Breast augmentation, as with any surgical procedure, has risks and possible complications. It goes without saying that one fundamental way to minimize surgical risk is to choose an experienced plastic surgeon. Those of us with recognized surgical training are better equipped to both perform the procedure and also to recognize and treat any complications appropriately.
Below is a brief description of some possible complications that may arise as a result of having breast augmentation surgery.
Any surgical procedure can develop an infection. Breast augmentation does not have a higher risk than any other plastic surgery procedure but because we are using an implant, the implications of an infection are more significant. I routinely use antibiotics to minimize infection risk and rarely see infections – but they do happen. I always tell my patients to let me know immediately if they notice increased redness or pain, especially if they have a fever. Prompt treatment is the key to successfully managing infections.
A Hematoma occurs when there is bleeding after surgery and this blood accumulates in a pocket beneath the skin. It is not a serious complication, but it must be managed properly. Small hematomas will be naturally absorbed by the body though bruising may be more prolonged. Larger hematomas are best removed to speed up the healing process. If patients notice an abnormal degree of swelling, they should let me know as a hematoma might be the cause.
Our body's natural response to foreign objects such as breast implants is to surround them with a thin layer of scar tissue called a “capsule”. It is a normal part of the healing process and occurs with all implants. Capsular tissue is only a problem when it becomes thick and restrictive, contracting around the implant. Depending on the severity of capsular contracture the breast implant may feel slightly firm to fairly hard. The shape of the breast may change, resulting in an asymmetric appearance. Capsular contracture may cause the breast to become tender with pressure, which may interfere with physical activity.
The treatment for capsular contracture is to remove the restrictive scar tissue and release the space around the implant. I make sure that I see my patients for follow-up care until any risk of contracture has past. Massaging the implant in the early days after breast augmentation surgery helps to keep the implant mobile and reduces the risk of contracture. The risk of developing this problem in my practice is about 4%. It’s reassuring to know that should it arise, there is an efficient way to treat it.
A change in sensation may occur following breast augmentation in the breast or the nipple area. Placement of the implant stretches the nerves that supply feeling to the breast. The majority of patients have normal sensation after the first week or so once the immediate swelling has resolved. Some patients find that their nipple area is extra sensitive and irritable to touch. This can last for several weeks until the nerve fibres have more time to heal but it always resolves. A few patients will describe reduced feeling, often just on one side, either in the nipple area or the skin below it. This also improves as the nerves heal but is more gradual and can take a longer time. It is very uncommon to have a long-lasting change in feeling, but it can occur. I advise my patients that the risk of any permanent change in feeling is less than 1%.
Every woman has some degree of breast asymmetry. One breast is always a little larger and lower than the other. In some women this difference is severe and can be more than a cup size. It has been said that the two breasts are “sisters, not twins”.
The goal of breast augmentation is to make the two sides as equal as possible. Exact equalness is very difficult to achieve. I find myself emphasizing this to my patients at the time of the consultation. When it comes to symmetry, a realistic understanding of what kind of results are possible is very important.
There are a number of possible risks and complications that can arise during and after surgery. We do our very best to identify risk factors before surgery and take steps to reduce each patient’s risk profile. Things like quitting smoking and arriving on the day of surgery with an empty stomach helps to minimize anesthetic risks.
Any surgical risk in a properly prepared, healthy patient is very small, but I tell my patients, “It’s never zero”. The only way to have no risk is to have no surgery. As long as patients are well informed about their choices and comfortable with the surgical plan, the knowledge that risk factors exist does not prevent them from having the surgery that they wish. Our goal is to have every patient heal quickly and efficiently and have a happy outcome.