Tuberous breast surgery is technically challenging and is associated with specific risks. These risks include but are not limited to the following:
The risk of significant bleeding following tuberous breast surgery ranges from 0.5-1.0%. Should you notice the sudden onset of swelling, bruising, or drainage of one or both breasts, you should contact the office immediately. Bleeding may require a return to the operating room for exploration and treatment of the bleeding vessel. Untreated collections of blood may result in infection and a higher risk of capsular contracture, or scar tissue, of the breast.
The risk of infection is also quite low and is approximately 1%. Infection is associated with swelling of the breast, pain, redness of the skin, fevers or chills, and sometimes drainage from the incision. Although most infections occur within several days after surgery, this complication is possible at any time. While mild infections may resolve with antibiotics, severe infections may necessitate implant removal for at least three months prior to replacement with a new implant.
Breast implants are quite durable and rupture is relatively rare. Although a breast implant may rupture at any time after surgery, this is more likely to occur with implants which have been in place for more than ten years. The International MRI Study performed in 2006 showed a rupture rate of 15% for implants which were on average 11 years old. MRI screening is recommended by the FDA for silicone implants at 3 years after your initial surgery, and every two years thereafter, to assess for silent rupture. Dr. Naidu recommends yearly examinations to rule out any issues with the implants. If there is a questionable rupture, an ultrasound will be ordered because this is a relatively cheap and rapid study. If the ultrasound is equivocal, an MRI will be scheduled for further evaluation. If a rupture is found, removal with or without replacement is recommended.
Following placement of any type of implant into the body, whether it be a breast implant, a pacemaker, or a hip replacement, the body will form a small amount of scar tissue around the device to protect it. In approximately 5% of cases, the scar tissue may become firm and tight, creating something called a capsular contracture. In some cases, there is associated pain, or the shape of the implant may become distorted. For severe cases, surgical revision with implant replacement may be required.
A seroma is a pocket of clear fluid that sometimes develops in the body after surgery. A persistent seroma following tuberous breast surgery may result in an eventual infection or capsular contracture. While small collections may resolve spontaneously, larger amounts of fluid may require drainage or additional surgery.
Although rare, your breast and nipple sensation may increase or decrease after breast implant surgery. The risk of decreased nipple sensation is though to be somewhat higher with use of the peri-areolar incision (around the pigmented part of the nipple-areolar complex). It is unclear if the risk of a change in sensation is higher with tuberous breasts.
Breast implants are man-made devices, and will wear out with time. Nonetheless, it is not necessary to have your implants routinely replaced at ten or fifteen years after surgery if there are no active issues. You should keep in mind however that the risk of implant rupture does increase after approximately ten years.
Pain of varying intensity and length of time may occur and persist following tuberous breast surgery, although this is very rare.
There is very little data regarding the ability of tuberous breast patients to breastfeed either prior to or following surgery. Because of the anatomical variations found in the tuberous breast deformity, patients are advised that they will have a higher than average risk of an inability to breastfeed.
Breast implants make mammography more difficult. Although techniques have been developed to move your implants during the study, complete visualization of the breast tissue is generally not possible You should alert your mammography center that you have breast implants, and you should continue to perform a monthly self-examination of your breasts.