Breast implants have been used for around 50 years to increase size of the bust (breast augmentation). While the result has been satisfactory for many people, the FDA in the United States has produced the following comprehensive list of complications that can and do occur with breast implants.
The longer the implants are in place, the greater the risk of developing a complication. Many women however, develop complications in the first one or two years after insertion of breast implants. The increased use of larger sized implants in recent years has increased the number of complications, as has the use of textured surface implants. If you are considering breast augmentation with implants then a smooth-walled saline-filled implant located below the pectoral muscle is your safest alternative. When an implant is placed behind the muscle it is very difficult to tell the difference between the various types of implants (silicone compared with saline, textured compared with smooth, round compared with tear drop). Placing the implant under the muscle is a little like placing it under a carpet – you can see the mound but you can’t really tell what is causing it. This is why a smooth-walled saline implant is very difficult to distinguish from the other types of implants and is therefore preferred because of its clear safety advantage.
Nevertheless, even with a smooth-walled saline implant, especially when using a large implant, complications such as breast tissue atrophy, chest wall deformity and even deflation can occur. This is why an increasing number of women are opting to have breast augmentation by autologous fat transfer. This procedure avoids the use of an implant altogether. Autologous fat transfer is a much less invasive operation than breast implant insertion as there is no cutting involved. Virtually all the complications are avoided and the only disadvantage of autologous fat transfer compared to breast augmentation with implants is that you are not able to choose the exact increase in breast volume. With an implant you can choose precisely what volume you would like to have inserted. With autologous fat transfer, the volume will depend on the amount of fat available and how the fat grows once it is grafted into your breast tissue. With current techniques of fat grafting it is likely that most (if not all) of the fat that is grafted into the breast survives and becomes part of the natural breast tissue.
The result may not be as large a bust as can be achieved with implants, but your breasts will look and feel completely natural and you will have the peace of mind that comes from knowing that you have avoided all the complications associated with breast implants.
Breast Augmentation by Autologous Fat Transfer. Result after 1 year. As well as the size increase, note the natural improvement in her cleavage.
Complications of Breast Implants according to the FDA
- Additional Surgeries. Breast implants are not considered lifetime devices.
- Patients should expect to have surgeries for replacement every 10-15 years.
- Asymmetry. Breasts may not be symmetrical after implantation.
- Breastfeeding. Breastfeeding may or may not be affected by implants. Another consideration is that it is possible that a small amount of silicone may pass through breast implants’ silicone shell into breast milk during breastfeeding. The FDA states that there are no established methods for accurately detecting silicone levels in breast milk.
- Breast Pain. Ongoing pain in the nipple or breast.
- Breast Tissue Atrophy. Thinning and shrinking of the breast tissue and skin.
- Calcification/Calcium Deposits. Hard lumps around the implant that can be mistaken for cancer during a mammography.
- Chest Wall Deformity. Rib cage and chest wall can appear deformed.
- Deflation in Saline Implants. Leakage of saline caused by valve leak, tear or rupture of the silicone shell.
- Delayed Wound Healing. Incision site fails to heal normally.
- Extrusion. The skin breaks down, and the implant appears through the skin.
- Hematomas. Blood collects near the surgical site resulting in swelling, bruising and pain. Large hematomas may require surgical draining.
- Iatrogenic Injury/Damage. Damage to breast tissue or implant as a result of the implant surgery.
- Infection, including Toxic Shock Syndrome. Caused by wounds contaminated with bacteria or fungi. If antibiotics fail, the implant may need to be removed.
- Inflammation/Irritation. Redness, swelling, pain and irritation caused by the body as a result of injury or infection.
- Lymphedema or Lymphadenopathy. Swollen or enlarged lymph nodes.
- Malposition/Displacement. The implant may not be in the correct position after surgery. Shifting can occur due to gravity, trauma or capsular contracture.
- Necrosis. Dead skin or tissue around the breast caused by infection, steroids, smoking, chemotherapy/radiation and excessive heat or cold therapy.
- Nipple/Breast Changes. Increase or decrease in the feeling and sensitivity of the nipple and breast. May affect sexual response or breastfeeding.
- Palpability. The implant is felt through the skin.
- Ptosis. Breast sagging due to aging, pregnancy, or weight loss.
- Redness/Bruising. Bleeding during surgery can cause the skin to change colour; it is likely temporary.
- Seroma. Fluid may collect around the implant causing swelling, pain and bruising. The body may absorb small seromas; however, larger ones will require surgical draining.
- Skin Rash. Rash on or around the breast.
- Unsatisfactory Style/Size. The patient is unsatisfied with the overall look.
- Visibility. The implant can be seen through the skin.
- Wrinkling/Rippling. Wrinkling of the implant that can be seen or felt through the skin.