BY RONI RABIN
STAFF WRITER
April 14, 2005
One breast cancer survivor switched to silicone gel after her saline-filled implant shriveled up into a hard little knot the size of a golf ball.
Another switched because she didn't like the feeling of the saline "gushing up and down" when she lay down. And a third developed infections and had to have her saline implants removed - she did not have them replaced.
Breast cancer survivors who need reconstructive surgery are among the only women currently allowed to choose silicone gel-filled implants, and they are monitored closely for health problems. But even though silicone gel is hailed as having a more natural look and feel than saline-filled implants, breast cancer survivors are the first to acknowledge: There is no perfect solution. As the author of a medical article on the topic concluded years ago, "Neither prosthesis type is ideal."
Complications occur with both types, but the most common problem, capsular contracture - the formation of scar tissue around the implant, which causes the breast to harden - occurs considerably less frequently with saline-filled implants, studies show. Saline-filled implants, however, may be more prone to leak.
"There really isn't a safe procedure for breast reconstruction, and it's not fair," said Cecilia Claudio-Moskowitz of Glen Head, whose breast cancer was detected in 1996. "There's no good alternative."
Claudio-Moskowitz, 55, initially chose a saline-filled implant, but it shrank and hardened, possibly as a result of radiation treatments she received. In February, she had it replaced with a silicone implant.
"It looks natural, it feels natural," said Claudio-Moskowitz, a social worker who does volunteer work answering the Adelphi Breast Cancer Hotline. "I'm just hoping if anything goes wrong, it'll be caught early on."
Like many other breast cancer survivors interviewed, Claudio-Moskowitz said she chose implants over reconstructive surgery, which would have used her own abdominal muscle, because she wanted to avoid protracted surgery and a lengthy recuperation. She also wanted to maintain her abdominal muscles, she said: "Bad enough that I had to have breast cancer. I didn't want to lose my stomach muscle, as well."
Barbara Levitz, 54, of Island Park said her saline implant migrated under her arm, and she had it replaced with a silicone implant after six months. But even that is imperfect, she said.
"Once you have an implant, it's very uncomfortable; you feel like you have an underwire bra on," she said. Though the saline implant has a natural feeling, she said, "it's still a foreign object."
Implants can also become infected, either immediately after surgery or months later, sometimes necessitating surgical removal.
Shari Schaefer, 46, of East Rockaway developed repeated infections around her implants, which she attributes in part to her other health conditions, which include diabetes and lymphedema-related swelling. She had the implants removed in November after about 18 months.
"Anyone who is considering having this procedure should inform their doctor if they have diabetes, arthritis or high blood pressure or swelling," she said. "My doctor did warn me that it might not work out for me."
The exchange must go both ways, said Geri Barish, a founder of 1 in 9: The Long Island Breast Cancer Action Coalition.
"It's not as simple as popping an implant under the skin," she said. "There are successes, but there are also failures, and women need to have a real understanding of the side effects. ... We need to make sure doctors tell us the truth."
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