Complications and Risks of Breast Augmentation

Complications and Risks of breast implants/breast augmentation

Breast implant surgery is a common procedure and the risk of developing complications is relatively low.
However, in order for you to make an informed decision you need to be aware of any possible complications or side effects which may occur.

Any operation carries some risk. Complications which can affect anyone having surgery, including those having breast implants, include:

adverse reaction to the anaesthetic,
excessive bleeding, and
blood clots (often in the leg, known as a deep vein thrombosis, or DVT).

There are also a number of complications which affect breast implant surgery specifically. Some of these complications are outlined below.

Capsular Contracture

When an implant is inserted into your breast, your body builds a wall of scar tissue around the implant. Your body will do this with any foreign object, whether it is a hip replacement, or a breast implant.

The scar tissue will shrink, but the rate and extent at which it shrinks can vary from person to person, or from breast to breast. This shrinking is known as capsular contraction. If your scar tissue shrinks significantly, your breast will start to feel hard and may become painful.

Capsular contracture is the most common complication of breast implant surgery. It affects approximately 1 in 10 women. It is also the most common reason for further surgery. In some cases, the implant may have to be removed and replaced with a new one.

Many modern implants now have a textured silicone shell, which decreases the risk of capsular contracture occurring. Ask your surgeon about the materials your implant will be made from.

Rupture

If your implant ruptures, it means that a split or hole has developed in the casing of the implant.

When implants were first developed, they had very thin walls, and rupturing was common. Modern implants, which have been available in the UK since the 1990s, rupture much less frequently.

If your implant ruptures it does not always mean that you will require medical treatment. It will depend on what your implant is filled with and how your body reacts to it.

If a saline implant ruptures, it will not cause you any problems. This is because your body can safely absorb saline because it is a sterile solution of salts and water.

If your silicone gel implant begins to leak, the silicone will normally remain inside the capsule of scarring that your body forms around the implant.

Bottoming Out

When implants "bottom out", this means that the implants have descended too low on the chest, thus making the nipple too high on the breast mount. If bottoming out is apparent shortly after surgery, it is most likely due to over-dissection of the pocket.
If it occurs later on, it is usually due to the weight of the implant.

In order to correct bottoming out, the scar tissue at the bottom of the pocket is rolled up to where the "new" (and higher) crease/fold will be. This can be done via any incision, but the crease incision is usually favored. This is due to better visualization of the pocket. Correction of bottoming out via the transax incision usually requires the use of an endoscope. If needed, other areas of the pocket are sutured and closed as well.

Symmastia

Symmastia is usually a result of over-dissection of the tissues in the cleavage area. Some surgeons do this in hopes of creating, or increasing cleavage. Symmastia is commonly referred to as "breadloafing", or "kissing implants", or "uniboob". With this condition, the implants actually meet in the middle of the chest, giving the appearance of one breast, instead of two. Symmastia seems to be more prevalent among thin women, mainly due to the fact that thin women usually have less tissue and/or fat covering the sternum. Sometimes, the surgeon will attempt to release some of these tissues, in order to get the implants closer together. If you have a qualified, and experienced plastic surgeon, this is a complication you shouldn't have to worry about. It's the least common of all cosmetic breast augmentation complications.

Scarring

Following your breast implant operation, you will have some degree of scarring. In most cases, the scarring is relatively mild. However, in approximately 1 in 20 women, the scarring is much more severe. For these women, breast implant scars may be:

red, or highly coloured,
lumpy,
thick, and
painful.

If you have this type of severe scarring it should start to gradually improve as the scars begin to fade. However, it may take several years before you notice an improvement.

Creasing and folds

Sometimes, a breast implant can affect the appearance of the skin on your breast. Following your operation, you may find your skin has:

creasing,
kinking,
vertical ripple folds, or
rippling.

These types of complications are most commonly seen in women who have very small breasts before their operation.

Nipple sensation

Some women who have breast implant surgery find that their nipples feel different afterwards. For 3-6 months after your operation, you may find that your nipples become increasingly sensitive. Some women find them so sensitive that they become painful.

If your nipples are causing your considerable pain, speak to your GP or surgeon for advice about dealing with the pain.

Approximately 1 in 7 women find that their nipples become either less sensitive or completely desensitised (no sensation at all) following their operation.

Infection and bleeding

Infection following breast implant surgery is relatively rare. It is also unusual to experience internal bleeding.

However, if you are having an implant fitted for breast reconstruction following a mastectomy, you may be at greater risk of infection and bleeding.

Most infections can be treated using antibiotics. However, if your breast becomes severely infected, you may need to have the implant removed to prevent further complications developing. You should be able to have the implant reinserted once your infection has cleared up.

Some research suggests that you may be more at risk of infection and bleeding if you smoke because your wounds will take longer to heal. The British Association of Plastic Reconstructive and Aesthetic Surgeons (BAPRAS) recommends that you to stop smoking prior to your operation in order to help reduce the risk of complications.

Hematoma

A hematoma is a collection of blood in the surgical area. Basically, it is a pooling of blood that escaped from the vessels and became trapped in the tissues of the skin. First, there is frank bleeding into the space. If the space is limited, pressure slows and eventually stops the flow of blood. This forms a mass that can be felt, as is often painful. Sometimes, these resolve without any surgical intervention, and other times, they require drainage. To decrease your chances of developing a hematoma, do not use aspirin or ibuprofen (or anything containing those drugs) for at LEAST 2 weeks prior to (and after) your breast augmentation surgery, unless your surgeon instructs you to do otherwise. Other things to avoid include, but are not limited to, vitamin E and garlic supplements. These types of supplements thin your blood, which impairs clotting. You don't want excessive bleeding after your surgery.

Seroma

On very rare occasions, you may find that fluid builds up around your implant. The medical term for this fluid build up is called 'seroma'. In some cases, further surgery may be required in order to drain this fluid away.

Silicone implants

In recent years, the safety of silicone breast implants has been debated.

The Independent Review Group found no scientific evidence to support the relationship between silicone implants and illness in women. However, the Medicines and Healthcare Regulatory Agency (MHRA) is continuing to monitor the safety of silicone breast implants, and will take into consideration any new scientific evidence about this type of implant

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