Worried about implant side effects? Breast augmentation through a Q&A

Breast augmentation, which has now become widely popularized, has been a topic of interest for women of all ages for the past 30 years. In Korea, most breast augmentation procedures are cosmetic enlargement treatments, and it is estimated that about 90% of these involve the insertion of silicone gel implants.

According to an investigation by the Ministry of Food and Drug Safety, there were 940 cases of breast implant rupture and capsular contracture side effects in 2014, 985 cases in 2015, and 657 cases in 2016. Although the number of side effects is decreasing annually due to factors such as implant materials, accumulated expertise among doctors, prior awareness of side effects, and post-operative care, implants can fundamentally cause adverse effects; therefore, a shift in mindset is necessary to completely prevent the need for revision surgery or to perform revision surgery using methods other than implant insertion.  

We gathered various questions about breast augmentation and consulted Shin Dong-jin, Director of the SC301 Clinic Stem Cell Center. 

Q. What causes implant rupture? 

A. Despite advancements in materials and the widespread use of the procedure, implant ruptures occur because the implant is microscopically damaged during the process of making an incision around the armpit or areola, dissecting it from the tissue adjacent to the pectoralis major muscle, and inserting it either in front of or behind the muscle (inside the breast parenchyma). Although it may be fine immediately after surgery, silicone inside the implant can leak out through the damaged area over time.

Additionally, there is a possibility that the contents, such as silicone or saline, may leak if the implant is not fully unfolded, becomes wrinkled, or if the weakened area wears down continuously. Since there is no research worldwide on how to prevent this, the best preventive measure is for an experienced surgeon to perform the procedure gently and carefully at the desired point.

The most commonly used cohesive gel implants recently offer excellent tactile sensation, and surgery can be performed with only minimal incisions in the armpit or around the areola. They can create a natural shape, although this varies depending on the position. Unlike the silicone packs used in the past, they are considered relatively safe as the contents do not leak. They are robust enough not to rupture even under a load of approximately 1 to 2 tons. However, implant surgery carries the risk of complications such as foreign body sensation, rupture, or capsular contracture. 

Q. What are the side effects caused by implant insertion? 

A. One of the major side effects that can be caused by breast implant insertion is capsular contracture, in which the tissue surrounding the implant hardens. When human tissue recognizes the implant as a foreign substance and attacks it, inflammatory reactions and fibrosis occur around the implant as a reaction, leading to capsular contracture. Once capsular contracture occurs, there is a high risk of developing more severe contracture even with revision surgery. Additionally, breast revision surgery increases the likelihood that the silicone implant will be easily visible or palpable as the skin thins. 

Q. What are the precautions for implant surgery? 

A. The U.S. Food and Drug Administration (FDA) has stated that silicone implants used in breast augmentation must be replaced with new ones or removed every 8 to 10 years. The medical community estimates that problems may occur in approximately 40% of cases after 10 years of implantation. The Ministry of Food and Drug Safety of Korea has also established a policy recommending that individuals who have undergone silicone gel breast implant surgery check for rupture using magnetic resonance imaging (MRI) three years after surgery, and subsequently undergo rupture checks every two years.

Q. Are there any alternatives to minimize the side effects caused by implant insertion?

A. As an alternative solution to the potential side effects of breast implant insertion, there is a method of extracting excess autologous fat from the abdomen or thighs, mixing it with stem cells, and transplanting it into the breasts. The injected stem cells promote tissue regeneration and angiogenesis, helping the transplanted fat remain in the body. However, caution is required when simply transplanting fat, as transplanting too much fat at once to increase volume increases the risk of the fat failing to engraft and dying. Furthermore, patients should be wary, as a significant number of clinics advertising stem cell breast augmentation actually attract patients by performing only fat grafting or adding PRP (Platelet-Rich Plasma) injections.

Q. Are there any precautions to take when undergoing stem cell breast augmentation?

A. Stem cell breast augmentation has the advantage of causing relatively less tissue damage compared to implants and having fewer side effects due to its biocompatible nature using autologous tissue. However, even stem cell breast augmentation is not a 100% safe procedure without side effects. It is necessary to verify the breast condition is suitable for surgery and to conduct pre-operative care. During the surgery, sufficient stem cells must be extracted and injected into the precise locations to minimize side effects and achieve satisfactory results. After surgery, patients must strictly adhere to specific precautions for three months to ensure the transplanted fat engrafts, thereby preventing the need for revision surgery due to side effects or dissatisfaction. (Photo courtesy of SC301 Clinic Stem Cell Center)

Hankyung.com News Team newsinfo@hankyung.com