Risks of malignancy from previous breast augmentation

If you had a breast augmentation surgery in the past and were not sure about the type of implants used, you need to know the followings. In recent years rare cases of malignant lymphoma called anaplastic large cell lymphoma (ALCL) have been reportedly among people who had breast augmentation surgery in the past. This type of tumor is localized in the breast tissue and can happen after more than 10 years from the previous surgery. It is also noted that the rough surface implants called textured type is the one related to this condition.

If you are not aware which type of breast implants placed in the past, you should consult board-certified plastic surgeon about risks. In case of removal or exchange of the existing implants and if your old implants are the textured type, the entire capsules need to be removed surgically. This kind of surgical treatment requires inpatient care in a hospital setting.

Breast augmentation at an university hospital

Today, the director of our hospital performed breast augmentation surgery at a university hospital. It is an operation performed in the hospital under general anesthesia. The reason for doing it at a university hospital was to use a large implant of 300cc or more and to approach under the pectoralis major muscle. Smaller implants and submammary approaches may be possible with outpatient day surgery.

The benefits of performing these surgeries at a university hospital include using a large endoscopic device or multiple cases when large-scale chest muscle detachment is required or when adhesions that are difficult to detach are found in the space under the muscle. The wisdom of plastic surgeons is to help you work more safely and accurately. In fact, in today’s surgery, it was not easy to get under the pectoralis major muscle.

Today’s surgery was performed by a team of four specialists, including the director of our hospital, who is a part-time lecturer at the university, and an associate professor class. The work was carried out in collaboration with anesthesiology specialists and a skilled nursing team. Another benefit of performing surgery at a university hospital is that it can be performed with such team medical care. It enables safer, more efficient and more accurate procedures.

In addition to various breast surgeries, the director of this hospital also performs face lift, nasal plastic surgery and body work at the university hospital.

Breast lift under local anesthesia

Breast sagging can be natural, but it can also occur after breastfeeding. Usually, these drooping breasts are operated on both sides at the same time under general anesthesia, but there are cases where people do not want to receive general anesthesia or want to perform under local anesthesia for other reasons.

In our clinic, the treatment of drooping breast can be done under local anesthesia. In that case, due to the limited amount of anesthetic, surgery is performed on each side. Since it is a one-day surgery, you can go home immediately after the surgery.

Surgery for a ptosic (sagging) breast involves removing the skin around the areola, as well as removing the lower part of skin and adipose tissue, depending on the degree of ptosis. In some cases, liposuction is also used (in breasts with high fat content).

Surgery at the university hospital

A few weeks ago, we performed a major surgery at a university hospital where the director is an adjunct assistant professor. This case was done by removing the capsule and replacing the breast augmentation bag, especially in cases where encapsulation occurred in past breast augmentation surgery and was accompanied by severe contracture of the third degree.

Removing the thick capsules from past breast augmentation surgery can be a daunting task. To remove the capsule cleanly, it is necessary to carefully peel off the capsule while repeating delicate removal and hemostasis by a plastic surgeon.

These surgeries were performed with the participation of four specialists on the day of the operation with a team medical system in place. The breast augmentation bag could be replaced with a large one over 400cc, and the patients were very satisfied.

For complicated cases as above, we perform surgeries in the university hospital.

Removing the breast implants and the capsular contracture

The other day, we performed the removal surgery of the breast augmentation bag and the capsules for a patient who complained of pain in the neck and upper arm due to the encapsulation of the breast augmentation bag that the patient had in the past. This type of operation required careful removal of the capsules around the bag, so the operation was performed under general anesthesia after the patient was admitted to a university hospital.

Breast augmentation bags that were placed in the past can cause progressive encapsulation of the area (called capsular contracture), causing pain and chest deformity, as well as sometimes lymphoma. Please refer to this page for more details.

If you are considering removing the breast augmentation bag, please feel free to contact “Plaza Plastic Surgery”, which has 18 years of experience in the United States.

Breast lift performed under local anesthesia

If the breast is hanging down, it can be corrected in various ways. In the case of mild sag, it is common practice to place breast implants (silicon bags).

However, not everyone is interested in breast augmentation, and there are many who want to lift only while keeping the size of the breast intact.

In such a case, the lift can be performed simply by removing the skin of the breast. Although this method has a T-shaped scar left, it can be effectively lifted upward. Also, in most cases, it can be done as a day surgery under local anesthesia.

Tummy tuck combined with other procedures

Surgery called Tummy tuck is a surgery to correct sagging of the abdominal skin and subcutaneous tissue, which is associated with extreme weight loss from postpartum and obesity. Because it is a relatively large-scale operation, it is a treatment to be done after hospitalized.

At the same time as the tummy tuck, there are occasionally those who wish to perform liposuction surgery in the abdomen or correct the drooping of the breasts. However, we do not recommend doing two or more such operations together (compound surgery). The reason is that the risk of complications increases significantly.

It has been reported in the United States that necrosis of the tissues of the abdominal wall is likely to occur when Tummy tuck and liposuction are performed at the same time. In addition, when Tummy tuck and breast surgery are performed together, the operation time also becomes longer, the rate of causing deep vein thrombosis increases, water accumulates subcutaneously also in the site of tummy tuck (seroma), the healing of wounds said to be poor.

If you wish to do some of these surgeries, we recommend that you consider the next operation after a period of recovery from each surgery for safety.

On removal operation of breast implants

About several years after breast augmentation surgery, thick capsules are made around the implant with a considerable probability (up to 25%). This is called capsular contracture of a breast implants, and it is classified in three grades in the United States. Grade 1 has a slight wrinkle feeling when touched, but no visible abnormality; Grade 2 is one with wrinkles emerging on the skin surface, Grade 3 is a painful addition in addition to that, requires a removal operation.

Regarding the removal technique of the breast implant, it is not a easy surgery. Simply removing the bag may result in inadequate results. It is necessary to remove capsules that are in close contact with the surface of the bag at the same time. In particular, capsules on the front of the bag should be removed. Otherwise, the capsule will remain around the entire circumference and become a cyst (Seroma).

Upon removal of the capsule, it may cause considerable bleeding. Therefore, at our office, we do not recommend doing such surgery as an outpatient surgery. Our doctor becomes your doctor, we recommend to operate at university hospital.

Breast augmentation and lymphoma (part 3)

Although it is rare but when a breast augment implant bag was used in breast augmentation and reconstructive surgery after breast cancer surgery, a special lymphoma subsequently occurred in patients who had a textured type surface roughened type bag inserted. We have stated in the past that there is a slightly higher possibility than general population.

It is reported that this issue is becoming a big social issue in the USA today in the New York Times electronic version of the major newspaper in the USA. For details, please refer to the following site.

Breast augmentation and lymphoma (part 2)

We informed previously in the part 1 of this title, but the relevance between the implant (bag) used for breast augmentation and T lymphoma has been reported in Europe and the United States. This phenomenon is likely to happen when holding a breast augmentation bag for more than 10 years in the body, especially on a textured type product whose surface is rough. Actually, this Textured type is a kind of breast enlargement bag that is often used in breast rebuilding after breast cancer.

The textured type was said to have less effect of so-called capsule contracture, which makes it harder for the breast and stiffer than the Smooth type with smooth surface. However, on the other hand, it was also known that bacteria settled in the surface roughness, creating a phenomenon called infected biofilm.

The most important thing is that patients who have this breast enlarged bag in their body once palpated by themselves and feel uncomfortable, we recommend that you consult a specialist and perform MRI examination .

Breast reduction by liposuction

If the breast is too large and there are symptoms such as shoulder stiffness, it is common practice to cut out the breast tissue by the method called breast reduction method and then sew the skin again.
However, this method has problems in patients who are planning breast-feeding in the future. Another way that can be considered in such a case is to do a method of first reducing fat-portion of the breast by liposuction and then sewing only the skin of the breast. Feeding breastfeeding is possible with this method.

Breast augmentation and lymphoma

In Europe and the United States, some patients who have undergone breast augmentation in the past have lymphomas in their breasts and are currently monitoring such cases.

ALCL (Anaplastic Large Cell Lymphoma) is called T cell lymphoma in detail. Unlike the same type of lymphoma that occurs in the whole body, what is associated with breast augmentation is localized to the breast and the prognosis is said to be good. It is a phenomenon only seen in cases using breast enlargement bags, especially on the surface called Textured type more commonly found in grainy breast enlarged bags.
The US FDA has instructed plastic surgeons to inform these patients about such information. In France, there is a debate as to whether to prohibit the use of such breast enlargement bags more seriously. However, since it is a very rare phenomenon at frequent times, it seems that discussion has not been done in Japan either.

Breast augmentation and future MRI study

Most patients are in good condition for a while after being subjected to breast augmentation, but when you want to investigate whether there are problems with breast augmentation bags when it becomes stiff or when you feel a change like a streak (rippling), or that my general symptoms are not good , The best test is MRI study.

Although it costs a little, it is possible to detect bag breakage, leak (leak), degree of capsular contracture, peripheral abnormalities (breast cancer, lymphoma etc.). However, someone with metal in somewhere in the body may not be able to do so so it is necessary to check in advance. There may be cases when you have a tattoo (tattoo) in it.
The American FDA recommends MRI examinations every 3 years for people who have performed breast augmentation, but in reality it seems that there is not one who does so frequently.

About troubles after breast augmentation

Breast augmentation surgery is a wonderful operation that makes a very attractive body line. However, after undergoing this operation, there are things that I have to watch over for years. One is encapsulation or capsule contracture, and the breast implants occurring at a rate of 10-15% are in a state of hardening. If the condition gets worse, it will become a streak that you can understand by touching from the top of the skin, or you can understand it even by just looking at it. When such a condition occurs, it is necessary to remove the implant (breast enlargement bag) and also remove the capsule membrane that is completed.

It will be a larger scale surgery than when breast augmentation surgery was done for the first time. In general, it will be treated as a hospital admission. On the other hand, if you do not remove the capsule stuck to the breast augmentation bag, you can do with simple surgery if you just need to remove the bag, another complication of water accumulation in the capsule (seroma) also can occurs.

Besides this, damage of the bag (rupture) is said to occur at a probability of about 1% per year per one year. It is difficult to detect this by palpation alone, so image diagnosis such as MRI becomes necessary.
In case
It is said that about 25% of patients who have performed breast implants need to undergo surgery in the future if various other complications are added.

Relationship between breast implants and lymphoma

The French government recently warned that it is related to implants used for breast augmentation and specialized lymphomas (undifferentiated large cell lymphoma, Anaplastic large cell lymphoma (abbreviated as ALCL) in English) in breasts became.

Currently it is a very rare tumor and the prognosis is better than the lymphoma that occurs in the whole body so it is not a recommendation for patients who have done breast implants immediately. ALCL is a T cell type tumor called non-Hodgkin’s lymphoma, and there are about 60 cases reported in the world about localized breasts, but it is said that there are more than tens of millions of patients receiving a breast augmentation surgery Because it is so, it is extremely rare.

However, in Europe and the United States there is a system to make information disclosure early and the FDA also keeps monitoring on this subject.

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Plastic Surgeon in Tokyo Japan