Category: Complications

An Update on Implant Position in Breast Augmentation

This is an update to a blog post that I made last year on whether patients undergoing breast augmentation should place the implants above or below the pectoralis major muscle. In conjunction with the study that I mentioned in that prior blog, we now have another, recently published study from one of my dear colleagues and associates in the Journal of the American Society of Plastic Surgeons.

In their study, they found that several things increased the risk of problems following breast augmentation. To quote the article, “In the primary augmentation cohort, subglandular placement of the device was the strongest univariate risk factor for development of capsular contracture”. This means that women who have their breast implants placed on top of the muscle are at greater risk for development of a tight scar around the implant. Positioning the implant in that location is the highest risk of all risks for this complication.

My nearly 30 years of surgical experience and my practical experience as a plastic surgeon confirm the findings of these colleagues. There are many unexplained factors that create risk of any surgical procedure, but we certainly need to do our best to minimize those odds when and where we can. I hope you’ll give us a chance to evaluate any concerns you have about a prior procedure or any anticipated future surgeries.

If you want to take a look at the previous blog that I mentioned, you can find it here: http://www.brzowski.com/whats-better-on-top-of-the-muscle-or-underneath/

I Gotta Give It To a Colleague

As we learn more and more about a very unusual condition called Breast Implant Associated-Anaplastic Large Cell Lymphoma, I think a colleague and fellow member of the Plastic Surgery Channel really summed up our current understanding of this condition.

I suggest you watch the video they produced that features Bruce Vannata, MD.

http://www.theplasticsurgerychannel.com/2016/06/23/alcl-understanding-the-rare-link-between-breast-implants-lymphoma/

Key take home points from the video are as follows:

The disorder is extraordinarily rare = 238 cases out of millions of surgical patients.
It is a type of lymphoma (or overgrowth of lymphocytes) in fluid surrounding breast implants.
The condition is almost uniquely found in patients who’ve received a breast augmentation using implants with a very aggressive texture.
Patients with this disorder are usually discovered during evaluation for acute swelling of the breast years after their surgery. Evaluation by a plastic surgeon for swelling is recommended.
Treatment using implant removal with excision of the scar tissue around the implant is usually curative.

For further questions on this or should you desire additional information on breast augmentation with the best techniques that minimize your risk of this and other complications, please contact us for a consultation.