Reducing the Complications of Breast Augmentation Surgery
According to the American Society of Plastic Surgeons, more than 219,800 women
had their breasts augmented in 2001 and the demand for this procedure has continued
to rise. Yet, there are risks or complications associated with any surgical
procedure, such as the effects of anesthesia, infection, swelling, redness,
and bleeding; in addition, there are complications specific to breast implants.
Breast surgeons have attempted to reduce those complications. A new methodology
for breast augmentation with saline-filled breast implants has been shown to
reduce local complications significantly, as well as to reduce the incidence
of repeat surgeries (according to a study presented 11/03 at the ASPS/PSEF/ASMS
71st Annual Scientific Meeting in San Antonio). While previous studies have
noted reoperation rates of 20 to 25%, this new study methodology (performed
on 287 patients) reduced the reoperation rate significantly to 10%.
Designed by study author Leroy Young, MD, this new methodology addresses the
three most common reasons for reoperation: changing the breast implant size,
improving the "natural feel" of the breast, and minimizing capsular
contracture. The most common reason for reoperation is to change cup size.
To ensure patients chose the right breast implant size before their first surgery,
women were encouraged to see how different breast sizes would look on
their body type rather than simply to request the cup size the patient believed
they wanted. Ironically, seven to ten women in the US wear the wrong bra size
and are not aware of their current, correctly measured size. As part of this
study, women were measured to determine their preoperative bra sizes. Then,
using an extensive photo library, patients were asked to locate photos of women
who matched their body type and assess which photograph had the breast size
the patient desired. This allowed the patients to visualize how they might look
physically after augmentation.
The second most common reason for breast implant reoperation is to improve
the "natural feel" of the breast. To address this complaint, physicians
in the study used only smooth implants. Compared to textured ones, the smooth
implants wrinkle less underneath the skin, giving the breasts a more natural
feel.
The third most common reason for breast implant reoperation is to treat capsular
contracture, an unpredictable complication that occurs when naturally forming
scar tissue around the implant tightens and squeezes it. To reduce the risk
of this complication, physicians participating in the study followed a "no-touch"
technique. The no-touch method included meticulously rewashing surgical gloves
before handling any instrument and the implant. In addition, only the head
surgeon touched the implant, using a special Teflon cutting board and immediately
placing the implant underneath the muscle. All of these procedures helped ensure
that no foreign materials attach themselves to the implant, which could inflame
the surrounding tissue and cause complications.
Women who are considering breast augmentation surgery should discuss all of
the potential risks-including the risk of reoperation-with their surgeons.
In addition, women considering this procedure should ask their surgeons if they
have adopted these risk reducing surgical methodologies into their practices.
Created: 2/19/2004 - Donnica Moore, M.D.
