Breast AugmentationRisks and ComplicationsBreast augmentation can give fabulous results. However, it also poses some risks which can lead to complications and unfavorable results. This page will explain these risks and complications. After you have had a chance to learn about the risks on this page, be sure to visit Tips for Getting the Best Results from your Breast Augmentation to help you minimize your risks, expedite your recovery, and get the best possible results. Risks of Breast AugmentationCapsular contracture: This is a scar that forms around the implant, causing it to feel firm, look unnatural, and potentially hurt. When you see pictures of a woman with obvious implants who looks like she has "coconut breasts", she more than likely has a severe capsular contracture. These are much less common and less severe with saline implants than with silicone implants. If you develop a mild capsular contracture, you may not be bothered by it and may not even notice you have one. If you develop one which is moderate or severe, you will probably require surgery to correct the problem. Surgery involves removing the scar and placing a new implant. In spite of this, the capsular contracture may return. Placing the implant under the muscle has a lower risk of capsular contracture than placing the implant over the muscle. Interference with mammography: Breast implants interfere with the ability of a mammogram to "see" all of your breast tissue. Placing the implant under the muscle least interferes. With the breast implant under your muscle, mammograms can "see" about 90% of your breast tissue. With the breast implant over the muscle (AKA under the breast), mammograms can "see" 75% of your breast tissue. Either way, implants do not interfere with self breast examination, which is how the majority of breast cancers are discovered. They also do not interfere with ultrasound or MRI scans, which are helpful in evaluation of breast masses. Implant displacement: Implants can move out of position at anytime after surgery. They can move upward, downward, left or right. If they move only a little, you may not even notice. If they move alot, you may need further surgery to move them back into position. Fortunately, this problem is not common. One exception is in women who have very large implants. The larger the implant, the greater the chance that it will displace downward. Implant deflation: Saline implants can develop a leak and deflate. If so, your breast will shrink to its preoperative size over a matter of a day or so. You will need another surgery to replace the deflated implant. Risk of deflation is about 4% during the first year following surgery, then about 1% per implant per year for each year thereafter. Deflation is most likely to occur in implants that have not been over filled. Yes, you read that right. Over filling reduces deflation. This is because deflation is due to folding of the implant shell, which occurs repetitively in implants that are not over filled. After the implant shell has folded hundreds or thousands of times with your natural body movements, the implant shell tears - just like a piece of paper that has been folded time after time. Rippling: This is the visible appearance of waviness of the skin over your implants, like the ripples of a wave on a lake. Some doctors refer to this as "wrinkling." This occurs due to saline shifting around inside your implants. It is most troublesome if it occurs in the upper half of the breast, because it would be evident in low-cut clothing and swim wear. Rippling is uncommon when the implants are over filled and is less common with smooth implants than with textured ones. Also, when the implants are placed under the muscle, there is less chance of rippling in the upper half of the breast. Infection: Infection, if it occurs, usually does so within two months of surgery. The risk is about 1% and often requires removal of the involved implant and antibiotics. A new implant can be placed six months later, but that means you would have to go for six months with very uneven breasts. Nipple numbness: The national risk of having permanently numb nipples is about 15%. If the possibility of having numb nipples is unacceptable to you, you should not have this operation because no surgeon can guarantee preservation of nipple sensation. Breast feeding and pregnancy: Breast feeding ability is not altered by implants. Many women ask about the effect of future pregnancy on augmented breasts. In most cases, implants will not affect the fate of your postpartum breasts. Here is why: following pregnancy (and breast feeding), your breasts will shrink to their pre-pregnancy size (or there about). During this process of shrinking, your breast skin may either tighten or not tighten. If it tightens, you will most likely not have breast droop. If it does not tighten, then your breasts will unfortunately droop. Whether or not the skin tightens has little or nothing to do with the presence or absence of implants. Need for Further Surgery: Women unwilling to accept the potential need for further surgery should not have breast augmentation. Understand that if you receive any implant in your body - whether it be a pace maker, artificial joint, artificial heart valve, or anything - that one of the inherent risks is that you may need further surgery on it at some point in your life. With breast implants, you may need further surgery for capsular contracture, deflation, rippling, displacement, infection, desire for a different size, or another reason. You may also go a lifetime without having any problems. But, it is most prudent to assume that at some point, you will probably want or need another surgery to address one of these problems. To reduce your risk of needing further surgery, be sure to visit Tips for Getting the Best Result from your Breast Augmentation. Information on that page will help you to reduce your risks, expedite your recovery, and ensure the best result.
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Dr. Loftus is the highly acclaimed plastic surgeon who authored The Smart Woman's Guide to Plastic Surgery, which is the #1 Best-selling book on plastic surgery in the United States. She has appeared on CNN, MSNBC, THE TODAY SHOW and THE VIEW, discussing all facets of plastic surgery. People from all over the world travel to Cincinnati to seek her care.
Loftus
Plastic Surgery Center
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