Three times in my life as a plastic surgeon, I have been told by a patient I treated that I saved their life, literally. Once was when I emergently treated a patient’s staph infection. The other two are the ones I’d like to share in more detail because there is a takeaway message for women with cosmetic breast implants.
In both cases, these women had no idea that anything worrisome was wrong. They had hard areas in their breasts, and they both assumed they were capsular contractures. Capsular contracture is also known as “hardening of the implants.” It used to be extremely common in the earlier days of breast augmentation, and now is a complication that can arise in somewhere around 5-15% of women. Some contractures are painless and not that noticeable; very advanced contractures are painful and obvious. But they are not life-threatening.
Because contractures aren’t inherently dangerous, the firmness of my patients’ breasts didn’t alarm them. One had the firmness for a few months, the other, several weeks. When I saw these women for routine appointments, both of them were found to have very large tumors. One was benign but locally invasive (her treatment involved removing the tumor, several ribs, her pectoralis major muscle, and part of her sternum, then reconstruction), the other had advanced breast cancer that is being treated with chemotherapy. Thankfully, both are currently doing well.
Plastic Surgeons don’t always see their breast implant patients long term. While a number of my patients follow with yearly implant checks, many more don’t. Some women tell me they forget they have breast implants because they feel so natural. These are the women I want to reach with this message:
Please remember to examine your own breasts. If you are over 40, please get a mammogram yearly. And if you notice a change with your breast, please call your plastic surgeon or a breast surgeon.
It could save your life.
This patient has an 11 cm tumor of her right breast in the bottom left photo. She thought it was a capsular contracture. The bottom right photo is her after removal of her tumor, three ribs, part of her sternum, her pectoralis major muscle, and reconstruction with a TRAM flap and an implant. She is doing well.