A women who has smallish breasts may think of breast implants for cosmetic reasons. The most commonly used methods were silicone breast implants or saline implants when it came to breast augmentation. However, there are other plastic surgery techniques such as muscle flaps using different techniques (Ref. 7, p.595). This can be done in breast cancer patients where a larger piece of tissue had to be removed or for cosmetic breast surgery (breast reduction surgery or breast enlargement surgery). In the case of breast replacement or enlargement a muscle flap from a back muscle can be used to move forward.
Breast implants are useful in cosmetic breast surgery in order to achieve symmetrical appearance. However, silicone implants cannot be tolerated by every woman. In a large study where patients with silicone breast implants were followed from 1985 to 1998 no connection could be found to developing rheumatoid arthritis later (Ref.10, p. 969). A review of the world literature showed that there is no connection between rheumatological diseases and silicone breast implants (Ref.11).
Nevertheless silicone breast implant problems can develop. Ref. 8 (p. 1098) describes inflammatory changes that develop around the intact silicone breast implant.
This leads to a fibrous cyst, which walls off the regular tissue from the implant. In case of mini leaks, the body forms new fibrous tissue around the silicone, which walls off minor leaks. Years later the fibrous capsule can get calcified and this may be felt occasionally as discomfort. For lack of better term this was labeled “silicone breast implant syndrome”, but it is not really accepted in the literature as a disease entity at this time. There is no report in humans that silicone gel would migrate around to other locations in the body as some animal experiments have suggested (Ref. 8, p. 1098). The alternative is a saline filled implant , which can be filled according to the size needed as shown in this link. Should there be a leak in the future, this would be harmless as the normal saline would simply be absorbed. Revision surgery could be done at that time.
Alternative to breast implants: using the patient’s own subcutaneous fat from the abdominal area and mesenchymal stem cells derived from some of the fatty tissue breast augmentation can be achieved without invasive surgery. This is shown in this link. This was achieved by liposuction and subsequent needle injection under local anesthetic. This procedure is already in clinical use and will likely be the preferred method for most women wanting permanent breast augmentation.
1. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 235.
2. B. Sears: “Zone perfect meals in minutes”. Regan Books, Harper Collins, 1997.
3. Ryan: Kistner’s Gynecology & Women’s Health, 7th ed.,1999 Mosby, Inc.
4. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 245.
5. AB Diekman et al. Am J Reprod Immunol 2000 Mar; 43(3): 134-143.
6. V Damianova et al. Akush Ginekol (Sofia) 1999; 38(2): 31-33.
7. Townsend: Sabiston Textbook of Surgery,16th ed.,2001, W. B. Saunders Company
8. Cotran: Robbins Pathologic Basis of Disease, 6th ed., 1999 W. B. Saunders Company
9. Rakel: Conn’s Current Therapy 2001, 53rd ed., W. B. Saunders Co.
10. Ruddy: Kelley’s Textbook of Rheumatology, 6th ed.,2001 W. B. Saunders Company
11. EC Janowsky et al. N Engl J Med Mar-2000; 342(11): 781-790.
12. Wilson: Williams Textbook of Endocrinology, 9th ed.,1998 W. B. Saunders Company
13. KS Pena et al. Am Fam Physician 2001; 63(9): 1763-1770.
14. LM Apantaku Am Fam Physician Aug 2000; 62(3): 596-602.
15. Noble: Textbook of Primary Care Medicine, 3rd ed., 2001 Mosby, Inc.
16. Goroll: Primary Care Medicine, 4th ed.,2000 Lippincott Williams & Wilkins
17. St. Paul’s Hosp. Contin. Educ. Conf. Nov. 2001,Vancouver/BC
18. Gabbe: Obstetrics – Normal and Problem Pregnancies, 3rd ed., 1996 Churchill Livingstone, Inc.
19. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 251.
20. The Merck Manual, 7th edition, by M. H. Beers et al., Whitehouse Station, N.J., 1999. Chapter 250.
21. Ignaz P Semmelweiss: “Die Aetiologie, der Begriff und die Prophylaxis des Kindbettfiebers” (“Etiology, the Understanding and Prophylaxis of Childbed Fever”). Vienna (Austria), 1861.
22. Rosen: Emergency Medicine: Concepts and Clinical Practice, 4th ed., 1998 Mosby-Year Book, Inc.
23. Mandell: Principles and Practice of Infectious Diseases, 5th ed., 2000 Churchill Livingstone, Inc.
24. Horner NK et al. J Am Diet Assoc Nov-2000; 100(11): 1368-1380.
25. Ferri: Ferri’s Clinical Advisor: Instant Diagnosis and Treatment, 2004 ed., Copyright © 2004 Mosby, Inc.
26. Rakel: Conn’s Current Therapy 2004, 56th ed., Copyright © 2004 Elsevier
27. Suzanne Somers: “Breakthrough” Eight Steps to Wellness– Life-altering Secrets from Today’s Cutting-edge Doctors”, Crown Publishers, 2008