If You're Having Problems

BreastImplantInfo.org

If You're Having Problems

Are you having problems that might be related to your breast implants? Sometimes it’s hard to know. Here are some common complications.

Capsular Contracture: Almost every woman with breast implants has scar tissue surrounding her implants. This scar capsule doesn’t show -- it’s inside her breast, and is her body’s natural way of protecting her from a foreign object. Sometimes, however, that capsule is too tight for the implant. Capsular contracture is when the capsule is too tight and feels like it is squeezing the implant.

• It can happen with either saline or silicone gel breast implants
• It can be slightly uncomfortable or very painful
• It can change the shape of your breast, or make it look round and unnatural
• You may need surgery to fix it
• Once it is surgically fixed, it is likely to happen again

Symptoms such as:	Could mean:
pain in the breast, breasts look different from each other, breast feels firm or very hard, breasts look like round balls	capsular contracture

This condition will not usually get better by itself. If it is very painful or hard, it will require surgery to remove the scar tissue capsule and perhaps the implant. Some of your own breast tissue might get mixed in with the capsule, and you might lose some of your natural breast. Many insurance companies will pay to have your implant removed if a woman has Baker Grade III or IV contracture, which are the most severe types, because when implants are that hard they are especially likely to interfere with mammography and the detection of breast cancer.

Rupture: The implant is covered with a silicone envelope, which can tear or break. A rupture can be caused by a defect in the implant, daily stresses on the implant, an accident or other trauma, an accidental cut during implant surgery or biopsy, or the aging of the implant.

• Ruptured saline implants usually deflate quickly.
• A silicone gel leak or rupture can go unnoticed, even for a period of years.

Symptoms may include:	Could mean:
decreased breast size, uneven size of breasts, pain or tenderness, tingling, swelling, numbness, burning, changes in sensation, lumps	silicone gel-filled implant rupture
chest pain, breast rash, change in size of breast	saline implant rupture

The older implants are, the more likely they are to break or leak. Although implants can rupture at any time, the FDA found that most rupture by the time they are 10 years old.

Aside from surgery, the best way to confirm a rupture is with an MRI, or perhaps an ultrasound. These methods require a trained eye to see a leak or rupture. A mammogram is not accurate enough to find a rupture or leak.

Most insurance companies will not pay to have a ruptured implant removed, especially if the implants were for augmentation. Reconstruction patients have an easier time obtaining insurance coverage for removal of implants, but will need to prove the implant is ruptured, with an MRI or other test.

Most experts agree that ruptured implants should be removed as soon as possible, especially if it is a silicone gel implant. Silicone gel can leak from the implant into healthy breast tissue and go other parts of your body, such as the lungs and lymph nodes, where it could be impossible to remove.

Some women with leaking silicone breast implants have had to have all their own breast tissue removed because the silicone moved throughout their breast. The result is a mastectomy, not because of cancer but because of silicone.

Many doctors believe that silicone is harmless, and may tell women with ruptured implants that they do not need to have them removed. However, it has been conclusively proven that silicone gel from a broken implant can leak out and cause permanent damage to healthy breast tissue or skin. In addition, the FDA found that women with leaking silicone implants are more likely to report several serious, debilitating illnesses, compared to women whose implants have not broken.

For more information or personal stories, click here.

For scientific research on leaking implants, click here.

Infection: As with any surgery, infections can happen. Most infections appear shortly after surgery, within a few days or weeks. The most serious infections can cause toxic shock syndrome and can be fatal or result in gangrene. If the infection is very serious, the implant will need to be removed to treat it, and can be replaced after the infection has cleared up.

All implants, including breast implants, attract bacteria.

If a saline implant is no longer sterile, it might cause an infection when it breaks. Bacteria, mold, and fungus can grow inside saline implants.

Symptoms may include:	Could mean:
pain, redness, or fever	Infection

Disease and Serious illness:
Everyone agrees that implants can cause local complications, such as those listed above. There is much more controversy about whether it can cause diseases or disorders. Some women can have implants for many years and never have any problems, but as the years go by, many women with implants become seriously ill. Common symptoms include joint pain or stiffness, memory problems, trouble concentrating, fatigue, flu-like symptoms that don’t go away, or pain throughout the body (fibromyalgia). Auto-immune diseases such as rheumatoid arthritis, lupus, and scleroderma are also problems among women with implants. Are these symptoms caused by implants, are women who are susceptible to these illnesses more likely to get them if they have breast implants, or would these women have become ill even if they didn’t have implants?

Research has not yet answered those questions. Women with implants are more likely to have these diseases and symptoms in some studies, but not others. The Institute of Medicine (IOM) summarized 17 epidemiological studies that attempted to answer this question, but unfortunately, most of the studies included relatively small numbers of women who had implants for very short periods of time. Longer-term studies conducted after the IOM report have found some risk of diseases among women with implants. That is why the IOM study is not proof of implant safety. For more information on the IOM study, please see http://www.breastimplantinfo.org/what_know/iom_crit.html.

What studies suggest that implants cause diseases? A study by FDA scientists found that women with leaking silicone gel implants were more likely to develop fibromyalgia and several other painful diseases than women with implants that were not leaking. This study is described in more detail at http://www.breastimplantinfo.org/what_know/fda2001.html.

In the only study of women with rheumatology symptoms who had their implants removed, doctors found that 97% of women with pain and other rheumatology symptoms felt better after their breast implants were removed and not replaced. Many symptoms lessened or disappeared over the next few months. In contrast, 96% of the women who did not have their implants removed became even more ill. This study was conducted by a physician (Dr. Noreen Aziz) at the University of South Florida Colleges of Medicine and Public Health, who now works for the National Cancer Institute.

Studies published in 2001 by other scientists at the National Cancer Institute raised questions about the long-term safety of breast implants. Unfortunately, many doctors are not aware of these recent studies. One study found that women who had breast implants for at least eight years were twice as likely to die from brain cancer, three times as likely to die from lung cancer or other respiratory diseases, and four times as likely to commit suicide, compared to other plastic surgery patients. A second study found that women with breast implants for at least eight years were 21% more likely to be diagnosed with cancer compared to other women their age.

More large, long-term, studies of women who have had implants for 10 years or more need to be conducted in order to find out if these risks of cancer or death increase or decrease when women are studied for longer periods of time.

These are some of the diseases that need to be carefully studied among women with implants, to see if women with implants are at greater risk:

Symptoms may include:	Could mean:
dry mouth, dry eyes, persistent cough	Sjogren’s syndrome
joint discomfort, pain, stiffness, swelling	Rheumatoid arthritis
chronic fatigue	Chronic fatigue syndrome
difficulty swallowing or breathing	esophogeal immotility
memory impairment	neurological impairment
muscle weakness, walking problems, tremor, muscle spasm, slowed ability to think, poor memory	MS – Multiple Sclerosis*
muscle pain, stiffness, unusual fatigue	fibromyalgia
strong allergic reactions	chemical sensitivity
white or blue fingers and/or toes in the cold	Raynaud’s syndrome
excessive hair loss	an autoimmune response
hardening of skin	Scleroderma
achy or swollen joints, extreme fatigue, skin rashes, anemia, sensitivity to sunlight, kidney involvement, fever	Lupus

* Women with implants have been known to experience MS-like symptoms and have been misdiagnosed as having the disease when they do not.

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