Breast Implants

Breast implants are saline or silicone filled prosthesis used after mastectomy as a part of the breast reconstruction process or used cosmetically to augment small breasts. An implant consists of a fluid-filled, malleable pouch that is designed to mimic to the look and feel of natural breast tissue when inserted into a pocket created under the skin in a procedure called a mammoplasty. After reports that leakage from silicone-filled implants might be causing autoimmune diseases (e.g., lupus , arthritis , scleroderma) in some women, the Food and Drug Administration in 1992 called for a moratorium on their use outside clinical trials. The ensuing scare resulted in the largest product liability settlement in U.S. history and the Chapter-11 bankruptcy of Dow Corning Corporation, one of the makers of the breast implants. Despite legal settlements in the billions of dollars, the claims against silicone-filled breast implants remain anecdotal; numerous scientific studies have found no link or only a weak equivocal link between the breast implants and disease.

Women who have breast implants can breastfeed. While any form of breast surgery carries some risk that ducts and nerves may be damaged, most women with breast implants have happy and successful breastfeeding experiences.

Some mothers worry that the quality of their milk may be affected by breast implants. There is no evidence that the material in the breast implants can harm a baby (even if a leak in the implant packet occurs).

The location of the implant surgery can impact breastfeeding. When the packets are inserted under the fold of the breast or under the arm, there is less risk of damage to important nerves and milk ducts. Sometimes, breast implants are inserted at the edge of the areola. There is more risk with this surgical approach that the nerve sensation to the nipple will be damaged. If this happens, both milk supply and milk release can be affected.

On rare occasions, a woman gets breast implants because her breast development was abnormal. She may have too little glandular tissue to bring in a full milk supply. In such a case, her breastfeeding problems are not directly related to the breast implants, but to the earlier problem.

A lactation consultant can be a valuable resource to the woman who has experienced breast surgery.

Over the past few years, much attention has been focused on the safety of breast implants filled with silicone gel. Some women who have them have complained of chronic low-grade fever, fatigue and joint pain, and attributed these discomforts to their implants.

The Department of Health and Human Services commissioned the Institute of Medicine to conduct an independent review of all past and ongoing scientific research regarding the safety of silicone breast implants. It is the most comprehensive and current information available on the safety of silicone breast implants.

Following are the conclusions of the study.

There is no evidence that silicone breast implants are responsible for any major disease.

•There is no increase in either primary or recurrent breast cancer in women who have breast implants.

•Many women have local problems such as contracture (scarring around the implant) or rupture that require implant removal. Implants don\'t last forever.

This recent, independent study has given surgeons and patients more confidence in having silicone gel breast implants as an option for breast reconstruction.

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