A scientist at the University of Akron College of Engineering has developed a breast implant that is said to detect and treat cancer, although she and her team need to raise new funds to complete the product testing required by the US Food and Drug Administration before the technology is introduced to the market.
Dr. Judit Puskas said a breast implant with drug-emitting polymer coating has shown to reduce the inflammatory responses of the body.
While the drug-emitting polymers could be used in existing breast implants, the scientist said she wants to develop an entirely new generation of implants for detection and “targeted” treatment of cancer.
One of Dr. Puskas’ aims is to create breast implants that can be a substitute for the traditional chemotherapy that results in side effects such as nausea, vomiting, hair loss, and chronic fatigue.
According to a recent report, the scientist and her team need to raise at least $2 million to finance the ongoing research.
For years, Dr. Puskas has been studying the potential benefits of polymer, which is a technology dealing with large molecules that are composed of many “subunits.” While synthetic polymers such as plastics play an important role in different industries, biopolymers such as proteins and DNAs are believed to have an immense impact on medicine and plastic surgery.
Currently, all breast implants are made of a shell composed of medical-grade silicone materials that are highly compatible with the human tissue. However, Dr. Puskas is finding ways to create a new type of implant that uses an impermeable polymer that can be embedded with drugs not only to detect and treat cancer but also medications that can reduce the risk of infection, inflammation and pain following any breast surgery.
According to a study published by the National Cancer Institute, 12.4 percent of US women will have breast cancer at some point in their lives, with the increased risk highly tied to one’s age. It has been estimated that about 300,000 patients every year are diagnosed with the disease.
Last year, about 91,600 women had breast reconstruction mostly with the use of breast implants, according to statistics from the American Society of Plastic Surgeons.
About 70 percent of plastic surgeons are using fat graft as part of breast surgery, although the technique is more commonly performed on patients needing reconstructive procedures rather than cosmetic ones, according to a recent study published by medical journal Plastic and Reconstructive Surgery July issue.
In the past, fat graft, a technique in which doctors transfer fat from one area to another in an effort to create more volume, was not popularly used in breast surgery because the result was deemed to be unpredictable. But with the advances in plastic surgery, experts are now using techniques to increase the fat cell’s survival rate.
Literature suggests that fat survival rate of 60 percent and higher is deemed acceptable these days.
To conduct the study, the researchers interviewed 456 board-certified doctors who are members of the American Society of Plastic Surgeons or ASPS. Out of this number, 70 percent said they perform fat graft in breast surgery.
About 88 percent of the surgeons using the technique said they generally use their patients’ natural fat during breast reconstruction, along with other approaches such as implant surgery and tissue-based/flap procedure.
Advocates of fat graft said the technique is particularly helpful in reshaping the breasts to achieve a near normal appearance after lumpectomy or cancer surgery, which is commonly used to treat women who are still in the early stage of the disease.
About three-fourths of plastic surgeons who used fat graft said the abdomen was their preferred donor site because of the abundance of fatty cells.
Because a patient uses her own fat, there is no risk of rejection and adverse reaction, which may occur with the use of devices such as breast implants. However, the study has also shown the potential obstacles to the technique that used to be discouraged in the eighties as doctors have not yet figured out at the time techniques that would increase the transferred fat’s survival rate.
Some plastic surgeons are concerned that fat graft could result in difficulties in early diagnosis of breast cancer because the technique may sometimes lead to calcification. However, advocates allay such concern by saying that trained technicians can identify the difference between a cancerous lesion and “harmless” calcification.
But to prevent or minimize calcification and increase the fat survival rate, doctors purify the fat from the donor site, which entails removing impurities like blood. With proper purification, long-lasting or near permanent result is possible with fat graft.
Mastopexy, or more common referred to as breast lift surgery, corrects the saggy breast by reshaping and/or removing the loose skin and tissue; if needed, it also involves repositioning the nipple to create a more natural result.
Patients with overly large, saggy breasts will need reduction mammaplasty, aka breast reduction, to achieve long-lasting results. By removing some of the weight, there will be less skin stretching and drooping appearance over the long term.
However, some patients are apprehensive of having breast lift and reduction performed simultaneously, thinking that it could lead to longer recovery and more scarring.
First and foremost, the two procedures use the same incision sites, so additional scarring and longer recovery should not be a concern.
Combining lift and reduction has the same recovery length as performing only one procedure. Just to be on the safe side, most surgeons tell their patients to stay away from heavy lifting and rigorous exercise for at least a month.
Within the first few days after surgery, the breasts are very tender and painful. To control these post-op symptoms, surgeons usually require their patients to wear a binder or compression garment for at least two weeks. With the right amount of “support” and “compression,” swelling and seroma can be minimized—potentially leading to faster healing.
After a week or two, the sutures can be removed. However, wound reopening might still happen if a patient “rushes her recovery.” For this reason, heavy exercise and rigorous activities should be avoided for at least four weeks.
Majority of patients can return to their desk job a week or two after their breast lift with reduction surgery, although they have to be very careful with their movements and activities to avoid healing problems.
Because of the residual swelling and bruising, the final result could take six months to a year.
While combining lift and reduction has become a common procedure, many surgeons do not recommend breast surgery performed simultaneously with another [extensive] surgery involving a different area, e.g., tummy tuck, body lift, thigh lift, etc.
Multiple procedures performed at the same time could result to lower expenses and more convenient recovery, however, sometimes it is not ideal because of the additional risk, increased bleeding, and “unpredictable” results.
Conservative plastic surgeons limit the operating time to not more than five or six hours when doing elective procedures because it can put their patients to unnecessary risk.
There are four incision sites used in breast augmentation, namely the areola, underarm (transaxillary), breast crease, and navel (TUBA). Of course, the tradeoff with any cosmetic surgery is the risk of scar, which can be minimized or at least hidden within the natural folds of skin.
Currently, the areola and breast crease incision techniques are the most popular choice because they allow plastic surgeons to work close to the breasts, thereby reducing the risk of asymmetrical appearance. As a result, they are commonly used in revision or secondary breast surgery and cases where there is an existing deformity.
But placing the incisions around the edge of areola and within the breast crease may sometimes result to scar. While severe scarring is quite rare, some patients are prone to this problem (e.g., those with dark skin and people with a history of keloids).
To minimize scarring, patients are advised to apply care creams to the incision site after breast augmentation. If correctly used, they can reduce the appearance of the blemish and even promote proper wound healing.
Most care creams after breast augmentation contain silicone, a substance that is found to be effective in reducing, preventing, or softening the abnormal scars such as keloids and hypertropic scars.
Scar treatments are also available in sheets or dressing, and just like most care creams, they also contain silicone. Some doctors prefer them over topical gels because they provide pressure that can reduce the tension on the wound and limit the formation of collagen, which is the reason why raised scars occur.
However, many plastic surgeons recommend combining scar creams and silicone sheet/dressing to achieve the best result.
Meanwhile, this is a step-by-step guide on how to use scar creams and silicone sheet:
- In the morning, apply scar cream to the wound, which has completely closed. This should be rubbed gently onto the scar until it is fully absorbed. Some experts say that the application can also be done through light massage (moving the index and middle finger in a circular motion) to break up the collagen.
- Once the cream is fully absorbed by the skin, apply silicone sheets to the bare breasts before getting dressed.
- Remove the silicone sheet at the end of the day. Patients should remember that their skin needs to be able to “breathe” at least eight hours a day.
- Before going to bed, gently rub the scar treatment again onto the breast augmentation wound.
There are contradicting studies about cosmetic plastic surgery’s impact on one’s happiness, and its supposed ability to decrease psychiatric symptoms. But according to Jonathan Haidt’s The Happiness Hypothesis: Finding Modern Truth in Ancient Wisdom, attractive individuals are not happier than their plain-looking counterparts, although improvements, which may come in the form of aesthetic surgery, can lead to high levels of satisfaction.
On average, the book suggested that cosmetic plastic surgery patients will generally experience decrease in psychiatric symptoms such as depression and anxiety years after the procedure. But despite such claim, many plastic surgeons tend to turn down people who manifest psychological and emotional problems.
Dr. Tarick Smaili, one of the leading Los Angeles plastic surgeons, believes that while cosmetic surgery can have a positive impact on one’s life, this is not a quick fix to life’s problems.
“If you’re having a relationship problem, cosmetic surgery will not fix it. If you’re medically depressed or if you are suffering from emotional crisis, this is not the right solution since the root cause of the problem is not often about the physical appearance,” Smaili said.
While some studies claim that cosmetic surgery can make patients happier and more satisfied with their lives, there are also some reports showing otherwise. For instance, some surveys suggest that women who get breast implants have a higher suicide rates than people in the general population, although some experts think that individuals who are already thinking of committing suicide are more likely to want bigger bust.
However, a 2004 study published by Time Health and Science has shown that breast surgery, especially breast reduction, often has a positive impact on women’s psychological health. In fact, it goes even further by saying that only 3 to 14 percent of patients who had reduction mammaplasty were unsatisfied afterwards.
Meanwhile, the report has shown that older facelift patients—those in their late 40s and older—tend to be more satisfied with their surgery than people under the age of 40 who had the same procedure.
By contrast, young male patients in general experience less satisfaction following a cosmetic surgery than women.
Studies have always shown that women are more likely to seek cosmetic surgery than men, although it does not mean that male patients are left behind. In fact, rhinoplasty or nose job, which has the most significant impact on one’s appearance, has been the most popular procedures on men over the past several years.