Breast augmentation is one of the most popular cosmetic procedures performed today. It can provide remarkable improvements in breast size and shape for women unhappy with their natural breasts. However, like any surgery, it does carry risks. If mistakes are made during the procedure, it can lead to unsatisfactory results or serious complications. Understanding the potential problems can help you make an informed decision and choose your surgeon wisely.
All surgeries involve some inherent risks, even when performed by the most skilled and experienced surgeons. With breast augmentation, potential surgical risks include:
- Bleeding – This can occur during or after surgery and may require a return to the operating room to drain accumulated blood.
- Infection – Bacteria can be introduced during surgery and grow in the breast pocket or around the implant, requiring IV antibiotics or implant removal.
- Poor wound healing – Some patients are prone to thick, raised scars called keloids. Smokers also have a higher risk of wound healing problems.
These risks are relatively low with an experienced, board-certified plastic surgeon. However, they demonstrate how even proper surgical technique can result in complications.
Breast augmentation is performed under general anesthesia to keep you comfortable and pain-free. As with any anesthesia, potential risks include:
- Negative reactions – Some patients may have nausea, vomiting or dizziness from anesthesia drugs.
- Breathing problems – Improper airway management can lead to oxygen deprivation.
- Blood pressure changes – Anesthesia can cause blood pressure fluctuations.
A certified anesthesiologist monitors you closely throughout surgery to minimize anesthesia risks. Still, no anesthesia is completely without risk.
Implant placement errors
The plastic surgeon must create precisely sized pockets under each breast for the implants. Mistakes in forming the pockets or placing the implants can happen if the surgeon lacks skill and experience. Potential errors include:
- Implants placed too high – This gives an unnaturally round, buoyant look to the upper breast.
- Implants offset – When implants are not evenly centered under each nipple, it looks lopsided.
- Different levels – If one implant rides higher than the other, it appears imbalanced.
- Muscle damage – Improper dissection can damage the pectoral muscles moving the implants.
These types of surgical errors may require a revision surgery to re-center and reposition the implants properly. Choosing a board-certified plastic surgeon who specializes in breast augmentation can help avoid placement mistakes.
Implant selection errors
Breast implants come in a variety of shapes, sizes and surface types. Selecting the wrong implant style or size can lead to a visible error after surgery. Examples include:
- Overly large implants – Implants that are too big for the breast width create obvious augmentation with rippling and poor proportions.
- Small implants – Many women are disappointed with implants that end up smaller than they desired.
- High profile mistake – Using extra-projected implants on wide breasts gives a spherical look.
- Smooth versus textured – In some cases, the wrong surface type causes visible wrinkling or distortion.
Careful preoperative planning and implant sizing helps prevent selection errors. However, the only way to fix these issues is a replacement surgery to swap out the implants.
The breast pocket created to hold the implant naturally forms a lining called a capsule around the implant. In some cases, this capsule tightens and squeezes the implant, resulting in:
- Hard, painful breasts
- Misshapen breasts
- High-riding implants
- Distorted nipples
This complication, called capsular contracture, occurs in up to 18% of breast augmentation patients. Moderate contracture requires closed capsulotomy to break up the scar tissue. Severe contractures need surgery to remove and replace the capsule and implant.
Implant rupture and deflation
Although rare, breast implants can sometimes leak or rupture. Saline implants deflate quickly, causing the breast to change shape and size noticeably. Silicone implant leaks may go undetected without MRI screening. Ruptured implants require surgery to remove and replace them.
Implant rippling or wrinkling
If the implant is too large for the breast pocket, the edges of the implant can be visible under the skin. Wrinkling and rippling along the sides or bottom of the breast are signs the implant may be overfilled or the wrong size. Underfilled saline implants can wrinkle at the top as they deflate. Fixing visible rippling or wrinkling requires replacing the implants.
Visible implant edges
Implants that are too large or inserted improperly can sometimes be felt along the collarbone, sides of the breasts or other areas. The implant edges create visible bulges or ridges under the skin. Revision surgery can reposition the implants or exchange them for smaller options to correct visible implant edges.
Changes in nipple/breast sensation
Breast augmentation may damage sensory nerves, causing numbness, hypersensitivity, lost nipple sensation or erotic nipple sensation. Most sensation changes resolve fully within 6-12 months. However, some loss of sensation or numbness could be permanent.
Over time, the weight of breast implants can cause them to shift lower on the chest. When implants drop too low, they create an excessively rounded bottom of the breast and add sagging. This bottoming out requires a breast lift (mastopexy) to raise and reshape sagging breasts after augmentation.
If the implants are placed too close together, it can merge the breasts in the middle of the chest rather than creating cleavage. This complication is called symmastia or a “uni-boob” effect. Repositioning the implants farther apart and using larger implants may correct symmastia.
After breast augmentation, fluid can accumulate in the empty space left by surgical dissection. This seroma may need to be drained repeatedly with a needle until the space seals over naturally. Seromas typically resolve fully without surgery.
While relatively safe and straightforward, breast augmentation surgery does carry risks ranging from minor complications to serious errors that may require revision surgery. Choosing an experienced, board-certified plastic surgeon known for beautiful breast augmentation results is the best way to minimize risks and avoid mistakes during your surgery. Being fully informed about the potential problems helps you have realistic expectations for your surgical outcome.
Frequently Asked Questions
Can too large of implants cause problems?
Yes, very large implants that are disproportionate to your natural breast width can cause major problems. Oversized implants may:
– Look obviously fake with visible rippling/wrinkling
– Create a tight, painful capsule contracture
– Stretch the overlying skin excessively
– Cause nipple flattening or displacement
– Require premature removal/replacement due to excessive weight strain
The best approach is choosing an implant size proportional to your underlying breast dimensions.
What is double bubble deformity?
A double bubble refers to visible crease or indentation along the lower curve of the augmented breast. It occurs when the implant drops too low on the chest, creating an unnatural lower breast fold. Fixing double bubble requires lifting the implants back into position and tightening loose breast tissues.
Can incorrectly placed implants rupture easier?
Yes. Improperly positioned implants that are squeezed in too small a pocket or contorted into the wrong shape experience excessive pressure. This can cause the implant shell to weaken and rupture over time. Properly placed, natural-looking implants maintain their integrity better.
Should I massage my breasts after augmentation?
Gentle breast massage 2-3 weeks after surgery can help break up mild scar tissue to prevent capsular contracture. However, excessive massaging too early may cause bleeding or implant displacement. Follow your surgeon’s specific instructions for breast massage to avoid complications.
When do complications appear after breast augmentation?
Early complications like bleeding, poor healing and infection normally occur within the first 2-6 weeks after surgery. Capsular contracture and implant rupture may happen later at 6 months to 2+ years post-op. Anatomic problems like symmastia, bottoming out and implant displacement can occur months to years after the procedure as well.
Can smoking affect breast augmentation results?
Absolutely. Smoking severely slows healing after any surgery by constricting blood vessels. Following breast augmentation, smokers have higher rates of capsular contracture, implant leaks and infections due to poor tissue healing. Quitting smoking for at least 2 months pre-op and post-op is recommended.
What are sings of infection after breast augmentation?
Symptoms of a serious infection after breast augmentation include:
– Increasing breast pain/swelling
– Redness spreading from the incision
– Pus or foul-smelling drainage
– Flu-like muscle aches
See your surgeon immediately if you notice these warning signs of infection.