Risks and Potential Complications
As with any surgical procedure, breast augmentation is associated with some potential complications. Having a general anaesthetic is associated with low risks of chest infection, respiratory or heart compromise and blood clots in the leg (DVT) or lung (PE).
Early in recovery you may notice altered sensation, swelling, bruising and a small difference between the two sides. It is normal for all these to settle with time. Occasionally the procedure and be complicated in the immediate post-operative period by infection, haematoma, delayed healing and opening up of the wound which exposes the implant (extrusion). In the case of infection or extrusion it is necessary to remove the implant and allow the infection to be cleared and the tissues to settle for 3-6 months before having a new implant.
Other early to medium term complications include formation of a seroma, which is a collection of tissue fluid next to the implant. This normally self resolves but on rare occasions may require drainage by a radiologist. The scar does normally settle to be a pale fine line, however, in the first few months it is often pink and may become thickened. In this case you will be given an additional scar management plan to help this settle.
The bodies’ natural processes will wall off any foreign material in the body, including implants. A capsule (or internal scar) of tissue forms around the implant. This process usually has occurred by around 6 weeks post-op. The capsule can gradually thicken and get tighter with time and when this happens it is called capsular contracture. It can cause a change in the shape / position and size of the breast and in the later stages it may cause pain. This process is very patient dependent and occurs much more rapidly in some ladies and never in others. The most common reason for requiring further surgery to the breast after augmentation is to treat capsular contracture.
In ladies who have had anatomical (tear drop shaped) implants, there is the potential for implant rotation. Rarely this may require re-operation to re-orientate the implant.
Nipple sensation can be altered following augmentation. It may be increased or decreased for a number of months however the change is unlikely to be permanent.
Thin ladies will be able to feel the edges of the implants. There is no way to avoid this and it will be permanent. The upper part of the implant can be placed behind the pectoralis muscle to try and reduce this but the implant edges will still be felt further down the breast. As a rough guide if you can see your ribs when unclothed you will be able to feel and possibly see the edges of the implant. Over time ladies who are thin are more likely to develop rippling of the implant that becomes palpable or even visible in certain positions.
Recently there has been much interest in a type of lymphoma that is associated with breast implants. Breast Implant-Associated Anaplastic Large-Cell Lymphoma (BI-A ALCL) is a type of lymphoma that develops in the capsule of breast implants in some ladies. There is currently much research going on to assess the true incidence and cause of this lymphoma. The reported rates vary from 1 in 1000 in certain types of implants to 1 in 10 000. The actual incidence is as yet truly unknown. The condition most commonly presents with unilateral swelling of a breast associated with a fluid collection around it. It usually presents at least a year after augmentation but more commonly later than this. Diagnosis involves sending the fluid for special tests. The treatment is to remove the implant and the surrounding capsule. In very rare cases some ladies have required chemotherapy.