Shockwave Therapy: Goodbye to Lymphedema and Scars

Health Expressions Is Making Waves in Woman’s Wellness

Shockwave Therapy

There’s also a lot of talk about nonsurgical fat-melting and fat-freezing therapies. But why isn’t anyone freely discussing breast augmentation in this day and age, as sharing personal cosmetic treatments has become the norm?  When it comes to making a decision about breast surgery, women are faced with many choices.

Some women are naturally full-figured or have had children and inquire about breast implant surgery to lift their sense of vitality.  Other women who have beaten cancer may elect breast reconstruction surgery to restore what tissue was lost in the battle.  Shockwave therapy is a new breast enhancement procedure that can help women with after implant surgery that experience pain and scar tissue to effectively reduce pain and accelerate the healing process. In today’s post, we will discuss how shockwave therapy at Health Expressions in Rockville and Rochester NY can help women achieve better results after breast surgery.

Breast augmentations remain one of the most popular surgical operations, despite an increase in patients’ requests for noninvasive aesthetic procedures. According to the American Society of Plastic Surgeons, approximately a quarter million breast augmentation procedures are performed yearly. And the popularity has been rising by more than 1% annually- so it’s clear that women value this option.

A common misconception about breast augmentation revolves around the stigma that it is synonymous with breast enlargement.  There has been an equal interest in  women wanting smaller implant sizes (i.e., more C-cups than DD-cups)- and with sound reason. The desire for a more natural look is clearly driving this shift in preferences, but the biggest cultural shift has followed the ever growing number of breast cancer survivors looking to restore what was lost.

The majority of women with breast cancer get surgery as part of their therapy. There are various forms of breast surgery, and depending on the situation, it may be performed for a variety of reasons. For instance, surgery could be performed on:

  • Remove as much of the cancer as possible (breast-conserving surgery or mastectomy)
  • Find out whether the cancer has spread to the lymph nodes under the arm (sentinel lymph node biopsy or axillary lymph node dissection)
  • Restore the breast’s shape after the cancer is removed (breast reconstruction)
  • Relieve symptoms of advanced cancer

When a breast surgery or a breast implant is performed, fibrous scar tissue develops. Following implant placement, your body creates a protective capsule around whatever it senses as alien. The tissue capsule is generally soft or somewhat stiff, is hardly visible, and aids in implant retention. Certain women have a tissue capsule that is exceedingly hard and dense. The capsule tightens around the implant. Capsular contracture is a condition that causes chronic pain, a distortion in the breast’s contour, and causes the breast to rise higher on the chest.

How common is breast surgery after cancer?

Reconstruction following mastectomy is well known for its quality-of-life and psychosocial benefits. In 2016, 109,256 surgeries for breast reconstruction were performed. Breast reconstruction has had consistent annual growth over the years, with a 39 percent increase in procedure volume since 2000 and a 3 percent increase since 2015.  A spike in patient-driven requests for bilateral mastectomy with immediate contemporaneous breast reconstruction has been seen by many plastic surgeons. In the United States today, there are more than 3.1 million breast cancer survivors, many of whom require ongoing services and maintenance.

However, only about half of all women who need a mastectomy are given breast reconstruction surgery, and only about 20% choose to have it done right away. According to studies, just 23% of women are aware of the many breast reconstruction alternatives available. President Barack Obama signed the Breast Cancer Patient Education Act (BCPEA) in December 2015, and it went into effect in October 2016 to inform breast cancer patients about the availability and coverage of breast reconstruction and prostheses.  Although the number of plastic surgeons performing breast reconstruction has increased over time, there is still a large geographic variation in plastic surgeon density. Important research is emerging to provide light on how cultural preferences and availability to care can influence the decision to undergo breast reconstruction. Comprehensive and appropriate patient education remains paramount in our mission to deliver the best possible care, and geographical disparities in breast reconstruction remain clear opportunities for improvement. American Society of Plastic Surgeons 

Are you at risk of capsular contracture?

Capsular Contracture

If you’ve undergone radiation therapy in the past, especially after your original breast reconstruction surgery, you’re more likely to develop capsular contracture. Overall, however, the reasons why some people acquire capsular contracture and others do not remain unknown.

“Some of the other factors that may raise the risk of capsular contracture include rupture of an implant, hematoma (a build-up of blood where tissue was removed during surgery), developing a microbial biofilm (subclinical infection) on an implant, and a genetic predisposition to forming scars.” BreastCancer.Org 

How many people experience capsular contracture?

The most common complication after implant-based breast surgery is capsular contracture, which is one of the most prevalent reasons for reoperation. An overwhelming fibrotic reaction to a foreign body (the implant) causes capsular contracture, which has a 10.6 percent overall incidence. Archives of Plastic Surgery

Common Problems After A Breast Surgery

Breast Surgery

Breast implant illness (BII) is a term that some women and doctors use to refer to a wide range of symptoms that can develop after undergoing reconstruction or cosmetic augmentation with breast implants. It is also sometimes referred to as autoimmune/inflammatory syndrome induced by adjuvants (ASIA).

Post-Operative Breast Implant Illness can impacts each individual differently. However, common symptoms may include:

  • Joint and muscle pain
  • Chronic fatigue
  • Memory and concentration problems
  • Breathing problems
  • Sleep disturbance
  • Rashes and skin problems
  • Dry mouth and dry eyes
  • Anxiety Depression
  • Headaches
  • Hair loss
  • Gastrointestinal problems

The symptoms can appear any time after implant surgery — some people develop symptoms immediately, while some develop them years later.

New Wave in Breast Health Management Available In Rochester NY + Rockville MD

Extracorporeal shock wave therapy (ESWT) has undergone continuous development and has become a well-established therapy option both in urology and in orthopaedics/trauma surgery. Experimental and clinical studies have proved the effectiveness of extracorporeal shock wave therapy in the treatment of connective tissue diseases such as fibromatosis. The pathomechanism of capsular fibrosis after augmentation of the female breast with silicone implants presents a series of analogies with mechanisms that are generally recognized to be associated with fibroproliferative diseases. The starting point of the disease is the inflammatory reaction caused by the silicone and/or by the sub-clinical bacterial contamination of the implant surface and can create an inflammatory reaction and fibrosis.

Today, mainly direct immunostimulation and subclinical infection are held responsible for inducing and maintaining inflammatory reactions, which lead to overwhelming extracellular matrix formation. Extracorporeal shock waves (ESWs) are capable of inhibiting inflammatory processes and revealing antibacterial capacity.

ESWT is capable of decelerating capsule formation in contrast to multiple ESWT, which degrades fibrotic tissue. These findings seem to be associated with inhibition of inflammation and beneficial effects on pro- and anti-fibrotic proteins. https://pubmed.ncbi.nlm.nih.gov/25619782/

What is Shock Wave Therapy?

The medical professional should administer shockwave therapy. The clinician applies a probe to the affected breast or lymphatic tissues, which is coated in a special gel. Extracorporeal shock wave therapy (ESWT) is a noninvasive treatment that involves delivery of shock waves to injured soft tissue to reduce pain and promote healing.  (Read More)

Will Shock Wave Therapy Work For Me?

Extracorporeal shockwave therapy has demonstrated greater improvement than intermittent pneumatic compression therapy in breast cancer-related lymphedema- with faster results and better clinical outcomes.

https://www.google.com/amp/s/scialert.net/fulltext/amp.php%3fdoi=ijcr.2018.77.85

ESWT speed up reduction of lymphedema as well as improve shoulder range of motion of affected arm so ESWT is an effective modality in the treatment of lymphedema after breast cancer treatment in post-menopausal period.

Keywords: shock wave, breast, therapy

Referenced in this article:

1.Fischer S, Mueller W, Schulte M, et al. Multiple extracorporeal shock wave therapy degrades capsular fibrosis after insertion of silicone implants. Ultrasound Med Biol. 2015;41(3):781-789. doi:10.1016/j.ultrasmedbio.2014.10.018

2.Breastcancer.org. 2021. Capsular Contracture: Causes, Risks, Signs, Symptoms, and Treatments. [online] Available at: <https://www.breastcancer.org/treatment/surgery/reconstruction/corrective/capsular-contracture> [Accessed 4 July 2021].

3.Liu, MD, D., 2021. New plastic surgery statistics and breast reconstruction trends. [online] American Society of Plastic Surgeons. Available at: <https://www.plasticsurgery.org/news/blog/new-plastic-surgery-statistics-and-breast-reconstruction-trends> [Accessed 4 July 2021].

4.Nermeen Mohamed Abdelhalim and Ahmed Fathy Samhan, 2018. Comparison of Extracorporeal Shock Waves Therapy Versus Intermittent Pneumatic Compression Therapy in Breast Cancer-related Lymphedema. International Journal of Cancer Research, 14: 77-85.

5.Mahran, Hesham. (2015). Extracorporeal Shockwave Therapy for Post-Menopausal Patients with Breast Cancer- Related Lymphedema. International Journal of Cancer Research ISSN: 2051-784X. 49. 1618-1625.

6.Mayo Foundation for Medical Education and Research. (n.d.). Physical Medicine and Rehabilitation. Mayo Clinic. https://www.mayoclinic.org/medical-professionals/physical-medicine-rehabilitation/news/sports-medicine-practitioners-embrace-benefits-of-extracorporeal-shock-wave-therapy/mac-20454275.

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