Breast Implant Risks and Side Effects What to Ask Your Doctor
Reviewed by Walter Erhardt, MD
From mammography (breast X-ray) and breast-feeding considerations to implant rupture and other potential complications, breast augmentation with implants is associated with a number of potential risks.
It is important to be aware of breast implant side effects, how to prevent them (where possible) and what to do should they occur.
Many women with breast implants can breast-feed, but in some cases breast implants may interfere with breast-feeding.
Discuss your thoughts about breast-feeding with your plastic surgeon in advance of your surgery date. This information may affect your choice of incision and implant placement. For example, a periareolar incision (around the edge of the nipple) may disturb your milk ducts. In addition, placing implants below the chest muscle is least likely to disturb the milk ducts and may be an option if you plan to breast-feed. Be open with your surgeon regarding your future plans and desires.
Breast implants can make it slightly more difficult to read a mammogram. This should not be taken as a reason to skip your annual breast cancer screening exam. Mammograms are the best way to detect breast cancer when it is in its earliest and most treatable stages. This is true regardless of whether or not you have breast implants.
Additional views called Eklund displacement views may be required if you have breast implants. Tell the personnel at the breast imaging center about your implants when you make the appointment so they can schedule the extra time for Eklund displacement views.
Your plastic surgeon may be able to refer you to a center that sees many women with breast implants. Remind the technician about your breast implants at the time of your mammogram. On rare occasions, mammograms may cause implant rupture.
Anaplastic Large Cell Lymphoma
Recently a question has been raised about a possible connection between breast implants and risk for anaplastic large cell lymphoma (ALCL), a rare lymphoma (blood cancer) that affects white blood cells called T cells. ALCL may occur in the capsule of scar tissue that forms around the implant. The Food and Drug Administration is now developing a registry to get a better handle on this potential risk. To date, there have been 60 reported cases of ALCL worldwide among the 5 to 10 million women who have received breast implants for cosmetic or reconstructive reasons. Reviews of the cases include both saline- and silicone-filled breast implants as well as textured and smooth implant surfaces. The most common presenting symptom is the development of a seroma (accumulation of fluid) around a breast implant, but not all seromas are ALCL. Treatment involves implant removal, although some women may require more aggressive therapy. For the latest information on this emerging risk, visit our article on breast implants and ALCL now.
Loss of Sensation
After breast surgery with implants, you may experience some loss of sensation in your nipple and breast area. This results from damage to nerve endings in the breast and nipple. The loss of sensation may become permanent. Certain breast augmentation techniques may confer a higher risk of this complication than others. Your surgeon can determine the most appropriate implant type and surgical technique to reduce your risk of this breast sensitivity side effect.
Capsular contracture occurs when scar tissue forms a capsule that compresses the implant, causing it to become hard and misshapen. This can occur any time after your breast implant surgery. It is close to impossible to predict who will develop capsular contracture, but risk factors may include breast trauma or not having a sufficient amount of skin to cover your implant. Surgery is often needed to correct capsular contracture.
Occasionally, one or both of the breast implants shift below the fold where the breast meets the chest (inframammary crease), creating a line or indentation across the bottom of the breast. This double bubble breast augmentation complication can occur if the implants are too large or if they are poorly positioned. Double bubble is rare and can be corrected with revision breast surgery.
Leaking or Leaching of Breast Implant Material
If a saline breast implant leaks, the saltwater solution is seamlessly and harmlessly absorbed by your body. If a silicone gel-filled breast implant leaks, local complications such as hardening or scarring of breast tissue may occur. There is, however, no risk of the silicone gel migrating outside of the breast and causing systemic disease.
Breast implants can break or rupture, resulting in deflation. Ruptures can occur for many reasons, including the natural aging of the implant, excessive compression or trauma to the breast. If rupture occurs, the size and shape of your breast may change. Typically, implant removal with replacement or another type of surgery is required if your breast implant ruptures.
Alternatives to Breast Implants
If you are interested in breast augmentation but want to avoid implants, there are alternative procedures. Ask your surgeon if you might be a candidate for auto augmentation, a procedure that uses a woman's existing breast tissue to enhance projection.
Another option is fat grafting breast augmentation. In this procedure, the surgeon uses liposuction to remove fat from one part of your body, such as your hips, buttocks or stomach, and inject it into your breasts. Fat transfer is used to enhance the appearance of the breasts following breast reconstruction or lumpectomy, to correct a deformity or to refine the results of augmentation with implants. It is not currently a primary breast augmentation procedure.
Auto augmentation and fat grafting are not without risks of their own, including infection, bleeding, anesthesia complications and dissatisfactory aesthetic results.
Ask Your Surgeon
Whatever procedure you choose, discuss possible side effects with a board-certified plastic surgeon who has experience in breast augmentation. Ideally, breast implant risks should be discussed during your initial consultation and any preoperative visits. Start this process now.
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