What are the risks of breast implant surgery?

Breast implants may make it harder to detect breast cancer on a mammogram. Other risks of breast implant surgery include:

• Capsular contracture. One of the most common problems caused by breast implants, this condition occurs when scar tissue around the implant hardens and begins to squeeze the implant. It can cause hardening of the breast tissue, rippling in the skin of the breast and changes in the shape of the breast. It may also be painful. Surgery is sometimes needed to remove the scar tissue or replace the implant when capsular contracture develops.
• Loss of feeling in the nipples or breast tissue due to nerve damage. Often this is temporary, but it may be permanent in some women.
• Differences in size or shape of the breasts after surgery.
• Changes in the implant. Normal activity or an injury to the breast can damage the implant, causing it to leak, deflate or rupture. Over time, the implant may harden, develop ripples, shift position or change shape. Surgery may be needed to remove the implant and replace it (if desired) if any of these changes occur.
• Infection (not common). This can occur at any time, but it typically occurs during the first week after surgery. In some cases of infection, the implant may have to be removed for several months and then replaced.
• Blood collection under the skin, or hematoma (uncommon).
• Abnormal scarring (uncommon).

Having more than one procedure at the same time, such as a breast lift and breast enlargement, increases the risk of problems after the surgery.

There are both acute and later (chronic) risks of breast implant surgery. The acute risks include bleeding, hematoma, infection, deep venous thrombus, and pulmonary embolus. The later risks include capsular contracture or scar tissue formation around the implant, rupture of the implant, loss of sensitivity of the nipple, inability to lactate, and scarring. Malpositioning of the implant can be either a technical error or be associated with capsular contracture. Double bubble deformity and bottoming out can occur with malposition of the implant or capsulitis as well. In general saline and silicone gel implants should be replaced at least every 10 years as they are not lifetime devices.