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What is a prosthetic break?

Una rotura de implante mamario se produce cuando hay un desgarro u orificio en la cubierta externa de la prótesis. Cuando se produce una rotura en un implante relleno de solución salina se puede producir un desinflado, ya que el líquido sale del implante y éste se desinfla como si se tratara de un globo lleno de agua. En las prótesis de gel de silicona el relleno es más espeso y cuando se rompe el implante el gel permanece dentro de la cubierta o se esparce fuera pero habitualmente queda contenido por el tejido de cicatrización que se forma en torno al implante.
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What types of prostheses are there?

It is important to know the type of prosthesis because it implies the consequences of its breakage.

All prostheses are made of an external material, usually silicone, that forms the cover and acts as a container and a filling that gives volume to the implant. There are two main classes depending on the material used for the filling:

1. Saline prostheses: they are filled with a liquid substance made up of water and salt, similar to what is called physiological serum, and which we find naturally in our body.

2. Silicone gel prostheses: they are the most widely used at present and they are denser in texture than saline. The basis of its composition is silicone and the latest generation and most recommended are those of high cohesiveness.


What types of break are there?

Depending on how the content of the prosthesis spreads when broken, two types of rupture are distinguished.

1. Intracapsular rupture: occurs when the content of the prosthesis remains inside the cover or is contained by the scar tissue generated around the implant. They involve less risk since the filling of the prosthesis hardly comes into contact with the tissues of our body. Some studies show that three quarters of ruptures are of this type but that within two years 10% of these ruptures progressed to extracapsular. This evidence indicates that early detection of breakage reduces risks and the expansion of the filling to other areas.

2. Extracapsular rupture: it occurs when the contents of the implant expands outside the cover and the capsule that the tissues form around the prosthesis. Typically, the gel or liquid is in nearby areas, but can move to the axillary nodes, the rib cage, the abdominal area or even through the upper limb. The expansion of the silicone gel to these areas can produce granulomas or siliconomas that are the natural reaction of our body against a foreign body and that we can perceive as small lumps palpable to the touch at times.


Why does a prosthesis break?

The most frequent cause of breakage is wear and tear over the years. The implants currently used do not expire and therefore there is no recommended or necessary date for replacement. Many prostheses will accompany us throughout life without giving us any problems, however there are some situations that should alert us to the possibility of breakage.

The most frequent causes of prosthetic breakage are:

1. The natural aging of the prosthesis. The current prostheses do not have a certain duration, so they can last the entire life of the patient. However, the more years pass from the implant, the greater the probability of rupture.

2. Capsular contracture. This is the natural reaction of the tissues that occurs after an implant intervention around the prosthesis. When this reaction is excessive it can produce a compression on the implant that leads to its breakage.

3. Damage from other interventions. Other surgical interventions on the breast can result in the instruments used perforating the prosthesis. Therefore, before a biopsy or other intervention, we must alert the professional who performs it to the existence of the implants.

4. Physical stress on the chest. The prostheses are designed to be compatible with a normal life and with the practice of exercise or sports. However, trauma to the chest area or intense pressure on the chest can lead to rupture. If we suffer a strong impact on the chest such as that which can occur in a traffic accident, it may be advisable to perform a revision of the prostheses.

5. Inadequate manipulation of the prosthesis. Although it is very infrequent in the procedure of the intervention in the operating room and during the transfer of the implant to the hospital, a rupture may occur that goes unnoticed.


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