Reconstructive breast surgery is now more common than it used to be, with techniques and implants improving all the time, and the risk of complications reducing. However, there are still some risks connected with any type of surgery and a few that are particularly connected with breast reconstruction using breast implants. If you are worried about any of these possible problems, please talk to your surgeon.
Side effects and complications specific to breast enhancement surgery are rare, but may include: implant rupture/deflation, capsular contracture, infection, necrosis, haematoma/seroma, inflammatory reaction, extrusion, wrinkling and folds, interference with standard mammography, pain, breast feeding complications, change in breast sensation, dissatisfaction with cosmetic results, rotation, ptosis, distortion, calcification, tissue atrophy/chest wall deformity, gel diffusion, adulterated fill, inadequate tissue flap, and deformation.
Rupture
If the outer shell of a silicone breast implant breaks (this is called implant rupture), the gel usually stays in the area around the implant, and on rare occasions very small amounts of silicone might move into other parts of the body. This migration of silicone is diminished with improved modern implants, and current research does not indicate any adverse effects from this ‘free’ silicone gel, except the presence of some local enlarged lymph nodes. In some cases rupture might be ‘silent’ and not cause any symptoms. However, most surgeons recommend that a ruptured implant is removed.
Gel leakage
In rare cases, minute quantities of silicone might diffuse through the shell of gel-filled implants. However with the advance of implant technology and shell design such as barrier coating, gel diffusion is drastically reduced. If gel did leak out, it would mostly be contained by tissue that the body forms around the implant which helps prevent the gel from seeping into surrounding tissues. Leakage of a small amount of silicone rarely causes problems and usually does not require any action. If there is a lot of leakage, your surgeon may recommend further surgery.
Deflation
This can occur with saline implants immediately or slowly over a period of time and is noticed by loss of size or shape of your breast. Causes of deflation include damage during surgery, capsular contracture, trauma or intense physical manipulation and unknown/ unexplained reasons. A deflated implant requires additional surgery to remove and to possibly replace the breast implant.
Rippling of the breast implant
Visible rippling may occur with implants.
Capsular Contracture
When any foreign body, such as a breast implant, is put into your body, your immune system responds by forming fibrous tissue (a capsule) around it. Within the natural healing process, this fibrous tissue might contract. This is known as capsular contracture. If this contraction is severe, you may have tightening, hardening, and changes in the shape of the reconstructed breast, which may be uncomfortable.
In many patients, contractures will never occur. In other patients contractures can occur weeks or years after implantation, as the body’s response to any foreign object varies greatly from person to person. How much the capsule will contract, if at all, is hard to predict. In some cases, correction of capsular contracture may require surgical intervention and it is possible for capsular contracture to reoccur. Nevertheless improvements in breast implant design, especially with textured implants, and surgical techniques have contributed to reduce the rates of capsular contracture.
Reoperation
Additional surgery to the breast and/or implant will likely be necessary over the course of their life. You may decide to change the size or type of implant, requiring a reoperation, or you may have a reoperation to improve or correct your initial surgical outcome.
Breast Implant Removal
Breast implants have a limited lifetime and the implant may have to be removed or replaced which may necessitate revision surgery. Various factors, including the type of implant inserted, the type of surgery, injury to the breast, and excessive repetitive compression of the implant, may impact the longevity of the implants.
Pain
As expected following any invasive surgical procedure, pain of varying intensity and duration may occur following breast implant surgery. Very occasionally, severe pain associated with arm movement has been reported. If you have any pain following surgery, you should contact your surgeon or doctor for prompt investigation.
Changes in the Nipple
It will not be possible to preserve the nipple if there is any possibility that it may contain cancer cells. Although it is possible to reconstruct the nipple, it is important to note that reconstructed nipples usually have no sensation; you can discuss this with your surgeon, who can advise you what your options are.
Infection
Infection is possible in any operation. If you develop an infection you will need to see your doctor as soon as possible and you may need to have a further operation to remove the implant or tissue expander until the infection has cleared and then replace your implant. Although most infections can be treated successfully, infections can cause serious problems and may result in increased scarring. In a small number of cases these infections may come back.
Dissatisfaction with Cosmetic Results
Scar deformity, hypertrophic scarring, capsular contracture, asymmetry, displacement, incorrect size, unanticipated contour, palpability, and sloshing (Natrelle™ 150 and saline-filled implants), may occur. In some cases, cosmetic concerns may also lead to medical concerns. Careful surgical planning and technique can minimise, but not preclude, the risk of such results. Pre-existing asymmetry may not be entirely correctable. Revision surgery may be indicated to maintain patient satisfaction but carries additional considerations and risks. If the patient is dissatisfied with the cosmetic result, revision surgery may be indicated; the device can be replaced with another device of different height, width, projection, volume, shape or filling, or may be placed in a different position in order to achieve a cosmetic result which is more pleasing to the patient.
Allergic reaction to anaesthetic
Nobody knows exactly how frequently anaesthetics cause allergic reactions. At the moment, the best estimate is that a life-threatening allergic reaction (anaphylaxis) happens during 1 in 10,000 to 1 in 20,000 anaesthetics. Your anaesthetist will choose the drugs for your anaesthetic by taking into account many different factors, in particular, the type of operation, your physical condition and whether you are allergic to anything.
Most people make a full recovery from anaphylaxis. It isn’t known how many anaphylactic reactions during anaesthesia lead to death or permanent disability. One review article suggests that 1 in 20 serious reactions can lead to death. This would mean that the chance of dying as a result of an anaphylactic reaction during anaesthesia is between 1 in 200,000 and 1 in 400,000 anaesthetics.
Nerve damage
It’s possible, but highly unlikely, that you could suffer nerve damage after a general anaesthetic. The size of the area may vary according to the nerves affected, from a very small patch of numbness, tingling or pain, to most of a limb. The pain can be a continuous, aching pain or a sharp, shooting pain. You may also get inappropriate warm or cold sensations. If motor nerves are damaged, there may be weakness or paralysis (loss of movement) of muscles in that area. The risk of a significant peripheral nerve injury lasting more than 3 months is estimated to be less than 1 in 2,000 patients having a general anaesthetic. Permanent damage, lasting more than a year, is estimated to occur in less than 1 case in 5,000.
Poor wound healing
Wound healing may take longer in cases of infection, bleeding, fluid accumulation, overly tight stitches, over-large implants, improper support during healing, and pressure against the scar tissue.
To avoid poor wound healing, your surgeon may recommend that you wear a sports bra for approximately 5 months after surgery. Your physician can direct you to specialised bras that are also available. Wound healing may also take longer in patients who have diabetes or who smoke.
Potential general effects on health
There has been some controversy about the use of silicone gel-filled implants and their possible influence on developing autoimmune diseases such as connective tissue diseases (CTDs). CTDs are chronic inflammatory autoimmune disorders which can affect all connective tissues, i.e. joints, skin, muscles, and blood vessels, and therefore have multiple effects on many different organs throughout the body.
Several large studies have failed to establish a link between breast implants and well-defined CTDs. Even though few studies have been carried out, current literature suggests that there is no association between breast implants and connective tissue disease-like syndromes (atypical connective tissue diseases). Moreover, it is difficult to define atypical connective tissue diseases. These diseases seem to occur at the same rate in women with or without breast implants, which makes it difficult to conclude whether breast implants play a role in the development of such diseases. If you have any concerns, you should speak to your surgeon.
Our breast implants are backed by a replacement policy. So for peace of mind, be sure to review our NatrellePLUS™ Warranty.