According to the American Society for Aesthetic Plastic Surgery, breast augmentation surgery is the most popular cosmetic surgery in the United States, with more than 350,000 surgeries performed each year. Of those, 95,000 are done on women age 40 or older. Women over the age of 40 may choose to have breast augmentation or reconstructive surgery in order to correct breast volume after pregnancy, reshape the breast due to the natural effects of aging, or to make the breasts proportionate and symmetrical to enhance self-esteem.
Breast augmentation is the No. 1 cosmetic surgery in the United States.
History
Breast augmentation and breast reconstructive surgery by the use of silicone-filled breast implants was first conducted in 1963, with the first saline-filled implants introduced in 1965. Popular silicone-based implants were restricted by the U.S. Food and Drug Administration in April 1992 after reports of women claiming the implants were hazardous to their health and responsible for autoimmune diseases. In 2000, the FDA approved saline-filled implants, finding them safe and effective for use in breast augmentation and breast reconstructive surgery. After extensive testing and research, silicone implants were deemed safe by the FDA and were reintroduced in 2006.
Types
Breast implants may be divided into two categories: silicone implants and saline implants. Silicone implants are made of a silicone rubber shell and filled entirely of silicone gel, while saline implants have the same silicone rubber shell but are filled with a sterile saline solution. Silicone gel implants have a feel that is closer to natural breast tissue and may look more natural, but silicone ruptures are more difficult to detect and the implants are harder to replace. Ruptures that occur in saline implants are almost immediately visible by deflation of the breast. While silicone implants are considered fixed volume, saline implants are sealed with a valve and can offer adjustable volume, providing the option of postoperative size adjustment.
Risks
Because implants can obscure the view of the breast tissue, they can potentially delay the diagnosis of breast cancer. It is critical for women over 40 to have annual mammograms, but those with implants may require special mammography views. It is recommended that women over 40 with silicone breast implants undergo MRI breast screening to reduce the chance of implant rupture three years after their surgery and every two years thereafter. According to a study by the National Cancer Institute, women with breast implants are at higher risk for respiratory and brain cancer, although the link is unclear, and also have an elevated risk of developing connective tissue disorders, such as rheumatoid arthritis.
Warning
Surgeons should be notified during consultation of any medications or other drugs that are taken regularly in order to prevent adverse side effects during or after the surgery. Women who are undergoing hormone replacement therapy for the treatment of menopause may be at increased risk for the development of blood clots during or after breast augmentation surgery, according to the American Society for Aesthetic Plastic Surgery. To reduce the risk of blood clots, special elastic stockings may be required before, during and after surgery, or anti-clotting medications may be required. During the surgery, compression devices may be used to maintain normal circulation.
Considerations
According to a study conducted at Vanderbilt University Medical Center, the results of which were published in 2003, women who are over the age of 40 and receive breast implants have an increased risk of suicide. While the definite cause is unknown, researchers speculate that women who undergo breast augmentation surgery have higher rates of body-image dissatisfaction than the general population; some may even suffer from a serious condition known as body dysmorphic disorder. Additionally, they may have unrealistic expectations about the outcome of the surgery or may experience a postoperative complication that could lead to physical discomfort or a depressed mood. It is suggested women 40 or older may benefit from an extensive mental-health evaluation prior to breast-augmentation surgery.
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