to determine if breast implants can positively affect her self-esteem and sexual functioning. Complications The plastic surgical emplacement of breast implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), late hematoma (post-operative bleeding after 6 months or more), seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the "bread loafing" of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants—capsular contracture and capsular rupture—are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 percent of the patients. Statistically, 20 percent of women who underwent cosmetic implantation, and 50 percent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark. Safety In the 1990s, several reports reviewed the few studies evaluating any increased risk of systemic and auto-immune diseases among women with breast implants. The conclusion at that time was that there was no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. However, the Institute of Medicine report pointed out that these earlier studies included too few women to conclusively evaluate the impact on these rare diseases. In addition, many of the studies included women who had breast implants for just a few months, which would be too early to develop a diagnosed autoimmune disease. In recent years, large epidemiological studies have reported clinically and statistically significant increases in some of these diseases. A study by Watad and colleagues that was published in 2018 compared and examined the medical records of more than 24,000 women with breast implants to more than 98,000 "matched controls" who did not have breast implants but shared very similar demographic traits. The study found a statistically significant 22% overall increase in diagnosed autoimmune or rheumatic disorders. The greatest increases in diagnoses for women with breast implants was for Sjögren's syndrome, Multiple Sclerosis (MS), and sarcoidosis, each of which were 58%-98% higher in women with breast implants. That analysis was based on Israeli women with breast implants as confirmed by medical records, and the