More than fifteen thousand breast implants implanted every year. These placed in people who have undergone breast augmentation, but also people who have had breast reconstruction after cancer.
Are you also considering breast augmentation or breast reconstruction yourself? On this page, you can read more about implantation, the advantages and disadvantages of silicone implants, and about the possibilities of alternatives.
Silicone breast implants have used worldwide for breast augmentation or breast reconstruction for about 40 years. There are several million women with silicone breast implants. In recent years, there have been frequent concerns in politics and the media about the consequences of having those implants.
For example, there are women who attribute serious health problems to silicone breast implants. However, various international scientific studies have so far failed to show a connection between these complaints and silicone breast implants.
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That does not mean that women who are considering a breast implant have many questions about implantation and the advantages and disadvantages of silicone implants. You might too. We hope that this educational material will help you make an informed decision. Because the vast majority of people with a breast implant are women, we focus on women in the text.
Why a breast implant?
Most women (seventy-five percent) choose a breast implant because they want bigger breasts. Reasons for this include:
- dissatisfaction with the size and shape of breasts;
- wanting back to the original breast size, for example after pregnancy, correction of uneven breasts.
The other twenty-five percent have breast reconstruction as their goal. This usually concerns women who:
- One or both breasts are missing after breast cancer, women who have one or both breasts removed because of mastopathy (many lumps in the breast);
- women who have had one or both breasts removed preventively because they are carriers of a gene for breast cancer.
A breast implant does not guarantee happiness
However, they do not guarantee a greater sense of self-esteem and can also have unpleasant consequences. Whether a breast implant is the most suitable solution depends on your personal situation, for example, your age and various physical aspects such as:
- the current shape of your breasts;
- the position of your nipples;
- the condition of your skin;
- your general health.
Radiation therapy can also have an effect. The possible complications of an implant, for example, capsular contracture (see the heading ‘Risks of silicone breast implants’), are closely related to this.
Therefore, consult your plastic surgeon (and possibly your breast cancer nurse) and experts with experience about the options and risks. Also keep in mind general surgical complications such as bleeding, infections, and consequences of the anesthesia.
Making a well-considered choice
Before you choose a (silicone) breast implant, it is wise to carefully consider the alternatives. There may be options that also give you a more positive body image but have fewer risks. You can think of, for example, a transplant of your own body tissue, external breast prostheses, and special bras with fillings.
A training to gain more self-confidence or a more positive self-image may also be an option. If you opt for a non-surgical alternative, you will avoid the disadvantages that operations – at least initially – often entail.
In order to be able to make a well-considered choice whether or not to have a breast implant, it is wise to gather a lot of information. You can do this through this educational material, your doctor, and various patient associations. Only if you are well aware of the pros and cons, can you determine whether a (silicone) breast implant is the best choice for you?
If you are considering a breast implant because you are missing one or both breasts due to breast cancer, a breast cancer nurse can properly inform you about your specific situation and the possibilities.
If you opt for a breast prosthesis, all surgery data will be stored in the national register DBIR, Dutch Breast Implant Registry. Only in the event of a national recall action can it determine which patients have a certain type of prosthesis in the body.
Ask yourself questions
You need a lot of information, but it is also important that you know why you want a breast implant, what you expect from it, and what you can or do not spend on it. For example, you may ask:
- what you want to achieve with a breast implant;
- whether this is also possible with other means;
- how necessary it is for you to have two breasts and/or larger breasts;
- what an implant may cost you physically, psychologically, and financially;
- whether the advantages outweigh disadvantages such as controls and possible replacement surgery.
Types of breast implants
A breast implant consists of a cover (a silicone pouch) and a filling. There are different types of implants:
- silicone breast implants;
- implants filled with physiological saline;
- other implants.
In addition, there are grafts whose filling consists of their own body material.
Silicone breast implants
Silicones widely used in industry but also in medicine, for example as a layer around hypodermic needles and for implants. People also come into contact with silicones in daily life. All people have some silicone in their body; babies, for example, because teats made of silicone. In itself, a little silicone is not harmful to the body.
Silicone breast implants used since the 1960s. Doctors, therefore, have a long experience with it and that is an important advantage. The contents of a silicone breast implant can be firm or soft. Solid implants filled with a kind of gelatinous gel. The contents of soft implants are more like a liquid.
In general, soft silicone breast implants found to feel much more natural than other implants and have less chance of wrinkling. In addition, a soft implant may require a smaller scar than a solid implant. Firm implants often retain their breast shape a little better and less fluid leaks out in the event of a crack.
A silicone breast implant can have a roughened or a smooth shell. A rough exterior is less likely to cause capsular contracture than a smooth one but is more noticeable.
Breast implants with physiological saline
Breast implants filled with physiological saline used in medicine for years. Physiological salt has the same water to salt ratio as the human body. Should such an implant leak, the liquid from the filling can therefore more easily absorbed and processed by the body.
An implant filled with physiological saline also has a silicone cover. As with a silicone breast implant, the outside roughened or smooth.
There are also breast implants with fillings other than silicone or physiological saline. In general, less known about these breast implants, because they not used for as long as silicone breast implants.
Consequences of the implantation
Most women satisfied with the implantation. However, before breast implants give the desired result, the less pleasant consequences of the procedure are usually inevitable. Shortly after implantation, the breasts often look quite ‘battered’ and fewer positive effects are possible in the long term. What can you expect?
In the first weeks after a breast implant, most women experience:
- swelling with hard spots;
- discomfort and pain (the first few weeks)
- changes in the ‘breast feeling’.
You can also suffer from complications that can occur in any case during an operation and therefore also when placing a breast implant, for example bleeding, wound infection, or side effects of the anesthesia. During the first weeks after the procedure, you often not allowed to lift or do heavy work.
If all goes well, the breasts will look natural again after a few months. Other effects are also possible with a less successful procedure:
- Sometimes the breasts don’t look natural at all.
- The differences between the two breasts are more striking.
- The implants can cause wrinkles or folds, especially in women with little breast tissue of their own.
- The nipple is less sensitive.
- The nipple is very sensitive (for three to six months after surgery).
Risks of silicone breast implants
Silicone breast implants pose several specific risks. Whether they occur and the extent to which differ from person to person. Possible risks are:
- hairdressing shrinkage;
- damage to the implant;
- leakage (also called ‘sweating’);
- replacement operations.
Furthermore, there sometimes scar problems: the scar painful, not healed nicely, or remain very red.
That is a natural reaction. Capsule formation occurs in all women with a breast implant; some women don’t feel it, others feel a kind of hardening in the breasts. Sometimes the hairstyle will shrivel.
Then the implant and the surrounding capsule will harden. Hair shrinkage can cause breasts to change, feel hard, and hurt. Many women with hair shrinkage, therefore, opt for a new operation.
Whether capsule shrinkage occurs also depends on the material from which the exterior of an implant made. Shrinkage is more common with a smooth than with a toughened casing.
Damage to a silicone breast implant can vary from very small holes to large tears. They usually caused by surgery or injury. Damage to the implant is common, but it does not always lead to complaints; sometimes damage only becomes apparent during a replacement operation.
Silicone breast implants will always leak slightly, due to the composition of the silicone content and the shell. The implants that used today leak much less than implants that were previously common.
Leakage can cause the silicone to enter the abdominal wall. This does not have to have any consequences, but lymph node inflammation can also develop, for example. The degree to which silicone breast implants leak varies from person to person.
Especially women who opt for a silicone breast implant at a relatively young age should take into account that the implant will have to be replaced one or more times.
This means a new operation and therefore all the risks associated with an operation such as possible infections, bleeding, or complications from the anesthesia.
There are women with silicone breast implants who suffer from chronic fatigue, rheumatic diseases, eye complaints, stomach complaints, skin problems, and inflammation. They attribute these complaints to the silicone implant, but scientific studies have so far not confirmed this connection.
In principle, you can perform all daily activities with a breast implant. A silicone breast implant does not have to be an obstacle to breastfeeding. Furthermore, it does not increase the risk of breast cancer. With silicone breast implants you can do breast examinations yourself just as well as usual. You can also simply participate in the breast cancer screening program.
Please report that you have breast implants for an examination. With breast implants and with a lot of glandular tissue in the breast, the assessment of the X-rays is less possible.
More information about the assessment of the X-rays in women with breast implants is available from the Ministry of Health, Welfare and Sport.
If you opt for a (silicone) breast implant, the chance of one or more operations is high. Problems can arise with the implant and the life of a silicone breast implant simply limited. With a silicone breast implant, you in fact committed for a longer period of time.