The Hidden Truth About Breast Implants

Breast implants represent one of those taboo subjects. We just don’t talk about them. 

There are basically two reasons why a person opts for breast implants. Either by elective surgery to enhance the appearance of the breasts, or as a result of a surgical process called breast reconstruction after a mastectomy for breast cancer. I am a physical therapist who specializes in lymphedema and works in oncology. I’ve lost count, but over the years, I have treated hundreds of women who have breast implants. Many of my patients opted for breast reconstruction to regain the symbol of their femininity after losing one or both breasts to breast cancer, while others chose to have breast implants to enhance their breasts. Almost unanimously women who have breast implants prefer to live with them than without. After having a mastectomy and going through breast cancer treatments some women decide against having more surgery and decline reconstruction, and go flat-chested instead. 

Living with breast implants is not without challenges. The major problem I have seen is a lack of awareness and education that the implanted breast prostheses require maintenance for optimal function and tissue health. This last statement may have come as a surprise to you! Well, you are not alone! When I tell a woman with breast implants who presented to my clinic, that her discomfort is due to swelling and that she has tissue tightness, or fibrosis, around the breast implants, the most common response I hear is “I thought these symptoms came with the territory, so I just lived with it!” There are many subtle ways your body is required to respond and adapt to any surgically implanted prosthesis. Breast implants impact how the lymphatic system is able to move fluid around the breast. They may also impact how the arm, or chest wall and ribs, are able to move. If you have elected to have the implants for breast enhancement or if you had breast reconstruction following a mastectomy, knowing how to care for the breast implants and what symptoms to be aware of will go a long way to improve your experience and your comfort. 

The foremost reason a woman may seek my service after breast implant surgery is that there is pain, or swelling, and hardening of the breast tissue. Often the subjective description will be: “My breasts feel heavy and tight.” When you think about it, a breast implant is a foreign object that the surgeon inserts into the body. We are familiar with the concept of organs being rejected by the body, such as when a kidney transplant requires pharmaceutical management to prevent the body from rejecting this vital life-supporting organ. 

Anatomically breasts are categorized as glands. Even though comparatively speaking, the breast gland may not be in the same category as a vital organ such as a kidney or liver, the body can and does respond to the placement of a foreign object in the breasts as it does to placement of a foreign object anywhere in the body. The breast implants may cause irritation and create an inflammatory reaction in the surrounding breast tissue. That may translate into various symptoms such as pain, swelling, hardness or even a sensation of heat. Though I’m certain most people haven’t heard this, breast implants are sometimes rejected and have to be removed. 

In my lymphedema clinic, I have seen lymphedema associated with breast implants that were inserted for the purpose of breast enhancement, as well as associated with breast reconstruction. And why not? Swelling, also called lymphedema, is an inflammatory response related to any injury or surgical incision of the body. If the swelling is mild, it simply expands the breast tissue and though this may be esthetically pleasing to the individual seeking to enhance their breasts, it can also lead to an uncomfortable increase in pressure in the breasts. As a lymphedema specialist I know first-hand, that if the swelling is allowed to persist, hardening of the breast tissue a condition referred to as capsulitis may 

occur. If you read my blogs and Q/A on this website, you will learn more about the protein molecules dissolved in lymphatic fluid and the role they play in tissue hardening when this fluid is allowed to pool. 

Capsulitis is a condition I have commonly treated in my lymphedema clinic. This occurs when the tissue around the breast implants hardens and basically encapsulates the implant, resulting in a loss of tissue flexibility. Though this is not a life-threatening condition, it is often associated with pain and discomfort and results in the breast becoming firm, and less mobile. There is treatment to improve this condition. A physical therapist versed in lymphedema and myofascial tissue techniques will be able to decrease discomfort and improve the softness and health of the breast tissue. In my clinic I utilize a combination of moderate tissue cooling, tissue mobilization and myofascial release work to improve the symptoms. An individualized exercise program will also aide in targeting and rehabilitating the surrounding tissue, assuring that optimal functional mobility is maintained. 

To sum it up: In my professional opinion anyone with breast implants should perform a maintenance program to keep the implants supple and the breast tissue healthy. 

In my next blog I will discuss what this maintenance program should look like, and the benefits of cooling the breast to reduce inflammation and support tissue health.

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