Breast Augmentation Complications

Although capsular contracture and ruptured breast implants are the most well-known types of risks and complications from breast implants, there are several possible problems that can occur in breast augmentation patients.

Potential Complications Following Surgery

Before you choose to undergo breast augmentation surgery, it is important to learn as much as you can about the potential risks and complications from breast implants. Choosing an experienced and board-certified plastic surgeon can reduce the likelihood of post-operative complications and unsatisfactory results. It is important to note, however, that regardless of the type of implant used or the way it is placed, it is probable that you will need to have one or more additional surgeries over the course of your life because of complications or other breast implant problems. Potential reasons for secondary breast surgery include ruptured breast implants, capsular contracture, rippling, displacement, and infection.

Capsular Contracture

It is part of the body’s natural response to form a layer of scar tissue around a breast implant as it heals. This scar tissue is referred to as the capsule. When the capsule begins to contract, however, it creates pressure on the new implant, causing pain, hardening of the breast, and distortion of the breast shape. This can happen to one or both of the breasts. There is some evidence to suggest that capsular contracture can be avoided by placing the breast implant beneath the chest muscle rather than on top of it.

The degree of a patient’s capsular contracture is measured by the Baker Grading System. In grade one, the breast is soft and looks natural, which is to say that there is no noticeable capsular contracture and everything is fine. A grade two breast is a little firmer than it should be, but looks normal. At this stage, surgery is not warranted, but it may be a sign that the capsule is beginning to contract and should be watched carefully. Grade three is the point at which the breast is very firm and has begun to look abnormal. At grade four, the breast is hard, painful, and doesn’t look natural. To repair breast implants at a Baker grade three or four, surgery is required. The surgeon can either do an open capsulotomy, which involves going into the breast and scoring the capsular tissue to loosen up the capsule, or a capsulectomy, which is the removal of the capsular tissue altogether.

It is not known why capsular contracture occurs. Some believe that using an implant with a textured surface or placing the implant under the chest wall will reduce the chances of capsular contracture, but studies have neither proven nor disproven this theory.

Rippling

Another of the common risks and complications from breast implants is rippling. Rippling occurs when the filling material inside a breast implant shifts around and allows a wrinkle or fold to appear in the outer shell. The result is a bump, ridge, or valley that can be felt and sometimes seen on the surface of the breast. Rippling is less common in certain types of breast implants, including smooth-surfaced implants, silicone gel implants, and implants that are placed beneath the chest muscle.

The external visibility of a breast implant depends on the thickness and quality of the patient’s skin. If an implant is large or there is little muscle or fatty tissue to conceal it, any rippling that occurs will be more noticeable. Rippling is most likely to appear on the outer side of the breast, along the bottom of the breast, and toward the cleavage.

Infection

Infection is a serious risk that can occur with any type of surgery, including breast augmentation. When infection occurs, it usually does so within one to six weeks after surgery. Most infections can be treated with antibiotics. In some cases, however, the breast implant may need to be removed. The infection must clear (which can take up to several months if it is severe) before the implant can be replaced. Infections are known to increase the likelihood of capsular contracture.

Symptoms of infection include fever, tenderness, redness, and inflammation. To avoid infections, breast augmentation patients should not submerge their incisions in a bath, swimming pool, or other body of water until the breasts have completely healed. They should also avoid touching the incisions or bringing any product, such as lotion or deodorant, in contact with the stitched area. It is important to keep this area clean throughout the healing process.

Hematoma

Hematoma occurs when there is a collection of blood within tissue, an organ, or a cavity of the body. The most common instance of hematoma is a bruise. Although we ordinarily think of bruising as a minor type of injury, depending on the severity of the hematoma and its location, serious problems can develop. Hematomas that occur after breast augmentation can increase the likelihood of breast implant problems such as capsular contracture and infection.

Hematomas typically occur soon after surgery but can also occur later on. Although some degree of post-surgical bruising is normal and the body is able to absorb small hematomas, large ones require the use of surgical drains to allow for proper healing. Surgical draining must be done carefully, as the insertion of the tubes may cause damage that can result in ruptured breast implants.

Nipple Numbness and Breast Sensation Changes

The shifting or disruption of nerve pathways during breast surgery can temporarily or permanently affect sensation in the nipples and breasts. Sensation may be intensified, weakened, or sometimes even eliminated. These changes in nipple and breast sensation can affect sexual response or the ability to nurse a baby. In May 2000, an FDA study on saline-filled breast implants revealed that after five years, 10 percent of women reported intense nipple sensation, while another 10 percent indicated loss of nipple sensation.

Although it is rare for women who undergo breast augmentation to experience serious risks and complications from breast implants such as permanent nipple numbness, temporary sensitivity or numbness is a common post-operative side effect. It will usually last between several days and a couple of months and then gradually fade as the nerves begin to heal.

Displacement

Displacement is a rare condition that involves the implant shifting from its desired position. When implant displacement occurs, it will typically take place within the first few days after surgery and may be corrected with additional surgery. Breast implant displacement is most common in women who have very large implants, or in cases where an unusual placement technique is used. For more information about displacement, talk to your cosmetic surgeon.

Ruptured Breast Implants

Both saline and silicone breast implants can rupture and leak. Ruptured breast implants that are filled with saline will deflate rather quickly, causing the breasts to shrink within a day or two. The saline solution, which leaks into the body from a hole in the implant shell or a faulty valve, is harmless and can be easily absorbed by the body. In most cases, the ruptured breast implants can be easily replaced.

Silicone breast implants, however, may show no signs that a rupture has occurred. Since silicone gel is thick, it can remain within a breast implant even after it has ruptured, or leak very slowly into the breast. Silicone leaks are classified in three categories:

• Intracapsular - when silicone is contained within the fibrous capsule that surrounds the implant
• Extracapsular - when silicone has leaked into the breast tissue outside the capsule
• Migratory – when silicone moves into other areas of the body

Migratory leaks are very rare and there has been no evidence to suggest that the silicone causes any serious conditions. However, women with silicone breast implants should have regular MRI screenings to check for signs of ruptured breast implants.

Several factors can increase the chances of ruptured breast implants. These include:

• Damage by surgical instruments
• Excessive handling during surgery
• Compression during mammographic imaging
• Trauma or intense physical pressure
• Severe capsular contracture
• Stacking of implants (multiple implants per breast pocket)
• Normal implant wear caused by aging

Mammography Interference

Breast implants have not been linked to an increased risk of developing breast cancer; however, implants can interfere with cancer detection during routine mammograms. Saline or silicone gel breast implants can make it difficult for the x-ray machine to see all of the breast tissue, creating the potential for tumors or other abnormalities to remain hidden. Breast implants that are placed under beneath the muscle create fewer problems than those placed just beneath the breast tissue, but they can still get in the way.

When making an appointment for a mammogram, you should choose a facility that has technicians who are experienced in the methods necessary for obtaining reliable mammograms of breast implant patients. You should mention that you have breast implants while making your appointment and again when you arrive for the mammogram. This will allow the technician to use the proper techniques to get a reliable screening while avoiding compression that can lead to ruptured breast implants.

Breast Augmentation and Breastfeeding

Many women who are considering breast augmentation are concerned about risks and complications from breast implants that may affect their ability to breastfeed in the future. Sometimes, women who have breast implants will experience difficulty when breastfeeding. But what many people don’t realize is that women who have not had any breast surgery at all will often experience difficulty with breastfeeding, so there is nothing to suggest that breast implants make it any harder to breastfeed than normal. The only aspect of breast augmentation surgery that may interfere with breastfeeding is a change in nipple sensation. If nerve damage is sustained during surgery, causing the nipple to become either very sensitive or numb, breastfeeding may be uncomfortable.

Choosing the right type of incision can help reduce the chances of difficulty during breastfeeding. For example, inframammary breast implant incisions (made under the fold of the breast), transaxillary breast implant incisions (made in the armpit), and transumbilical incisions or T.U.B.A. breast augmentation incisions (made in the navel) normally don’t cause problems that interfere with breastfeeding. However, breast implants placed through areolar breast implant incisions (a smile-shaped incision made around the nipple area) can put patients at a greater risk for nerve damage to the nipple and developing difficulties with breastfeeding. Patients whose nerves are not damaged during breast augmentation and whose milk duct system remains intact may be able to nurse fully or partially.

Women also need not worry about ruptured breast implants causing harm to a baby. There is no evidence that silicone from silicone gel implants can leak into breast milk. Silicone molecules are too large to pass into the milk ducts.

Breastfeeding is still the preferred method of feeding a baby according to the American Academy of Pediatrics. It is important to discuss possible breast augmentation risks and your plans for breastfeeding during a cosmetic surgery consultation. Your surgeon will answer your questions and address your concerns, working with you to achieve the best results possible, even if you do not intend to have children in the near future.

Locate a Surgeon through DocShop

To learn more about capsular contracture, ruptured breast implants, or other risks and complications from breast implants, contact a qualified cosmetic surgeon in your area through the Doc Shop directory today or watch our breast augmentation video.