Risks and complications

Breast augmentation, like any surgery, has associated risks such as infection, bleeding, scarring, and problems with anaesthesia. There are also specific risks associated with these procedures including implant rotation and migration, difficulties with sensation in the breast and nipple, and possible rippling or rupture of the implants.

Breast augmentation complications are rare however and improvements in techniques for breast augmentation mean that the risks are lower now than ever before.

General Anaesthetic

Patients undergoing breast augmentation surgery usually do so under general anaesthetic. Those with a history of adverse reactions to anaesthesia, or with respiratory conditions and other medical considerations, can talk through alternative options for surgery, including local anaesthetic and sedation.

It may also be possible to employ a different surgical approach to avoid the need for general anaesthesia or reduce the length of time the patient needs to be anaesthetised.

Although patients will typically return home later in the day after surgery they will be monitored as the anaesthesia wears off to ensure their safety and comfort.

Blood Loss During Breast Augmentation

Breast augmentation risks include both blood loss and blood clots although such events are rare and usually well managed when they do occur.

Bleeding is a problem in around 1% of cases but the risk is highest in those taking blood-thinning medications and with certain medical conditions.

It is important to discuss these risks prior to surgery to ensure any necessary alterations to prescribed medications can be made.

Blood Clots

Deep vein thrombosis is another possible complication of surgery, especially where a longer procedure occurs and the patient is stationary for an extended period of time.

Women taking the contraceptive pill or who are on hormone replacement therapy (HRT) are at an increased risk of deep vein thrombosis, as are those undergoing multiple treatment interventions.

The risk remains relatively low however (3 in 10,000), and there are numerous ways to lower that risk further.

Staying hydrated, wearing surgical (pressure) stockings, and becoming active as soon as possible after surgery (even if just a short walk across the hospital room) all help reduce the risk of blood clots forming in the deep leg veins.

Breast Implants Infection

Whenever surgery occurs and the body is opened up in any way there is a risk of infection and this is another consideration for those considering breast augmentation surgery.

Patients with immune-system dysfunction will need to discuss their options carefully with their surgeon, as will patients taking immunosuppressant medications as some issues may make elective surgeries inadvisable.

The general rate of infection is 1-2% although most infections are treatable with a short course of antibiotics and are not life-threatening. Some patients may be prescribed prophylactic antibiotics if infection appears more likely or is deemed a significant risk.

Following guidance on dressings, incision-care, and return to work, exercise, and general activity after breast augmentation surgery can further reduce infection risks, as can ceasing smoking where applicable.

Breast Augmentation Pain and Discomfort

Some pain and/or discomfort after breast augmentation surgery is to be expected although this is usually well-tolerated by patients and subsides rapidly as the body heals from the procedure.

Swelling and tenderness can also occur, along with bruising, but such effects can often be remedied with analgesics and anti-inflammatory medications as advised by the surgeon.

More persistent breast implant pain may take the form of neuropathic (nerve) pain and can, in a small number of cases, become chronic.

Around 3% of patients experience some degree of chronic nerve pain after surgery, a similar rate to other types of surgery, and such symptoms are usually managed through chronic pain treatment rather than further surgery.

Breast Implants and Breastfeeding

Women who may become pregnant after breast augmentation will be encouraged to consider their options carefully so as to avoid unnecessary worry and complication as concerns breast augmentation and breastfeeding.

Altered sensation in the nipple and skin of the breast can occur if the nerves in the breast are damaged during surgery or affected by scar tissue during healing.

This may make breastfeeding painful and/or impractical for some women and can make it preferable to delay breast augmentation until after a patient feels her family is complete.

Nerve and Nipple Sensation

Whenever breast augmentation surgery occurs there is a risk of nerve trauma and damage in the breast and nipple. This may result in both short and long-term neuropathic pain, numbness, or other changes in sensation in the breast and nipple, especially where the nipple is detached and repositioned during surgery.

For some women the desire for a change in appearance outweighs the potential risks of altered breast and nipple sensation and for others it is a significant concern that influences their choice of breast implant size, incision site, and procedure.

Capsular Contracture

Capsular contracture is a risk with any type of implant surgery as scar tissue forms around the implant. The scar tissue may harden and contract causing distortion of the implant, a hardening of the tissue, and pain on some occasions.

The phenomenon can occur months or years after breast augmentation surgery and may necessitate removal of the implant and the capsule with replacement breast implants inserted.

Although no clear cause of capsular contracture is known, risks are thought lower with the use of micropolyurethane coated silicone breast implants, the avoidance of oversized breast implants, and caution over returning to work or exercise too quickly.

A 1-2% risk of capsular contracture is associated with coated implants although their relatively recent introduction makes long-term analysis difficult.

Standard silicone shell implants have an 8% risk at six years and a 14% risk at eight years. Patients who experience problematic bleeding with breast augmentation surgery, or who develop an infection are thought at higher risk of capsular contracture.

Asymmetry

Immediately after breast augmentation surgery, some asymmetry is common as the breasts can be swollen and tender. As the swelling dissipates and the implants settle into place this asymmetry is likely to correct itself but in some cases the breasts remain asymmetrical in appearance.

All women have a natural asymmetry in the breasts however, with the left breast usually slightly larger than the right. Where the breasts are significantly uneven further surgery can be carried out although this can increase other risks associated with breast augmentation.

Implant Migration and Rotation

Breast implant migration is a rare phenomenon but can occur and may require corrective surgery. The use of micropolyurethane coated silicone breast implants makes this problem even less likely than with a standard silicone shell as the breast tissue actually grows into the implant and holds it in place.

This breast implant coating also helps reduce the risks of teardrop-shaped breast implants rotating after surgery, although a 1-2% risks exists when using standard silicone shell models.

Surgery to reposition the implant may then be necessary although this can often be avoided by carefully selecting the type of breast implant to be used.

Breast Implant Leakage

The danger of breast implants leaking varies between different models with cohesive gel silicone implants unlikely to leak but possibly experiencing shell failure.

Standard saline implants have a 5% risk of leaking and can deflate quite quickly as the saline solution enters the surrounding tissue. Saline solution leakage is considered unproblematic in terms of toxicity but there is some concern regarding silicone exposure.

However, any rupture is likely to be very slow, meaning that little silicone enters the system even in the rare event of a breast implant shell failure. In most cases the breast implant can be removed and replaced promptly without difficulty.

Implant Rippling and Palpability

Very thin patients with little breast tissue are more likely to be able to feel the breast implant and to develop and notice breast implant rippling than those with more tissue between the implant and the skin.

This is largely an issue with saline implants and traction rippling is constant with heavy implants, making it important to choose breast implant size, shape, and model carefully during consultation.

Sub-pectoral breast implants can reduce the implant palpability and visible signs of rippling although the outer edge and cleavage areas may still show some rippling on occasion.

Replacement of the breast implants may be desirable in cases where rippling is significant but some women find that although they can feel the implant beneath the skin there is no visible rippling.

Get in touch. Talk to our helpful team or book a consultation with Mr Lucian Ion. Call 0207 486 7757

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