Breast Implants After Breast Cancer

Transportation Lodging Child Care And Elder Care Assistance

You may not live near the hospital where youll have your surgery.

Sometimes, there are programs that help with local or long-distance transportation and lodging. Some also offer transportation and lodging for a friend or family member going with you.

There are also programs to help with child and elder care costs.

Learn more about transportation, lodging, child care and elder care assistance.

Breast Implant Placement: Over

Breast implants can be placed either on top of the chest muscle or underneath part of all of the chest muscle. Talk with your surgical team about which would be best in your particular situation.

Keep in mind that sometimes the plan youve discussed with your surgical team for where the implants will be placed may have to change depending on what happens during the mastectomy. For example, over-the-muscle placement may not be possible if the remaining breast skin is not thick and healthy enough after some tissue has been removed. Under-the-muscle placement may not be possible if some of the chest muscle or a lot of the layer of tissue on top of the chest muscle was removed during the mastectomy.

Heres what you need to know about each implant placement option:

Subpectoral implant placement means the breast implant is placed underneath part or all of the chest muscle. Part of the chest muscle is usually cut or divided so the implant can be placed under it. The surgeon may sew a material called acellular dermal matrix to the tissue at the bottom of the breast to create a pocket that helps hold the lower half of the implant in place.

Advantages of subpectoral implant placement include:

Disadvantages of subpectoral implant placement include:

Advantages of prepectoral implant placement include:

Disadvantages of prepectoral implant placement include:

What Happens After Breast Reconstruction Surgery

After surgery, you may need to stay in the hospital for up to a week. Your team of providers will watch you to ensure youre healing. You may wear a surgical bra. As your breasts heal, the bra supports your breasts and reduces swelling. When its time to go home, your provider will give you instructions detailing how to care for yourself.

Your provider will help you manage pain after surgery. They may recommend prescription or over-the-counter pain medication. Follow your providers instructions carefully when taking medication.

If you had reconstruction on one breast, you may need more surgery to make your breasts match. This may include breast reduction surgery or breast augmentation.

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Are There Risks With Using Implants

Some people worry that implants could cause other illnesses. Surgeons in the UK follow strict safety standards when using implants.

You can discuss which type of implant might be the best for you or whether you might prefer other types of reconstruction.

Do talk to your surgeon if you have had breast implants and are worried.

Should I Get My Old Breast Implants Removed

It is important to realize that the Food and Drug Administration notes that breast implants are not expected to last a lifetime. That means that for most women, they will need to remove or change their breast implants after a certain amount of years. Leaving in breast implants for too long could potentially increase BIA-ALCL risk.

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Can You Get Breast Cancer Even With Implants

There is no link between breast implants and breast cancer. You are also not at risk of breast cancer from them. However, research shows that women with breast implants are at a greater risk for anaplastic large-cell lymphoma . Non-Hodgkins lymphomas, such as ALCL, are not caused by the immune system.

Breast Implant Associated Cancer : Information For Consumers

The TGA has published the outcomes from the breast implant review. Read the update.

On this page:What are breast implants? | What is breast implant associated cancer? | Your questions answered | Who can get breast implant associated cancer? | How is breast implant associated cancer diagnosed? | What is the treatment and prognosis for breast implant associated cancer? | How do I spot the symptoms? | What if I have implants but no symptoms at all? | Should my implants be removed even though I have no symptoms? | Can I get Medicare benefits for tests and treatment of breast implant associated cancer? | Report any problems to the TGA | Further reading

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Should I Consider Removal To Avoid Breast Cancer After Implants

The FDA does not recommend implant removal for patients who are not showing symptoms of breast cancer after breast implants. This is because the risks involved with surgery are greater than the risk of developing cancer after implants.

Patients should, however, watch for BIA-ALCL symptoms like:

• Presence of a mass or pain near the implant
• Fatigue, memory loss, or brain fog

If any of these symptoms develop, patients should talk with their health care provider immediately for further evaluation. This may include diagnostic imaging and fluid or tissue assessment.

Risks From Breast Implants Are Real But Low

Millions of women have breast implants and about 400,000 women in the United States get breast implants each year, according to the American Society of Plastic Surgeons. Of those, 300,000 are cosmetic surgeries and 100,000 are reconstructive surgeries.

The largest risk for patients are local complications — problems at the site of the implant, Wilkins explains. These can include pain, changes in nipple and breast sensation, leakage, or tightening of scar tissue around the implant.

Whats not as well understood is that breast implants usually do not last a lifetime, he says. The longer you have them, the more likely it is that leakage or other complications will develop and that you will require additional surgeries to remove and potentially replace them.

The good news, Wilkins says, is that with modern, semi-solid silicone gel implants, leaks are usually contained and easily treated replacing them can usually be done in an outpatient setting.

Additionally, according to American Society of Plastic Surgery data , approximately 48,000 breast implant removal procedures occur each year.

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What Are My Breast Reconstruction Choices

Most types of breast reconstruction have improved dramatically in recent yearsboth in terms of how the procedures are done and their results. Any choice is acceptable as long as its a shared decision between the physician and the patient, says plastic surgeon Paris Butler, MD, MPH. We are not here to persuade you to have breast reconstruction or choose one technique over another.

Below are approaches for those who have had a mastectomy:

Should My Implants Be Removed Even Though I Have No Symptoms

Medical experts do not recommend removing your breast implants if you do not have symptoms of BIA ALCL, even if your implants are no longer supplied in Australia. This is because BIA ALCL is a rare cancer with excellent cure rates if it is detected early.

The risk of developing BIA ALCL is lower than the risks associated with an anaesthetic and surgery. The complication rate of revision surgery involving implant removal or replacement is also higher with each revision procedure.

Generally, breast implants are not lifetime devices, regardless of breast implant associated cancer. Typically they are removed after 10-15 years. The longer you have the implant, the more likely it will need to be removed. Common reasons for removal are contracture or movement of the implant.

Breast implant associated cancer is rare, but the risk is higher with certain types of breast implants. If you do not remember whether your implants are smooth or textured, or what brand they are, your surgeon or the clinic that holds your operation record should be able to advise you on these details.

It is best to discuss with your surgeon what they would recommend in their clinical opinion given the type of implant you have and the benefits versus risks of removal of implants in a healthy person with no symptoms. You can also discuss a plan for regular check ups. You can seek a second opinion to help you decide on options, or if you are unsure or concerned about the advice you receive from your surgeon.

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Is There Anyone Who Cant Have Reconstructive Surgery

Some women may not be healthy enough to have breast reconstruction surgery, and smokers face a higher risk of complications with DIEP flap surgeries. Nicotine causes blood vessels to constrict, so the vessels are smaller and can spasm, leading to flap loss, says Dr. Mastroianni. Smoking is also known to dramatically slow wound healing.

Other women arent candidates for DIEP flap because of scarring from previous surgeries in the belly area, but they arent automatically excluded, says Dr. Mastroianni. CT scan imaging can help us make sure there are still good blood vessels. But if a woman has had a prior tummy tuck procedure, she can’t have the DIEP flap surgery because the area I would use to reconstruct the breast has been taken.

Making An Informed Choice

Each person is unique. Your breast cancer treatment, your body, your breast shape and your lifestyle affect not only your reconstruction options, but also the pros and cons of your options.

Your plastic surgeon will help you choose the type of reconstruction that will give you the best results and fit your lifestyle, while minimizing the risk of complications.

Study your options and make a thoughtful, informed choice after carefully considering the pros and cons of each option.

Although this decision may seem overwhelming, it may help to know most women whove had breast reconstruction dont regret the method they chose .

If youre a good candidate for a procedure, there are fairly few complications with any of the current methods .

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Surgical Mesh To Support The Implant

During the operation, your surgeon may also use a surgical mesh called an acellular dermal matrix . This helps to keep the implant in place and create a natural droop.

The mesh can be synthetic or made from pig skin or cow skin. Using pig or cow skin might not be acceptable to some women. Talk to your surgeon if this applies to you.

In women with large breasts, the surgeon can reduce the size of the opposite breast and use some of the spare skin to cover and support the implant instead of using ADM.

What Does A Breast Implant Reconstruction Procedure Entail

A breast implant is the most common form of breast reconstruction, and it involves the use of either a silicone shell filled with either saline or silicone . At MSK, we most commonly use silicone because its softer and feels more like a natural breast.

For many of our patients, implant surgery involves two steps.

On average, the expansion process takes around six to eight weeks. Then, after another six to eight weeks, we remove the expander and put the final implant in its place.

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First Steps: Meeting With Your Surgeons

Determining whether youre a candidate for breast reconstruction, and if so, which options you qualify for, is often a multi-step process that involves some back-and-forth among you, your breast surgeon, your plastic surgeon and the rest of your cancer care team.

Patients should see a breast cancer surgeon before consulting with a plastic surgeon for reconstruction. The breast surgeon should have a pretty clear recommendation about whether you need a mastectomy or a lumpectomy. This may be a clinical judgement that changes depending on where you go for treatment or which doctor you see.

The type of surgery chosen is often a personal decision for the patient. Sometimes a woman has a very small tumor that could be removed with a lumpectomy, but she doesnt want to deal with radiation and lifelong mammographic surveillance. Or, she may have anxiety about the potential for a cancer recurrence. Genetic mutations, such as BRCA1 and BRCA2 that are known to increase the lifetime risk of breast cancer, are appropriate medical indications for prophylactic mastectomies. A woman with one of these genetic mutations may choose to have a bilateral mastectomy for her own peace of mind.

Should Textured Breast Implants Be Removed

The FDA does not recommend removing textured breast implants or tissue expanders unless you have symptoms. Symptoms may include fluid build-up around the implant, swelling, pain and a lump in the breast or underarm.

Let your health care provider know if you have any of these symptoms.

Some women who have textured breast implants, but have no symptoms, may choose to have textured implants removed. However, the surgical risks of removing implants can be greater than the risk of developing BIA-ALCL.

If youre considering removal of a textured breast implant, talk with your health care provider about the possible surgical risks for you and make an informed decision. These risks should be weighed against the risk of BIA-ALCL before choosing to have textured implants removed.

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Breast Implant Risks And Maintenance

Before you decide whether to get breast implant reconstruction, make sure you understand the risks and benefits and how to care for breast implants over time. Here are some things to keep in mind:

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  You shouldnt expect your breast implants to last a lifetime. Women who have implant reconstruction usually have one or more surgeries at some point because of a complication or to improve how their breasts look and feel. The longer you have implants, the greater the chance that they will develop a complication.

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  About once a year, youll need to schedule an appointment with a healthcare professional who can check your implants for rupture and other problems.

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  The FDA recommends that women with silicone-filled implants should have regular exams using magnetic resonance imaging or ultrasound to screen for silent implant rupture . This screening should begin 5 to 6 years after the implant is placed and then be repeated every 2 to 3 years. These imaging tests may not be covered by your insurance ask your surgeon if they can help you work with your insurance company to get them covered in advance.

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  If you notice any abnormal changes in your breasts or implants, you will need to see a healthcare provider right away.

Possible complications that can occur after implant reconstruction include:

A Natural Alternative To Breast Implants

Although using implants lets you recover faster, not everyone likes the way they look or the prospect of needing future surgeries to replace them if they rupture. A natural alternative involves using fat and tissue from another area of your body to fill in your breasts.

In the past, doctors removed muscle, fat and skin from the abdominal wall, the back, the inner thighs or the buttocks and moved it to the chest to form breasts. This procedure was painful and had a long recovery. But now an updated technique lets you use your own tissue with less pain and faster healing. During this surgery, called a perforator flap procedure, your surgeon moves only skin, fat and tissue not muscle to your chest area. Not everyone is a candidate for this procedure, depending on anatomy and previous surgical history, but its a good option for some women.

Using your own tissue creates a more natural look. And you can also have a tummy tuck, thigh lift or buttock lift at the same time if you have tissue removed from those areas.

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Extra Images Might Be Needed

The standard mammogram is two views of each breastâa total of four pictures. But women with breast implants typically require a couple of additional views of each breast. The extra views are gathered to detect cancers that might be obscured by the implants, the ACS says.

“They’re called implant displacement views,” said Dr. Patel, a member of the National Comprehensive Cancer Network’s Guidelines Panel for Breast Cancer.

The breast is drawn out, pushing the implant toward the chest wall “so more of the breast tissue is visualized with the mammogram,” Dr. Patel explained.

Implant displacement views involve relatively little compression, “just enough to keep the breast still,” Dr. Baker noted.

Is Implant Removal Advised

There are still many people with recalled breast implants in their bodies. Unless you have symptoms of BIA-ALCL, the FDA does not recommend removing the implant.

If you have breast implants, continue your regular healthcare provider visits and follow-ups. Make sure your healthcare provider knows that you have implants, and let them know the type and brand if you know that. Notify them if you notice any changes in your breasts or have concerns about your implants.

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How Will These Rules Likely Impact Patients

Women considering breast reconstructive surgery using implants at MSK are routinely informed of the risks and the benefits of breast implants. Our patients are also presented with the other options reconstruction with their own tissues or external prosthesis, for example that may be suitable. At MSK, we take pride in providing individualized treatment plans for each patient. Our doctors and nurses clearly explain the pros and cons of each procedure, empowering our patients to make the best possible choices for themselves.