BREAST IMPLANT REMOVAL AND AUTOIMMUNE DISEASE continued...

The actual procedure of removing the implants is relatively easy. The implant is removed through the same incision through which it was inserted, and the capsule around the implant is removed in its entirety. If there is any rupture of the silicone, it is important that the entire capsule be removed because the silicone particles can be embedded into tissue surrounding the area. This is a more technically complex surgery, but most board-certified plastic surgeons can perform such a total capsulectomy.

As this book goes to press, surgeons are removing fewer and fewer silicone breast implants because the scientific data suggests no sure connection between autoimmune disease and breast implants. For those women who do want to switch, though, silicone implants can be replaced with saline.

Still others have the implants removed but not replaced at all. Some of these patients do quite well; others experience some difficulty accepting the fact that they no longer have the fullness they had with the breast augmentation. Sometimes this loss feels very similar to that of a woman who has undergone a bilateral mastectomy, and there can be significant depression that needs to be worked through.

THE FUTURE IMPLANT

At this point in time, saline implants prevail. As mentioned, they are produced mainly by two United States companies: the Mentor Corporation and the McGhan Corporation. These implants must be filled with saline solution during the actual augmentation operations. In addition, there is a European line called a PIP saline implant, which is also available prefilled.

Silicone breast implants are available to plastic surgery patients as long as these patients have had previous silicone breast implants or as long as these patients fit the criteria for inclusion in what is considered an FDA evaluation study or adjunct study, discussed earlier. Approximately six hundred plastic surgeons who actually have access to the implants and are allowed under federal law to use them are currently reviewing silicone breast implants in the United States.

Table 12-1.

Breast Augmentation

Regarding breast augmentation (see Table 12-1), initial recovery time is four days, and complete recovery time is four to six weeks. Here the risk factor is minimal if the patient is in good health. The pain factor is moderate. Most patients are uncomfortable for the first four days. Surgeon's fees for breast augmentation range anywhere from $3,000 to $4,000. Saline breast implants cost anywhere from $950 to $1,300, and silicone breast implants usually cost about $1,800. Additionally, there are costs for anesthesia fees and the use of the operating room.

VitaDocs Medical Reference from "The Plastic Surgery Sourcebook"

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