Breast Augmentation Considerations

When considering breast augmentation surgery, here are several things to consider before making your decision to have the procedure.

What Are Potential Breast Implant Complications?

Most patients are very pleased with their breast augmentation surgery results. However, undergoing any surgical procedure involves risks of complications and side effects related to anesthesia, infection, swelling, redness, bleeding and pain. In addition, there are potential complications specific to breast implants, including the complications mentioned above, in addition to: breast implant placement issues, shifting, scarring, ruptures and leaking, tissue tenderness and hardening, lack of symmetry, nerve damage or reduced sensation to the breast areas. In some cases, revision surgery or replacement surgery are necessary, which will add costs to have the issues corrected, if necessary. Here are other things to consider in more detail.

Infection

Most infections resulting from any surgery appear within a few days to weeks after the operation; however, infection is possible at any time after surgery. Infections with an implant are harder to treat than infections in normal body tissues. If an infection does not respond to antibiotics, the implant might have to be removed, and another implant might be placed after the infection is resolved.

In rare instances, toxic shock syndrome has been noted in women after breast implant surgery, and it is a life-threatening condition. Symptoms include sudden fever, vomiting, diarrhea, fainting, dizziness and/or sunburn-like rash. See a doctor if these symptoms appear, for immediate diagnosis and treatment.

Deflation/Rupture

Breast implants deflate when the saline solution leaks either through an unsealed or damaged valve or through a break in the implant shell. Implant deflation can occur immediately or slowly over a period of days and is noticed by loss of size or shape of your breast. Some implants deflate (or rupture) in the first few months after being implanted and some deflate after several years. Causes of deflation include damage by surgical instruments during surgery, overfilling or under filling of the implant with saline solution, capsular contracture, stresses such as trauma or intense physical manipulation, excessive compression during mammography imaging, umbilical incision placement, and unknown/unexplained reasons. You should also be aware that the breast implant might wear out over time and deflate/rupture. Deflated implants require additional surgery to remove and to possibly replace the implant.

Capsular Contracture

Capsular contracture occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant. Capsular contracture is more common following infection, hematoma and seroma. It is also more common with sub-glandular placement (behind the mammary gland and on top of the chest muscle). Symptoms range from firmness and discomfort to severe pain, distorted shape, palpability of the implant and/or movement of the implant.

Additional surgery is needed in cases where pain and/or firmness are severe. This surgery ranges from removal of the implant capsule tissue to removal and possibly replacement of the implant itself. Capsular contracture may happen again after these additional surgeries.

Pain

Pain of varying intensity and duration can occur and persist following breast implant surgery. In addition, improper size, placement, surgical technique or capsular contracture might result in pain associated with nerve entrapment or interference with muscle motion. You should tell your surgeon about severe pain.

Additional Surgeries

Breast enhancement surgery will require future surgery at some point to replace the implants, as they are not intended to last a lifetime. If you choose not to have them replaced, you might develop dimpling and/or puckering of the breast following removal of the implant.

Dissatisfaction with Cosmetic Results

Dissatisfying results such as wrinkling, asymmetry, implant displacement (shifting), incorrect size, unanticipated shape, implant palpability, scar deformity or hypertrophic (irregular, raised scar) scarring can occur. Careful surgical planning and technique can minimize but not always prevent such results.

Hematoma/Seroma

Hematoma is a collection of blood inside a body cavity. A seroma is a collection of the watery portion of the blood (in this case, around the implant or around the incision). Postoperative hematoma and seroma can contribute to infection and/or capsular contracture. Swelling, pain and bruising may result. If a hematoma occurs, it will usually be soon after surgery. However, this can also occur at any time after injury to the breast. While the body absorbs small hematomas and seromas, large ones will require the placement of surgical drains for proper healing. A small scar can result from surgical draining. Implant deflation/rupture can occur from surgical draining if damage to the implant occurs during the draining procedure.

Changes in Nipple and Breast Sensation

Feeling in the nipple and breast can increase or decrease after implant surgery. The range of changes varies from intense sensitivity to minimal or no feeling in the nipple or breast following surgery. Changes in feeling can be temporary or permanent and may affect your sexual response or your ability to nurse a baby. (See the paragraph on breastfeeding below.)

Breastfeeding

It is not known if a small amount of silicone will diffuse (pass through) from the saline-filled breast implant silicone shell and find its way into breast milk. If this occurs, it is not known what effect it might have on the nursing infant. Although there are no current methods for detecting silicone levels in breast milk, a study measuring silicon (one component in silicone) levels did not indicate higher levels in breast milk from women with silicone-filled gel implants when compared to women without implants.

Calcium Deposits in the Tissue around the Implant

Deposits of calcium can be seen on mammograms and can be mistaken for possible cancer, resulting in additional surgery for biopsy and/or removal of the implant to distinguish calcium deposits from cancer.

Delayed Healing

In some instances, the incision site takes longer to heal than normal, which ranges from a week to 20 days.

Breast Tissue Atrophy/Chest Wall Deformity

The pressure of the breast implant might cause the breast tissue to thin and shrink. This can occur while implants are still in place or following implant removal without replacement.

Connective Tissue Disease

A review of several large epidemiological studies of women with and without implants indicates that autoimmune or connective tissue diseases (lupus, scleroderma and rheumatoid arthritis) are no more common in women with implants than in women without implants.

Cancer

Published studies indicate that breast cancer is no more common in women with implants than those without implants.