Complications of Breast Augmentation

Reviewed by Michael Olding, MD, FACS

Breast augmentation can be a complex surgery, and complications may occur. More invasive surgery can mean more risk, and longer breast augmentation recovery time. As a general rule, the more invasive a procedure is, the greater the risk.

Before you have breast enlargement surgery, discuss possible complications with a board-certified plastic surgeon who has experience performing breast augmentation. Risk can be reduced by choosing a skilled, experienced plastic surgeon to perform the procedure and by carefully adhering to the surgeon's instructions, both before and after the surgery. Start the process now.

Some breast augmentation risks include:

Infection

If infection occurs, it's usually within days or weeks of surgery. In rare cases infection can occur long after breast surgery — even when the incisions are completely healed. The earlier an infection is diagnosed and treated, the better the outcome. In severe cases it may be necessary to remove the implant until the infection subsides. (It can be replaced at a later date.)

Asymmetry

Asymmetrical (uneven) breasts can occur following breast augmentation for a variety of reasons, including uneven healing. One solution is fat transfer breast augmentation, which uses injections of your own fat to make your breasts appear more symmetrical. This procedure can also be used after breast reconstruction, for the treatment of tuberous breasts or for a modest (less than one cup size) enhancement.

Bottoming Out

Bottoming out is a complication that occurs when the implant rides too low in the breast tissue, causing the nipple to point upwards. Correction for bottoming out involves breast augmentation revision surgery that re-creates the pocket(s) within the breast that holds the implant(s).

Double Bubble

Double bubble breast deformity is a postsurgical complication that occurs when one or both breast implants drop down below the inframammary crease (the fold where the breast meets the chest), creating an indentation or line across the lower part of the breast. This "four-breast effect" may correct on its own; if not, revision breast augmentation surgery can be performed.

Synmastia

Synmastia refers to the breasts being too close to each other. Surgery may be needed to correct synmastia.

Capsular Contracture

Capsular contracture, or breast hardening, can occur anytime after surgery, typically within a few months. A capsule created by scar tissue compresses the implant, causing it and the breast to look distorted. In the most advanced cases, the implant can feel hard and misshapen. The implant itself has not changed or hardened, but the capsule squeezing the implant has caused it to feel as though it has. Visit our article on capsular contracture for more detailed information on this complication.

Anaplastic Large Cell Lymphoma

Breast implants may increase a woman's risk for a rare blood cancer called anaplastic large cell lymphoma (ALCL). So far there have been 60 reported cases of ALCL among 5 to 10 million women with breast implants worldwide. Though small, this number is striking given the rarity of this cancer. The Food and Drug Administration is now creating a national registry of ALCL cases linked to breast implants. This cancer does seem to be less aggressive when linked to breast implants than when found in the absence of implants. Treatment often only entails breast implant removal. Symptoms may include pain, swelling, asymmetry and/or lumps. Talk to your breast surgeon, gynecologist or primary care doctor if you are concerned about your risk for ALCL. For the latest information, visit our article on ALCL and breast implants now.

About the Reviewer of This Article

Michael Olding, MD, FACS, of Washington, D.C. is board-certified in plastic and reconstructive surgery by the American Board of Plastic Surgery and is a member of the American Society of Plastic Surgeons, the Northeastern Society of Plastic Surgery and the National Capital Society of Plastic Surgeons, where he was elected president. Dr. Olding specializes in cosmetic plastic surgery procedures and clinically related activities in cosmetic surgery, cosmetic facial surgery, breast augmentation and reduction, rhinoplasty, body contouring, liposuction and melanoma. He is also one of the area experts on soft-tissue fillers (Restylane, Sculptra and Botox). He received his doctorate in medicine from the University of Kentucky in 1980 and completed his internship at Cornell Medical Center. He completed his fellowship in plastic and reconstructive surgery at McGill University in Montreal. Dr. Olding maintains hospital staff privileges at George Washington University Medical Center, Sibley Hospital and Children's Hospital in Washington, D.C. More about Dr. Michael Olding