The two most common types of breast implants, based on the material used to fill the implant sac. are saline and silicone gel implants. While saline implants look less natural in some cases, silicone gel implants produce more side effects. Therefore, both options have their advantages and disadvantages. Since the beginning of their use, the scientific opinions about the safety of the breast implants were controversial. The main debate exists around some relatively rare, yet unusual side effects that some women report after breast implant surgery, ranging from skin conditions to neurological symptoms.
Local Skin Changes
Local skin changes are the most common group of complaints after breast implant surgery. Redness of the skin (hyperemia) and swelling are normal in the first few weeks after surgery. If, however, they persist, it may be due to different causes, such as an allergic reaction to implant components, poor hygiene after surgery, and skin infection. If the implant gets somehow displaced, it may apply pressure on the breast tissue, producing swelling. Rupture of the implant is the most severe complication, because the content of the implant is released into the surrounding tissues.
Pain is expected to disappear during the first week after the surgery, but some patients report constant or intermittent pain which persists for months or even years. This is often attributed to neuropathic pain caused by disturbed nerve endings during the surgery, but it can sometimes become a real cause of disability for these women. Neuropathic pain is commonly treated with non-steroidal anti-inflammatory drugs and antidepressants, but surgical treatment is sometimes necessary in order to eliminate the pain. The nipple and breast area can also become painful due to infection after surgery, but this is usually accompanied with other symptoms, such as hyperemia of the skin, swelling, and increased body temperature.
Enlarged Lymph Nodes (Lymphadenopathy)
If the content of the implant (usually a silicone implant) starts leaking from the implant sac into the surrounding tissue, the tissue initiates a so-called foreign body reaction, which is a type of inflammation. Although current studies show that the incidence of silicone leaking from the implant has been significantly reduced during the past 10 years, it still occurs in some cases. The tissue affected by inflammation releases the inflammatory mediators which send a signal to the immune system to increase the defense mechanisms. Therefore, lymph nodes can be enlarged and painful, especially in the armpit region.
Interestingly, many women report persistent systemic symptoms after breast implant surgery. Some of them include fatigue, joint pain, muscle stiffness, shortness of breath, night sweats, diarrhea or constipation, and many others. Some women even develop psychological problems leading to depression and sleeping problems. Scientists have been struggling to explain these manifestations and their relation to breast implant surgery, but so far, there are several possible answers. In some of these women, pre-existent allergies to various allergens were detected, and usually women with an atopic constitution (prone to allergies) reported these unusual symptoms. In one of the studies, 69% of women resolved their issues by explantation (removal of the implant), while in the rest of the cases, symptoms remained the same or decreased.
The modern approach to breast implant surgery is to perform a more detailed pre-surgery examination, including history of allergic reactions and allergy testing, especially to the components of breast implants.
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