Examination Of The Implanted Breast
MASS VERSUS IMPLANT EDGE
Many patients present to Dr. Linder for breast revision surgery. They have concerns over “feeling something that is just not right” within one or both breasts. It is important to decipher whether there is a mass, lesion, scar tissue contracture or the implant edge that is leading the patient to this disfigurement and/or palpability of a mass versus the edge of the bag. With saline implants, scar tissue contracture can lead to enfolding of the bag and with a Baker IV contracture, can lead to pointing and deformity of the implant causing the edge to feel obvious and palpable. Patients often do not know whether this is the implant edge or a mass. If there is any question and the surgeon cannot decipher a mass from the edge of an implant, diagnostic radiographic testing should be performed. With saline implants, mammograms and ultrasounds are sufficient. With silicone gel implants, an MRI can be used in order to determine whether there is a rupture of the cell of the implant as well as to determine the integrity of the implant itself. Any suspicious mass within the breast should be diagnosed by mammogram ultrasound and if necessary, tissue biopsy through FNA (fine needle aspiration) or true core biopsy. Because of the significant rate of breast cancer in women (approximately one out of every eight and a half women may develop breast cancer), all masses in our practice are looked at seriously and diagnosed through proper diagnostic and/or biopsies.
Scar tissue contracture may certainly lead to distortion of the implant causing palpability of the edge of an implant. Patients often are not sure what this edge is, whether this is a mass or the bag edge. With silicone gel implants, it is more difficult to detect the edges of the implant on enfolding and therefore MRIs are very useful. Most importantly, any time a woman’s breast feels different, we must decipher lesions, palpable masses, pre-malignant tumors versus implant edge versus scar tissue contracture.