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  1. 1. Breast Plastic Surgery Side effect Roa M. Bamanie Dr. Barbara Heifferon
  2. 2. The technology of advanced science in all its wide range has met many people’s demands. Advanced science, whether in the medical field or other fields, is devoted to benefiting people and improving their daily life styles. People always consider science, especially in the medical fields, as the magic solution to their problems, for example, taking a painkiller to relive a painful sore. In fact, medical science does not always work the way that the majority of people expect. Undoubtedly, medical science is a double- edged sword, so we have to use it wisely. Nowadays, technology in the medical field has developed to reach other aspects than just improving people’s lives by curing and preventing certain diseases. Recently, medicine started to provide new types of surgeries to increase the self confidence of people who are dissatisfied. People who believe that they are unattractive and receive comments about their bad appearance suffer and become introverted and depressed. For example, a girl with a huge nose prefers to live by herself and does not welcome contact with the outside community to avoid offensive comments about her appearance. At this point, medical surgery, known as plastic surgery, can solve her problem and reshape her nose. Plastic surgery could be a perfect solution for such a situation. However, lately, plastic surgery has started to become a controversial matter. It seems to be uncontrolled; not only people with serious problems are benefiting from the plastic surgery, but also those who want pretty faces and great bodies. In addition, people overuse these kinds of surgeries without any awareness of their side effect or risks. In 2008, over 10.2 million cosmetic surgical and nonsurgical procedures were performed in the United States, according to statistics released by the American Society
  3. 3. for Aesthetic Plastic Surgery. The Aesthetic Society, after collecting multi-specialty procedural statistics since 1997, reports the overall number of cosmetic procedures has increased 162 percent since the collection of the statistics first began. (1) The most frequently performed surgical procedure was breast augmentation. The overused breast augmentation procedure is not the only type of breast surgery, for there are also breast lift and breast reduction surgery procedures. In this case of overusing the plastic surgery, the controversial question would be, are these kinds of surgeries a magical way of having a perfect body with no dark side involved? Will these kinds of surgeries change women’s lives for the better or worse in terms of their health, sex and comfort? It is well known among professionals in the field that each surgery has a potential risk in addition to its own side effects. Women who become fascinated by this surgery must know the truth about what they might be going through. It is the physician’s responsibility to inform his or her patient about all the known risks which are associated with this surgery, as well as short-term/ long- term side effects. Women need to know that this surgery is not a magical surgery. Breast plastic surgeries can affect the quality of life for women. It can bring discomfort, create bad health, disrupt sexual life or it can even threaten their lives. As a result, breast plastic surgery, and especially breast augmentation, which is the most popular procedure in the U.S, must not be used by women without medical needs because of its gravity. Women jeopardize their lives when they decide to do these kinds of surgeries. Breast plastic surgery is not as small a surgery as many people think it is. For example, breast augmentation is performed by inserting a breast implant behind breast tissue or
  4. 4. above the breast muscle. Implants come in a variety of shapes and sizes, with varying designs, in a range of materials such as saline breast implants and silicone gel breast implants. They can be placed in different positions through a variety of incision locations. (2) This means that these materials which are used to augment the breast have direct contact with the muscle and the skin, which can cause numerous complications. Indeed, there are many reports of complications with implants that have been published in medical journals and discussed at public FDA meetings. There are a number of short- term and long-term risks that any woman thinking about getting breast implants or about removing or replacing older implants needs to be aware of. First, local complications refer to problems that occur in the breast area that are obviously related to the breast implants or the surgery. Second, common complications include infection and other surgical risks: chronic breast pain, breast or nipple numbness, capsular contracture, breakage and leakage, necrosis (skin death), the need for additional surgery, and cosmetic problems such as dissatisfaction with how the breast looks with the implant. Women can lose their normal healthy life after breast surgery. Many studies of saline breast implants and silicone gel breast implants conducted by implant manufacturers have shown that many reconstruction patients experienced complications within the first three years. For example, the chart below describes the percentages in types of complications experienced after the reconstruction surgery: Complications Within 3 Years Rate Re-operation 46% Implant Removal/Replacement 25% Capsular Contracture (Baker’s III/IV)* 16% Implant Rupture 6% Tissue/Skin Necrosis** 6%
  5. 5. Breast Pain 6% Scarring 6% Infection 2% Source: FDA’s slide # 49 Baker III or IV capsular contracture is a painful condition where scar tissue around the implant tightens, thus causing * .the breast to become firm, hard, and distorted Necrosis is a painful and disfiguring condition where the skin or tissue dies ** Additionally, almost half of first-time augmentation patients experienced at least one local complication such as pain, infection, hardening, or the need for additional surgery. Also, Augmentation patients with silicone breast implants experienced complications within the first :three years as follows Complications within 3 Years Rate Re-operation 21% Capsular Contracture (Baker’s III/IV)* 8% Scarring 8% Implant Removal/Replacement 8% Breast Pain 6% Nipple Sensation Change 3% Implant Rupture 1% Infection 1% Source: FDA’s slide # 39 * Baker III or IV capsular contracture is a painful condition where scar tissue around the implant tightens, thus causing the breast to become firm, hard, and distorted. Moreover, two years after the surgery, augmentation patients with silicone gel breast implants often suffer from increasing health symptoms that they had before surgery. For example, health symptoms that were substantially increased in numbers of augmentation patients are fatigue, generalized pain, joint problems, and muscle symptoms, neurological symptoms and morning stiffness. In some cases, the numbers tripled from before surgery to two years later. (3) Beside all these complications that occur sometime after the surgery, surgical risks are highest immediately around the time of surgery. These include the risks from
  6. 6. anesthesia, infection, and hematoma such as blood collecting around an implant. All of them can range from mild to severe. However, the complications, which occur afterward can require additional surgery later, which will have similar risks. Patients may need to face these surgical risks several times if they need surgery to correct implant problems or have broken or damaged implants that need to be replaced with new ones. (4) This highlights the fact that it is always important for women to consider two things before decideing to have the surgery. First, the breast implants are temporary, and they break at any time, and this means they will not last forever. Second, what are the women’s situations if they want to remove this implant because of its complications or disappointment? Back to the first consideration, many women who have implants live in fear of the implants breaking. All breast implants will eventually break. Studies of silicone breast implants suggest that most implants last 7 to12 years, but some break during the first few months or years, while others last more than 15 years. There is a finding by a FDA study that most women had at least one broken implant within 11 years and the likelihood of rupture increases every year. 7 Silicone migrated outside of the breast capsule in 21% of the women, even though most women were unaware that this had happened. In addition, implant makers short -term studies of today's saline implants suggest that between 3-9% break within the first three years, and one implant manufacturer's study of their silicone gel implants found that between 3 and 20% break within three years.(5) A Danish study of ruptured silicone gel implants suggests that most implants last for ten years, but by the time they are 11 to 20 years old, most will break, and after 20 years the few that are still intact will break eventually. (6)
  7. 7. The broken implants have numerous complications on women’s bodies and the only way to avoid these complications is to remove them. Silicone gel in implants can break down to liquid silicone at normal body temperatures, and there are reports of silicone leakage and migration from implants to the lymph nodes and other organs. (7) Liquid silicone can migrate to the lungs, liver, or other organs. A study published by the Royal Academy of Medicine in Scotland found that a woman with a broken silicone gel implant in her calf was coughing up silicone identical to the kind in her implant. (8) This has potentially serious implications for women with breast implants, since silicone gel breast implants are considerably larger and closer to the lungs than calf implants. Secondly, what if a woman needs to get her implants removed? Women who have implants sometimes decide to have them removed because of broken implants, complications, or disappointment with how they look or feel, or concerns about the long- term health risks. Some surgeons discourage patients from removing their implants, and the reason behind this discouragement is that surgeons know that some patients will be very unhappy with their appearance after the implant is removed. In reality, women with ruptured silicone implants often lose breast tissue as part of the removal surgery. If silicone has leaked into the breast tissue, the resulting removal surgery may be similar to a mastectomy. Removal can be much more complicated and expensive than the original surgery, especially after a silicone gel implant has broken. In conclusion, women are fighting a losing battle with breast implants surgery. (7)
  8. 8. Beside the risks, dissatisfaction and other situations may arise in such surgeries; breast implants can cause diseases or illnesses including auto-immune diseases and cancer.For example, a study of women who had silicone gel breast implants for at least seven years found that those with leaking implants were significantly more likely to report fibromyalgia, a painful autoimmune disease. (9) The risk of fibromyalgia remained even after statistically controlling for patient's age, implant age, and implant manufacturer. These researchers also found that women with leaking silicone implants were significantly more likely to report a diagnosis of at least one of the following painful and debilitating diseases: dermatomyositis, polymyositis, Hashimoto's thyroiditis, mixed connective-tissue disease, pulmonary fibrosis, eosinophilic fasciitis, and polymyalgia. Women not only lose their health by undergoing such breast surgeries, but they also disrupt their sexual and motherhood lives. In fact, women losing their nipple sensitivity and having painfully sensitive nipples are common local complications of such surgery. Furthermore, some women are dissatisfied with the cosmetic results of breast implants, because their breasts look or feel unnatural or asymmetrical, or they can hear a "sloshing sound" from saline-filled implants. Problems like these can interfere with sexual intimacy. Furthermore, breast surgery disrupts women’s motherhood. Mothers with any kind of breast surgery, including breast implant surgery, are at least three times as likely to have an inadequate milk supply for breastfeeding. (10) in addition, it is found that the
  9. 9. offspring born and breastfed after the mother had breast implants had higher levels of a toxic form of platinum in their blood than offspring born before the breast implants. (11) In conclusion, Brest surgery risks outweigh the benefits, and it can destroy or change women’s lives. Consequently, authorities’ responsibilities are to protect these women form being involved in such surgeries and to distribute the awareness among the women to improve their understanding and change their way of thinking about these kinds of surgeries. Works Cited
  10. 10. 1- percent., a. 1. (n.d.). Cosmetic Plastic Surgery Statistics. Plastic Surgery Board Certified Cosmetic Plastic Surgeons . Retrieved April 27, 2010, from 2- Shestak, K. C. (2005). Reoperative Plastic Surgery of the Breast (1 ed.). Philadelphia: Lippincott Williams & Wilkins. 3- 4- "Photographs and/or Illustrations of Breast Implant Complications." U S Food and Drug Administration Home Page. N.p., n.d. Web. 27 Apr. 2010. < 5- %20Panel%20Memo.pdf 6- Holmich L, Friis S, Fryzek J, et al. Incidence of silicone breast implant rupture. Arch Surg, 2003; 138: 801-6. 7- 8- James SE, Tarr G, Butterworth MS, et al. Silicone in the sputum after rupture of a calf implant. J R Soc Med 2001;94:133-134 9- 10- Bondurant S, Ernster V, Herdman, R, eds. Safety of Silicone Breast Implants. Washington, DC: Institute of Medicine; 1999 11- Maharaj SVM, & Lykissa ED. Total platinum in urine of women exposed to silicone breast implants and in their children conceived after implantation by ICP-MS. Abstracts of Papers, 230th National Meeting of the American Chemical Society, Washington, DC, United States, Aug. 28-Sept. 1, 2005. American Chemical Society, Washington, DC, 2005; ANYL 510