Breast augmentation – facts and myths

They explode in planes, make breastfeeding impossible, cost a fortune – many myths have arisen around breast augmentation surgery. We ask the plastic surgeon Krzysztof Biegański from the Złotowska Clinic in Poznań to find out which of them contain a grain of truth.

Doctor, let’s start with the question that many women ask: do breast implants need to be replaced?

Basically there is no such obligation. Today, breast implants are made of the highest quality materials and most of them are covered by the manufacturer’s lifetime warranty. However, in some cases it may be necessary to replace them. One of the most common indications for implant replacement is the formation of a capsular contracture around them.

The fibrous capsule is the body’s natural reaction to a foreign body located in it. Regardless of whether you have an implant, a splinter in your finger or a knee prosthesis, your body always wants to surround the foreign body with connective tissue. On the one hand, this stabilizes the implant, but after many years the bag may become too thick and contract. The degrees of capsular contracture are described by the so-called Becker scale.

There are four degrees: I degree – the bag is imperceptible and invisible, II degree – hardening of the breasts palpable, III degree – the breast is hard and has an unnatural shape, IV degree – additionally there are pain. Stage III and IV are an indication for implant replacement and capsulectomy, i.e. excision of the capsule. It is difficult to say when capsular contracture occurs, maybe 30 years after breast augmentation with implants, but it can also occur much earlier.

In addition, it should be remembered that the breasts themselves change with age and, for example, after delivery, which may cause the patient herself to decide to replace the implants with a different size.

I heard the opinion that breastfeeding is impossible after breast augmentation?

It all depends on the surgical access, i.e. the way of implant insertion. Three different cuts are possible – in the armpit, around the areola, and in the breast fold. If the implants are placed through incisions made in the nipple area, there is a risk of disturbing the structures involved in the secretion of food. He most often cuts in the breast fold, so the feeding problem usually does not occur. In this case, more than 90 percent. patients can breast-feed.

Can implants increase the risk of breast cancer?

Absolutely not – many years of research and analysis by scientists from the United States, Canada and Europe have clearly shown that having breast implants does not increase the risk of breast cancer. Statistically, the chances of developing breast cancer in women without implants and in women with surgically enlarged breasts are equal.

However, breast implants have been shown to increase the risk of anaplastic large cell lymphoma (BIA-ALCL). The risk of its occurrence is defined as very low – since the first report of the disease in 1997, only a few hundred cases have been described worldwide.

Can you play sports with implants?

I recommend my patients to give up physical activity for the first two months after breast augmentation. Most often, however, you can walk a few days after the surgery, which additionally oxygenates the body and helps it regenerate. Full return to regular training is possible after the recovery period.

Apparently, breast augmentation is a procedure intended only for young women …

On the contrary, I have many middle-aged patients who decide to undergo surgery after childbirth or breastfeeding. It happens that the breasts become smaller after the end of the lactation period than before pregnancy, and often lose their firmness and elasticity. At work, I often consult women who say (and quote): the children sucked my breasts. In breast augmentation surgery, they see a chance to restore their former appearance. And it really is.

What prevents women from going to the consultation is very often the cost of the surgery – does breast augmentation cost a fortune?

It is definitely not a cheap procedure, but its price consists of several elements. Firstly, the cost of implants, secondly, the cost of the medical staff: plastic surgeon, anesthesiologist, instrumental and nurses, and thirdly, the cost of postoperative care. The price of breast augmentation surgery varies between about 14 to even 20 thousand zlotys in various centers.

It is said that anatomical implants are better than round implants – is that true?

It depends on what effect the patient wants to achieve. Some women want their breasts to be bigger but look very natural. In this case, anatomical implants that have a teardrop shape, which resemble the natural shape of the breast gland, will work better. However, if patients want a very nice cleavage, round implants will be a better choice. Round implants can also look natural, if we don’t overdo them with their size.

In the case of anatomical implants, there is a slight risk (less than 5%) of the prosthesis turning over, which requires the surgeon’s intervention. However, we can prevent this by choosing anatomical implants with a polyurethane coating, which, when fused with the body’s tissues, ensure a stable position and no risk of displacement.

Is breast augmentation with hyaluronic acid safer than implants?

Currently, no preparation of hyaluronic acid for breast enlargement is authorized in Europe. A few years ago, breasts were actually enlarged with a preparation of highly cross-linked hyaluronic acid, but it turned out that it causes encysted nodules, which made it difficult to detect neoplastic changes and could cause inflammation.

Recently, history repeated itself with another filler – the hydrophilic aquafilling gel, which migrated in the body of patients leading to serious complications. The breasts can be filled either with your own fat or with implants, which have a coating that is resistant to chemical and mechanical effects. It is worth remembering that breast implants are medical products, such as artificial hearts, thoroughly tested and complying with the highest safety standards.

How about exploding on airplanes?

Breast implants don’t explode either on airplanes or in any other way. Importantly, most of them also have a lifetime warranty against breakage. Indeed, in the 80s, when the implant shells were not so tight yet, it happened that they cracked. Of course, this can happen even today, but we are talking about extremely rare cases.

Is it possible to recognize at first glance that a woman has enlarged breasts?

This may not always be noticeable with round and very large implants. However, with anatomical implants that look very natural, the probability is much lower. On the other hand, the cut hidden in the breast fold is almost invisible.

Should checkups be performed more frequently after breast augmentation?

There is no obligation to do so because breast implants have no influence on the risk of breast cancer. However, we recommend performing an ultrasound every two years. Mainly to see if nothing is happening to the implants and if a fibrous bag is formed.

Can the implantation of breast implants cause stretch marks?

Usually, patients try to prevent it by lubricating their breasts with oils or shea butter. It is possible, however, if we implant very large implants in a woman who has little stretchy skin.

So, when deciding on the size, it is better not to overdo it?

When choosing the perfect size, we take into account the patient’s preferences on the one hand, and anatomical limitations on the other, i.e. the size of the chest and the stretch of the skin, which we always measure. If we overdo it, i.e. choose too large implants, we can disturb the body proportions and get an unnatural effect. Stretch marks may also appear.

Is the fashion for very large implants behind us?

It is different – some women dream of larger, but natural-looking breasts, while others want to have very large breasts and a prominent cleavage. I also notice differences in different countries – in South America, patients prefer very large breasts and round implants, while in Europe rather smaller and natural-looking ones. In Poland, I would say that it is half and half.