The pressure of the breast implant may cause breast tissue thinning (with
increased implant visibility and palpability) and chest wall deformity. This
can occur while implants are still in place or following implant removal without
replacement. Either of these conditions may result in additional surgeries and
/ or unacceptable dimpling or puckering of the breast.
Patients who elect to have large breast implants can sometimes suffer the
consequences of having these larger devices with the following problems:
The
most frequent deformity seen however; is the one from prior breast surgeries.
Capsular Contracture and improper
placement of implants are the two
complications contributing to the greatest amount of patients requiring surgery
again.
Breast
deformities can happen because of a surgical procedure or they can be
developmental. Developmental deformities which present themselves as birth
defects such as Poland’s Syndrome; which shows poor development of the chest
muscles reflecting in poor or absent development of the breast.
These
deformities in the breast are called “Tubular breasts” because of the shape that
they resemble. The breast shape is elongated and thin with a narrow base. It
frequently has an enlarged, dome-shaped areola.
Most recently, surgeons have
referred to this deformity as “Constricted Breasts”.
Tubular breasts are hypo-plastic, which means that their development was stunted
shortly after the development in puberty. Tubular breasts usually do not
contain enough glandular tissue so women who suffer from this condition
frequently will have breastfeeding problems, and will more than likely need to
supplement their infants’ nourishment with formula.
The
tubular breast has many variations, but all share certain common features:
Small breasts located under an enlarged nipple and areola
High and narrow inframammary fold
An
abnormally narrow breast tissue base
An
abnormally wide areola with a central protrusion of the breast tissue
through the areola.
The nipples tend to be very plump.
Often the breast tissue cascades falling over the tight fold, and producing
significant sagging and shape distortion.
Poland Syndrome
is a rare birth defect characterized by underdevelopment or absence of the chest
muscle (pectoralis) on one side of the body and webbing of the fingers on the
same side. The incidence of Poland Syndrome is approximately one in 32,000 live
births, and its occurrence is almost always sporadic, congenital disease with a
low reoccurrence in the same family. It is three times more common in males
than in females. Typically 75% of all cases of Poland Syndrome involve the
right side of the patient. Breast asymmetry is seen with most patients who have
Poland Syndrome, along with rib torsion, rib rotation, or a sunken chest.
Pectus Excavatum
or commonly referred to as PE is known as a funnel breast or hollowed breast and
is a deformity of the front of the chest wall with depressed breastbone
(sternum) and ribs. This deformity makes the sternum (breast bone) which is
abnormally depressed or caved inward. Pectus Excavatum is the most common
congenital chest wall deformity. Pectus Excavatum is present birth generally or
arises shortly thereafter. It is often progressive; with the depth of the
concave sternum increasing as the patient grows. The male to female ratio for
this deformity is 3:1.
Pectus Carinatum
or commonly referred to as PC is known as “pigeon breast”, chicken breast, or
keeled chest. There is a flattening of the chest wall on either side with
forward projection of sternum that gives a bowed out appearance. PC is the
second most common congenital deformity of the chest wall and constitutes
approximately seven percent of all anterior chest wall deformities. This
deformity is more common in males than females with the ratio being 4:1. This
deformity is apparent at birth and tends to worsen as the child grows.
Scoliosis
is associated with the axial torsion of the rib cage and is manifested by one
chest wall projecting more than the other. Scoliosis always has breast
asymmetry giving the illusion that one breast is larger than the other side.
This deformity is an abnormal curvature of the spine that usually shows up
during adolescence. In most people the curvature is so mild that no treatment is
needed. Pre-operative asymmetry is dependent on many things – mainly the most
important factor, the presence and nature of asymmetry pre op. With the
presence of Scoliosis, it is common to have asymmetry to the breast which is
related to the size, dimension, chest wall degree (the way your ribs and muscles
form), and the location of laxity or sagging and position of the nipple/areola
complex.