March 27, 2000 (Chantilly, Va.) -- The following are excerpts from guidelines issued by the American Society for Aesthetic Plastic Surgery (ASAPS) to doctors who are preparing informed consent forms for women considering breast implant surgery. The guidelines identify 26 separate risks, including:
- Risk of rupture and leaks. Breast implants, similar to other medical devices, can fail. Implants can break or leak. When a saline-filled implant deflates, the liquid is absorbed by the body. Rupture can result from an injury, from no apparent cause, or during mammography. Damaged or broken implants cannot be repaired; ruptured or deflated implants require replacement or removal. Breast implants cannot be expected to last forever.
- Mammography. Breast implants may make mammography more difficult and may obscure the detection of breast cancer. Implant rupture can occur from breast compression during mammography.
- Skin wrinkling and rippling. Visible and palpable wrinkling of implants can occur. Some wrinkling is normal and expected. This may be more pronounced in patients who have saline-filled implants or thin breast tissue. An implant may become visible at the surface of the breast as a result of the device pushing through layers of skin.
- Pregnancy and breastfeeding. Although many women with breast implants have successfully breastfed their babies, it is not known if there are increased risks in nursing for a woman with breast implants or if the children of women with breast implants are more likely to have health problems. There is insufficient evidence regarding the absolute safety of breast implants in relation of fertility, pregnancy, or breastfeeding.
- Calcification. Calcium deposits can form in the scar tissue surrounding the implant and may cause pain, firmness, and be visible on mammography. These deposits must be identified as different from calcium deposits that are a sign of breast cancer. Should this occur, additional surgery may be necessary to remove and examine calcifications.
Michael D. Towle is based in Chantilly, Va., and writes regularly on health and legal issues for WebMD.