Updated 3/2017 -- photos and all links (except to my own posts) removed as many no longer active.
I received a call recently from a patient who is one month postop from an augmentation mammoplasty. She and her family physician had found a “lump” in her left breast on a wellness exam. The patient who loves her new implants was worried she something was wrong and she would have to have the implants removed.
I asked her to come in and allow me to do an exam. She happily agreed.
My first thought was not breast cancer. All her mammograms prior to surgery had been normal. Her breast exam prior to surgery had not revealed any abnormal lumps.
My first thought was a palpable implant valve.
Fortunately, I was right.
This patient is thin, has little breast tissue, submuscular saline implants. She did not want silicone implants. While the valve is flat and non-projecting on the surface of the implant, in women such as this patient the valve can sometimes be felt.
In reassuring the patient, she and her husband were educated. I reminded them of the muscle anatomy. The border of the pectoralis just misses covering the implant valve. I pulled out a saline implant for them to see and feel the valve.
Even though the surface is smooth, the valve is 2-3 mm thick.
She will learn through self-exam her new “normal.” She will be encouraged to come back to my office yearly for a breast exam. She has been educated to continue to get her yearly mammograms.
REFERENCES
Breast Implants and Breast Cancer Screening: Implants and Breast Cancer Screening; Medscape article, 11/14/2003; Stacy M. Smalley, CNM, MSN
Saline-Filled Breast Implant Surgery: Making an Informed Decision, Updated January 2004 (pdf); FDA.gov
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