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Medical Edge Newspaper Column from Mayo Clinic

BREAST IMPLANTS: SAFER THAN THEY USED TO BE, BUT TEMPORARY

DEAR MAYO CLINIC: I am considering breast augmentation and was hoping you could tell me if there are considerable risks involved. I’m not too worried about the anesthesia, but more concerned if there are any long-term health risks with implants. I have heard of some association between implants and autoimmune disorders. — Edmonds, Wash.

ANSWER: While advances in materials and surgical techniques have made breast augmentation safer now than it used to be, as with any medical procedure, you are smart to think about how this surgery may affect your long-term health.

Some complications and risks associated with breast augmentation include the following. Most occur rarely.

— Rupture/deflation. An implant may come apart, leaking fluid into the breast and surrounding tissue and causing the implant to collapse.

— Capsular contracture. Scar tissue may form around the implant and surrounding breast tissue, producing a hard, unnatural shape.

— Hematoma. Blood and other fluids can pool around the implant, causing pain or infection.

— Infection. Replacing the implant may be necessary if you develop a severe infection.

Be aware that breast implants last, on average, about 10 to 20 years. Many women who have breast augmentation eventually need to have the implants replaced or removed, which involves undergoing another surgery.

Although considerable press coverage has been given to a possible link, scientific research does not support any increase in risk of autoimmune, connective-tissue or other disorders among women with breast implants. Examples of these disorders include lupus, rheumatoid arthritis and fibromyalgia. Several controlled studies have examined breast implants and connective-tissue disorders. None has found an association between the two.

You also may find it helpful to know that research has shown breast implants do not increase your risk of breast cancer or cancer recurrence, nor do they prohibit women from breast-feeding their babies.

Before you make a choice about whether to have breast augmentation, do some additional research and consult with a board-certified plastic surgeon to further explore the benefits and risks. By being well-informed, you’ll be able to come to a decision that’s right for you.

— Sherine Gabriel, M.D., Health Sciences Research;
James Knoetgen, M.D., Plastic and Reconstructive Surgery,
Mayo Clinic, Rochester, Minn.

Additional Resources:
Information on Breast Augmentation
Appointment Information
More Information on Breast Implants

DEAR MAYO CLINIC: It’s been over two years since my open-heart surgery for a valve repair and several bypasses. The doctors say all is well, but the area of my chest from breast to breast and the scar both continue to hurt. At times, this makes me panicky, as this “pulling” is a constant reminder of the surgery. My doctors say live with it. I’m 74 and played golf and walked daily before my surgeries, but this has ended my golfing days. Is this normal? — Anderson Island, Wash.

ANSWER: The pulling sensation that you feel following such extensive operations is normal. Remember that heart surgery is not a small event; it is a major physical and emotional experience, and both your body and mind need time to recover fully.

The pain you describe in your sternum area should go away over time. How long it takes to recover fully varies, but some discomfort at your stage is not unusual. The tenderness is due primarily to the scar tissue and the sensitivity of the nerves surrounding the area of the incision. Some patients find relief in rubbing therapeutic, over-the-counter oils such as cocoa butter onto the scarred area.

The primary therapeutic benefit of this process is the massage, which decreases the sensitivity of the nerves and softens the scar tissue. The oil can also help soften the skin and prevent dryness that sometimes adds to the tightness that is quite typical following a surgery. This kind of massage, however, should only be started after the skin has healed shut and there are no open areas or scabs.

In terms of your activity, you can safely play golf and walk and should not feel panicky or worry that you are hurting yourself. In fact, returning to your normal lifestyle — exercising and getting back to the things you enjoy — is the best medicine of all!

— Thoralf M. Sundt III, M.D., Cardiovascular Surgery, Mayo Clinic, Rochester, Minn.

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Medical Edge from Mayo Clinic is an educational resource and doesn’t replace regular medical care. To e-mail a question, go to www.mayoclinic.org, or write: Medical Edge from Mayo Clinic, c/o TMS, 2225 Kenmore Ave., Suite 114, Buffalo, N.Y., 14207. For health information, visit www.mayoclinic.com.