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What are the risks associated with breast augmentation surgery?

Arthur W. Perry, MD
Plastic Surgery
Breast augmentation has the standard risks of infection and bleeding. Infection is rare but when it does occur, it may require removal of the implants. The body simply cannot fight infection efficiently if a foreign object is present. Many plastic surgeons are reluctant to replace implants in a patient who has developed an infection. Bacteria lie dormant in scar tissue for a long time, and a second infection may be provoked by another operation. Most plastic surgeons will not replace the implants for at least six months.

Bleeding is not common after this surgery, but it can be dramatic if it does occur. Blood clots in the legs, clots spreading to the lungs, punctured lungs, and death have been reported with this procedure.

Implant-related problems include scarring around the implants, called capsular contracture. Scarring is the body's attempt to wall off the implant, to isolate it from the rest of the body. We simply don't know what causes the hardness or how to stop it.

In 15% of women, the breasts harden because of the scarring. About 5% develop deformed breasts, and 2% develop painful breasts. I will reoperate once, and once only, if one of these conditions arises. If the condition recurs, the patient should either live with the problem or have the implants removed. Some women fall into the trap of repeatedly having their implants and scar tissue removed, and new implants placed. Some seem to make a career of it. Some plastic surgeons use the asthma and allergy drug Singulair for two months after breast augmentations, to try to decrease capsular contractures. There is no evidence that this drug works.

Scarring around implants has nothing to do with skin scarring. In fact, many women with hard breast implants have excellent scars and women with soft implants sometimes have red, raised scars.

Implant wrinkles are common after augmentations, more so in droopy breasts, very small breasts, and when very large implants are used. The problem is most common if textured saline implants are used.

Saline implants can deflate after surgery. About 1% per year will do so. As a cumulative risk, this means that after ten years there is a 10% chance of deflation.
Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

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Straight Talk about Cosmetic Surgery (Yale University Press Health & Wellness)

The public’s recent exuberance toward cosmetic surgery has spurred an unprecedented demand for appearance-changing procedures. But how can an average consumer discern the hype from solid truth? ...
Tara Whitworth
Nursing
Anytime you have surgery, there are risks. However, the risks with breast augmentation surgery are relatively low. Risks associated with the surgery may include bleeding, wound healing problems, and blood collection (hematoma) or fluid collection (seroma). Infection is a risk, but your physician will prescribe antibiotics to decrease your risk. Other risks are implant deflation, capsular contracture, nipple asymmetry, and decreased nipple sensitivity.
Stuart A. Linder, MD
Plastic Surgery
The risks associated with breast augmentation include acute or early on and late or chronic risks. Acute or early risks including bleeding and/or infection. Hematoma is the most common complication of breast augmentation as it is with all surgeries. There is less than 1% risk of bleeding and this may be associated with lifting early on tearing blood vessels under the muscle requiring surgical exploration of the chest to alleviate the blood and/or allow for hemostasis. 

Infections may also occur early on because this is prosthetic device and thereby the incision should be clean and dry until sutures are removed to prevent risk of staphylococcus or streptococcal infections. Late or chronic problems may include a rupture or deflated implant, a scar tissue contracture referred to as capsular contracture, or malposition of an implant associated with bottoming out or lateral displacement of the bag. 

Other complications could include scarring, loss of nipple sensitivity or inability to lactate. In general, loss of sensitivity or inability to lactate is less than 5% by board-certified plastic surgeons in the United States.
Erik A. Hoy, MD
Plastic Surgery

As with any surgical procedure, your surgeon will review the risks and benefits of the procedure you are planning to undergo. The risks of anesthesia are inherent in any surgical procedure, but vary with mode of anesthesia, and the patient's comorbidities. There is a small but present chance of infection with the surgical procedure, which may require that the breast implants be removed in a second surgery. Other specific risks include wound healing problems, skin necrosis, and exposure of the implant, which again may necessitate removal. Other problems with the implant such as deflation, malposition, or problems with your body's reaction to it such as capsular contracture, are also possible. These may require revision or replacement of the breast implants. Wide or thickened scars, significant asymmetries such as differences in nipple position, implant position, etc. may also, although rarely, result. The important things to remember are that these risks are small, but present, and that all breasts are asymmetric, whether natural or augmented.

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Important: This content reflects information from various individuals and organizations and may offer alternative or opposing points of view. It should not be used for medical advice, diagnosis or treatment. As always, you should consult with your healthcare provider about your specific health needs.