Thursday, February 26, 2009

Breast Implant Deflation

Recently I had a patient call to tell me to report that her right breast implant had deflated.  She is a patient from the early years of my practice.  This is her second deflation, but this one is complicated by pregnancy.  She has listened to my “lectures” over the years and was not panicked.  She wanted to check in with me.
I reminded her
  • Your body will simply absorb the IV saline that was used to fill the implant.
  • It isn’t a medical emergency though it can be embarrassing.
  • We can take our time and fit it into your life/work schedule (If patient is pregnant, it can safely wait until the delivery of her baby).
  • Put a shoulder pad or some other padding in your bra to even it out for now.

I told her I would report the deflation to the implant company and get a file number for her case.  When she has delivered a healthy baby and finished breast feeding, then she should call me back.  At that time we will arrange a visit and decide what she wants to do (remove or replace; same size or smaller/larger; etc).
We didn’t discuss costs at this point in time.  We will later.  She unfortunately was augmented prior to the “extended warranty” offers that both Mentor and McGhan (INAMED) have now.  The programs didn’t exist prior to October 2, 2000.  The company will offer free implants for replacement.

Locally, the surgery center I use charges $840, anesthesia’s charge is $525, and my fee is $***(depends on time passed since surgery and whether I was the initial surgeon).  I began paying for the “extended warranty” for each patient out of my fee back in 2002 when I realized too many of them were failing to spend the extra $100.
I truly appreciate the patient who remembers the preoperative discussion and who read the information brochure. I try very hard to make sure the woman knows that the saline implant is not permanent. Approximately 1% deflate within 1 year, 3% within 3 years, and 10% within 5 years. Because of the warranty set at 10 years, I caution all of them that the mean deflation is 10-12 years (or half at that point). I tell them that it is rare to have a deflation at 1 year, but it can happen. And yes, the implant may last for 20 years, but don’t count on it. I tell them to begin saving money, if they get to 8-9 years without a deflation because they will likely end up out of the extended warranty period.
And all this is said on top of reminding them that this is surgery, the risks of surgery are infection, bleeding, anesthesia/drug reactions, scar, loss of/or decrease nipple sensation. The risks due to the implant include capsular contracture, asymmetry, visible wrinkling of the implant, deflation, repeat surgery to correct any of the before mentioned problems. You will need to be more careful with your mammograms. Four views will need to be done rather than just two. Make sure you go to a facility that is comfortable with implants and do mammograms often on women who have implants.

Other Posts of Interest:
It Happened Again (June 5, 2007)
Breast Implants – Some History (March 3, 2008)
Silicone vs Saline Breasts Implants (March 4, 2008)
Silicone Implants and Health Issues (March 5, 2008)

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