Breast enlargement with CF

Question

Hello dear expert team,
I am 31-years-old, 167 cm tall, weigh 62 kg, FEV1 80%, no children.
For about 10 years I have the thought in mind to have my breast enlarged, for one year I have several informational talks with different plastic surgeons and collect diligently all information that can be found in the internet. That is surprisingly not too much.
I would like to know which risks are arising from the implants for me especially in case of CF. The implants should be completely under the muscle in order to minimize the risk for a fibrosis of the capsule or other troubles like rippling, double bouble. Is there anything (mobility of the thorax...) that speaks against the location under the muscle that would not "be a problem" in case of the location over the muscle? The implants, that we have chosen, would have a maximum volume of 280ml, therefore not very large.
In order to perpare the operation, I will start 4-7 days before and i.v. therapy with the common drugs tobramycin and ceftazidim. I have informed myself in so far that an operation (anesthesia) is better in the course of the day than in the mornings, as I could like this already free the lungs and "get them going".
Do you have other things that I could pay attention to or that I could do for preparation?

As I have already talked to several physicians, I know that the enthusiasm from your side will also be limited and I understand this.
I would just have the operation done as well informed as possible.
Many thanks in advance for your knowledge!
Best regards,
T.

Answer

Hello dear T.,
in connection to a planned enlargement of the breast you turn to the CF expert team in order to ask, which risks could occur with this operation and with the implants especially in case of CF.
Even, what I can conclude from your question, if you have already decided for a breast implant and as ask for our advice about this, I would like to point out, to make again up your mind well about this intervention. Does the cosmetic aspect play such a great role in your life that it overweighs all disadvantages and possible complications?
However, back to the actual question. As the first risk, the operation itself should be mentioned. Each operational intervention represents in case of CF patients a higher risk compared to healthy people, especially due to the usually necessary general anaesthesia and the associated risk of infection. After the operation one may reckon that there will be an impairment of the mobility of the thorax and of the arms for several days or longer and therefore the mucus transport from the bronchi will for sure be impeded. Therefore it is recommended for CF patients who have to undergo an operation, to have an i.v. antibiotic therapy in the peri-operative phase and a good bronchial drainage before the operation.
Afterwards, an adapted breathing- and physiotherapy is urgently neccessary.
It is not known to me, that in case of women suffering from CF, there are special or additional problems other than the known ones arising from the breast implants. The occurrence of a fibrosis of the caspule is independet from the illness of CF. I would like to add for consideration however, that the enlargement of the breast is not going to last lifelong and that in general another operation has to follow at a later timepoint (after a few years) in order to change the implants or to remove them. Also this intervention has to be done under general anaesthesia with all possible and already above mentioned problems.
As you suspected, we cannot recommend the intervention from the medical standpoint of a CF pysician, however we hope to have answered your question accordingly.
I wish you all the best and send you my regards,
Dr. med. Christina Smaczny

18.08.2014