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Breast Augmentation Frequently Asked Questions

Health & Pregnancy

Do breast implants influence the occurrence of breast cancer?

No. Studies have never shown this to be a concern for humans. There is no evidence that breast implants cause cancer. The rate of occurrence of cancer in women with breast implants is similar to the rate among women without breast implants.

As the number of women with breast implants continues to expand, the international body of evidence now available demonstrates conclusively that there is no increased risk of breast cancer incidence or death associated with breast implants. In fact, the majority of studies report somewhat lower breast cancer incidence and mortality among implant recipients. Furthermore, those breast implant recipients who do develop breast cancer are not diagnosed later than average and have the same survival rate as non–implanted women (PRS 2007 120, December Supplement 1:37S; PRS 2006 118:118).

In addition, there is no evidence for breast implants causing cancer at other places in the body (PRS 2007 120, December Supplement 1:94S).

In short, there is no important difference in the stage of cancer when detected, tumor size, recurrence rates, or survival in augmented cancer patients compared to non–augmented cancer patients.

Can I have a mammogram if I have a breast implant?

Breast implants do cause less of the breast to be seen on mammograms. However, a displacement technique, like the Eklund technique, shown on the left, improves the amount of breast tissue seen (Illustration: Plastic and Reconstructive Surgery 120, December Supplement 1:85S).

Women with breast implants undergo mammography and other imaging techniques just as do women without breast implants. You may wish to have a preoperative mammogram and a follow up six months to one year after your breast augmentation surgery to establish a baseline. If you have had cancer before or have a family history of cancer, Dr. Pittman–Waller will most likely ask you to have a mammogram prior to breast augmentation surgery.

Routine screening will be more difficult with breast implants and you will need to have additional views. Breast implants may complicate the interpretation of mammograms by obscuring underlying tissue. Subglandular breast implants obscure more of the tissue than subpectoral breast implants. You should be sure to inform the mammography technician that you have had breast implants. Augmented patients do present more often with false-negative mammograms.

But remember, there is no important difference in the stage of cancer when detected, tumor size, recurrence rates, or survival in augmented cancer patients compared to non–augmented cancer patients.

Will the implant burst when I get my next mammogram?

Although it is possible, it's not likely. Mammography centers do many mammographies on women with breast implants and are very familiar with the proper techniques.

Can I still do a self-exam for cancer if I have breast implants?

breast self exam

Palpation, a self-exam of the breast for tumors by feel, may be facilitated by the long–term presence of an implant, which causes atrophy, thinning, and compression of breast tissue, thereby making the tumors easier to feel (Illustration: Plastic and Reconstructive Surgery 120, December Supplement 1:89S).

Do breast implants interfere with radiation therapy?

Mentor has not tested the in vivo effects of radiation therapy in patients who have breast implants. The literature suggests that radiation therapy may increase the likelihood of capsular contracture, necrosis, and extrusion.

Is it possible to get a silicone allergy?

It is possible for anyone to develop an allergy to almost any substance on earth. However, silicone allergies are very rare. We are all exposed to silicone in our environment every day. It is found in many household items, such as polishes, suntan and hand lotion, antiperspirants, soaps, processed foods, waterproof coatings, and chewing gum.

If I'm over 50 years old, am I too old to get breast implants?

General good health is important, not age.

Should I be at my ideal weight before I have a breast implant procedure?

You should be close to your ideal weight. A significant loss of weight after receiving breast implants could alter the results in a manner that is not satisfactory to you. There could be some ptosis (drooping) and a reduction in size. A significant gain in weight could cause an increase in breast size.

Can I still have children after having breast augmentation?

There are no unusual complications during pregnancy attributed to breast implants. Generally, stretching and sagging is no worse in women with breast implants than in women without.

What will happen during pregnancy?

Every woman is an individual and therefore has different results, whether before a pregnancy or after. Your breasts will enlarge and will go through all the usual changes associated with pregnancy. The amount of enlargement will vary from woman to woman and the size of the breast implants will factor into this as well.

Can I breast-feed with breast implants?

Breast implants may interfere with the ability to successfully breast-feed in a significant percentage of women. Different studies have reported different rates of breast feeding problems, ranging from 24% to 68%, compared to 7% in women without breast implants. Because the implant puts pressure on the milk ducts, there may a decrease in the amount of milk reaching the nipple, which may require supplemental feeding. The periareolar incision site may significantly reduce the ability to successfully breast-feed.

However, with good surgical technique and proper post–operative management, most of the complications associated with breast augmentation surgery that may lead to insufficient milk production can be minimized, but not always avoided (The Breast Journal 13:66).

A recent study measuring silicon (one component in silicone) levels did not indicate higher levels in breast milk from women with silicone-filled gel implants when compared to women without breast implants (PRS 120, December Supplement 1:123S). Dr. Pittman–Waller prefers the subpectoral implant placement which means the breast remains above the implant so there is less interference with the milk glands and the ducts that connect them to the nipple.

Do silicone breast implants harm the developing fetus?

There have been concerns raised regarding potential damaging effects on children born of mothers with breast implants. A review of the published literature suggests that the information is insufficient to show definitive conclusions. However, silicon levels in women with breast implants have been shown to be similar to women without breast implants (PRS 120, December Supplement 1:123S).

Do silicone breast implants cause major disease?

Concern over the association of breast implants to the development of autoimmune or connective tissue diseases, such as lupus, scleroderma, or rheumatoid arthritis, was raised because of cases reported in the literature with small numbers of women with breast implants. A review of several large epidemiological studies of women with and without breast implants indicates that these diseases are no more common in women with breast implants than those women without breast implants.

Will the feeling in my breasts or nipples change?

Feeling in the nipple and breast can increase or decrease after breast augmentation surgery. The range of changes varies from intense sensitivity to no feeling in the nipple or breast following surgery. Changes in feeling can be temporary or permanent and may affect sexual response or the ability to nurse a baby. Most women, about 90%, will not notice a permanent loss of nipple sensation, but about 10% percent will.

Will my breasts still move like normal breasts?

This depends upon multiple factors, such as the type of breast implant you receive, the pocket dissection, the way your body holds the breast implant and whether or not there is any degree of capsular contracture. It is possible for many women to have breast implants that are soft and move nicely, while other women have results that are firmer with a breast implant more fixed in position.

Will I get stretch marks when I have my breast augmentation? Can I prevent them?

Stretch marks are caused when the underlying skin tissue is stretched to the point that it tears and causes minute scars in the skin. Some women do get stretch marks from breast implants, but most don't. It's a rare reaction.

If you had stretch marks before receiving breast implants, because of pregnancy or other factors, the breast implants will sometimes fill out the breasts and make them less noticeable. If stretch marks do appear, they often become less noticeable with time.

Medically speaking, there is no topical cream or anti-stretch mark product that has been proven to have any benefit, despite claims to effectiveness that are often wildly exaggerated and not substantiated by any scientific evidence. However, using oils and butters, like cocoa butter, butter lotion, and vitamin E certainly won't hurt. Some women believe it has helped them, others don't.

Once present, repairing the appearance of stretch marks is also controversial. The effectiveness of laser treatments is not definitive, although some women believe they have been helped. Retin-A has been found to reduce the appearance of stretch marks by increasing collagen production and the turnover of new skin, as it does for wrinkles. However, it should not be used by pregnant women as it can affect the fetus.

Will smoking affect my healing?

It is best to stop smoking before breast augmentation surgery. Nicotine, carbon monoxide, and many other toxic tobacco by–products clearly interfere with normal wound repair. Hormones that actually retard the production of new skin and wound repair may also be produced. Vasoconstriction, the constriction of blood vessels, reduces blood flow and oxygen delivery to the skin and extremities. Binding of toxins to hemoglobin in the blood further enhances this oxygen deficient state. Numerous cellular functions, critical to wound healing, are altered by the presence of tobacco by–products. Delayed healing, wound dehiscence or tearing, postoperative infections, and poor scarring are, therefore, at an increased risk of occurring in the patient who smokes tobacco (PRS 108:1064–1065).

A recent study enrolled 84 tummy tuck patients. post–operative infections occurred in 13 of the patients. All but one of them were smokers. Another study reported a rate of problems with wound healing in smokers that was 3.2 times greater than that of non–smokers, with almost half of smokers having post–operative complications (PRS 121:305e).

Smoking is problematic in plastic surgery. It impairs wound healing, causes significant adverse outcomes, and increases the complication rate in elective plastic and cosmetic surgery. Dr. Pittman–Waller recommends that you stop smoking at least one month before and one month after surgery.

Can I go to a tanning salon or sunbathe if I have breast implants?

Not for the first year. Tanning, whether from the sun or in a tanning salon, will not hurt the breast implant, but may make the scars worse. Tanning will generally turn the scars redder in light skinned women and darker in darker skinned women.

If I am pregnant will my breast augmentation surgery be canceled?

Yes. Anesthetics can cross the placenta and can affect the central nervous system of the fetus. There's no reason to take any risk where the developing fetus is concerned.

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Breast Augmentation – Breast Lift (Mastopexy) – Breast Reduction

San Antonio Plastic Surgeon Virginia Pittman Waller MD