Women who have undergone breast augmentation surgery with prosthesis implantation should have the same check-ups and with the same frequency, according to age, family history, etc., as women who do not have implants.
Mammography and breast implants
Many women have the idea that the realization of a mammography can produce its rupture, and that is not so; there is only a greater risk when the prostheses are old and deteriorated.
The woman who goes for a mammogram should inform in advance that she is wearing a prosthesis, and if she has any symptoms, such as pain or any other sign, she should mention it in order to evaluate whether or not it should be performed. If there is any doubt that the prosthesis may be broken or deteriorated, we must make sure of its integrity with other methods such as ultrasound or magnetic resonance imaging, before performing a mammography.
The prostheses should not break when compressing the breast during mammography, so it must be performed by qualified and expert technicians.
Medical tests with breast implants
In our center we initially perform three projections to each breast: two (caudal cranial and oblique) to each breast, without prosthesis, using the Eklund technique. This procedure is done by gently pushing the prosthesis towards the chest wall and the breast forward, and is easier when the prostheses are retro pectoral, that is, behind the pectoral muscle. The purpose is to visualize as much breast tissue as possible for diagnosis. Then we make a projection to each breast, generally oblique, with prosthesis, for its evaluation. Although it is not the ideal method for its study, only if there is a leak due to extracapsular rupture.
For this reason, and because it is the fastest, most economical and innocuous complement to mammography for a good diagnosis, we always perform a breast ultrasound later, which can also give us signs that suggest intracapsular ruptures or other alterations, in which case we must inform the patient of the need for an MRI.
Breast MRI is the only technique that reliably and sensitively detects alterations, lesions and ruptures of the prostheses. It is harmless, painless and does not require contrasts to assess the prostheses. It is one of the least invasive methods.
The replacement surgery in general is not as complicated as you may think, the old incision is used and the prosthesis is changed through the same hole, the postoperative period is not very painful because the implant pocket is already made.
Complications of breast implants
The most frequent complications that can present the prosthesis are capsular contractures and ruptures.
The body after the implantation of the prosthesis creates a fibrous capsule around it, because it reacts as if it were a foreign body; this is normal, but sometimes it goes to more and the breast feels firmer and hardened, producing a moderate capsular contracture. In addition, it can become deformed and pain may appear.
On the other hand, breast prostheses wear out after implantation, which increases the possibility of rupture. At 20 years the risk can reach 95% while at 10 years it is 62%.
During the first year of implantation of the prosthesis it is advisable, and I would say necessary, to visit the plastic surgeon several times, to see how it evolves. Ten years after implantation, and if no problems have arisen before, it is advisable to perform an MRI to check them.
Regarding purely breast revisions, I have already said at the beginning that they should be like any woman without prosthesis, depending on age and other factors.
Remember: be conceited but be safe.