of
silicone gel but did not hide, either, the existence of some specific
effects where the flexible envelope ruptured. Rigorous scientific data
on this are still incomplete.
The lifespan of breast implants pre-filled with silicone gel cannot be
guaranteed because it depends on the possible occurrence of
complications. During a patent’s lifetime new surgical interventions
are sometimes necessary to ensure maintenance of the beneficial nature
of the breast implant.
Apart from the risks linked to mammoplasty (anaesthesia and surgical
risk), insertion of a breast implant poses risks specific to the
implant itself; the three main risks are:
- capsular contracture, the normal and usual reaction of the body to
foreign tissue designed to isolate and protect itself. This is mainly
an aesthetic complication but requires reoperation in cases of
functional impairment or pain.
- rupture, made especially likely by a violent impact and the aging of
the breast implant. The replacement of the breast implant is then
mandatory.
- wrinkling or a wavy appearance. This most often occurs with breast
implants pre-filled with gel that is more elastic than silicone gel.
But other types of risks specific to breast implants also exist,
including poor positioning or rotation of the breast implant and in
very rare cases, distortion of the chest wall caused by a capsule left
in place for too long.
The insertion of silicone gel-filled breast implants has no impact on
breastfeeding and there is so far no scientific evidence of a
relationship to the possible occurrence of breast cancer or the risk of
triggering inflammatory diseases. It is necessary to specify the
presence of breast implants during mammography so that the examination
technique can be adapted to this. .
The insertion of a breast implant requires a rigorous monitoring
protocol until one year after surgery and at least every five years
thereafter. Monitoring under gynaecological supervision and breast
cancer screening should be done as usual.