Stephen McCulley, Reconstructive and Aesthetic Surgeon. MBChb, FCS(SA)Plast, FRCS(plast)

Potential complications after breast augmentation — FAQs

What are the side-effects of breast enlargement surgery?

Although a high percentage of breast augmentation operations are extremely successful, you need to be aware of the possible risks and complications associated with the surgery. These are listed in the following table:

Infections

In the first few weeks following your operation it is possible that you could get an infection in your breast tissue. This will present itself with symptoms such as soreness, swelling and a fever. Consult your surgeon immediately for the best chance of successfully treating the infection with antibiotics. However, depending on the severity of the infection, it is possible that the implant may need to be removed so that the infection can be treated properly and to minimise further risks to your health.

Capsular contraction

A common problem with breast enlargements is when the body forms a layer of scar around the implant, causing scar tissue to build up around it over time. It can become firm. This can be uncomfortable or look different. In this situation, the surgeon can attempt to remove the scar tissue and usually change the implant. It is thought the most common cause is a very low-grade infection stuck onto the implant.

Sensitivity

The sensitivity of the skin on and around the breast and nipples can be affected after a breast enlargement operation. Some women find that their breasts are more or less sensitive after the procedure, in some cases this can be permanent, but for most women the sensitivity settles down over time.

Implant ruptures

Occasionally breast implants can leak — this happens when the implant splits or tears and the liquid inside seeps out. In the case of a silicone implant, it is very difficult to detect leakage, as the silicone leaks out very slowly. Regular MRI screenings or ultrasound are the only way to detect a rupture in a silicone implant. In most cases the silicone is held within the scar capsule and harmless. If it moves beyond the capsule it can cause lumps, discomfort and lymph glands to enlarge, however this poses minimal threat to your safety, but can be uncomfortable.

Wrinkling

The outer cover or shell of implants can sometimes be prone to wrinkling or folding. This can cause a rippling effect that can occasionally be visible on the sides of the breast. Most implants are likely to wrinkle or ripple a small amount. The effect of this is more commonly visible in thin patients.

New breast angst

Sometimes women who have wanted larger breasts for a long time find themselves disappointed once they have finally gone through with the operation. The surgeon may have misinterpreted the patient’s desires, or the patient may simply struggle to adjust to their new shape, causing what is called ‘new breast angst’. We would advise giving yourself time to acclimatise to your new breasts; it often takes a few weeks for the implants to settle into their final position. If, after a couple of months, a patient still felt uncomfortable and unhappy with her breast implants, we’d advise having a chat with your surgeon.

What are the warning signs of complications from breast implants?

As with all forms of surgery, the weeks following the operation are crucial for spotting the signs of any problems. Naturally there will be tenderness and some local swelling and bruising, but it is worth checking with your surgeon if you experience any of the following symptoms:

  • severe pain in either or both of your breasts
  • inflamed redness on the breasts
  • an intense burning sensation in the breasts that causes discomfort
  • excessive swelling on or around the breasts
  • deflated breasts
  • coloured discharge from your wounds or an unpleasant smell
  • a raised, feverish temperature
  • any excessive aching or unusual lumps

Will breast augmentation affect the sensation in my breasts?

Yes, for a little while, but this should return to normal. The swelling can cause pressure on the nerve endings in your skin which can result in numbness. Sensation should gradually return as your body heals.

How long will it take to regain normal sensation in my breasts?

Most patients find normal sensation returns within a few weeks. For others it can take three to six months, but for some patients it can take up to a year for their breasts to regain normal sensation. Don’t panic if it feels as though sensation isn’t returning quickly; but if you’re worried, mention it to your surgeon during your follow-up appointment.

Will breast augmentation affect the sensation in my nipples?

Yes, for a little while. Also, it’s common to have permanently less sensitive nipples following breast augmentation. This is due to the pressure on your nerves caused by the swelling, and in some cases where nerves have been cut during your incision.

This may be applicable if you had an incision around the nipple.

Will breast augmentation affect the sensation around the incisions?

Your incisions may feel numb as the nerves may also have been cut. This will heal in the weeks and months following the operation, with normal sensation eventually returning.

I have a burning sensation in my breasts. Is this normal?

Yes, it’s normal. A burning sensation following breast surgery is common, and it’s caused by the muscles and nerves being stretched. It should clear up on its own in time.

My breasts are itchy. Is this normal?

Yes, it’s normal to have an itching sensation after breast augmentation. It’s caused by your skin being stretched dramatically over the implants, similar to stomach skin in pregnancy. As your skin adapts and recovers from the stretching, the itch will go away. It can help to massage your skin before and after your surgery to help it recover its elasticity and soothe the itch.

I have a sensation of sharp shooting pains in my breasts. Is this normal?

Yes, this is completely normal. You will get these quite regularly in the few weeks following your surgery, and they can still happen even a few months afterwards. They should calm down and become much less frequent. If you’re still experiencing these pains from three to six months post-operatively, you should seek medical advice.

My breasts are feeling very hard. What does this mean?

It’s normal for the breasts to feel firm and tight for the first few weeks after breast augmentation — this is due to the swelling. However, if it’s been several weeks or months since your surgery, and the hardness is accompanied by a change in shape in one or both breasts, there could be a possibility of capsular contracture, so we’d advise going back to see your surgeon.

What are the risks of infection?

As with all major surgery and skin incisions, there is a small risk of infection. This risk can be lessened by following your surgeon’s post-op wound care sand aftercare instructions as closely as you can. If you do develop an infection, or have any unusual redness or swelling that doesn’t settle down, contact us or get medical advice.

What kind of scarring will I get?

This depends greatly on the type of skin you have, the quality of the surgeon, the location of your incisions, your aftercare and how your body heals, so it varies from person to person and is impossible to predict. However, as a general rule, normal wound healing would result in a shiny red scar that gradually lightens to a shiny white; slightly paler than your usual skin tone. Take a look at what breast surgery scars normally look like for a better idea.

What kind of scarring would be unusual?

Raised areas of scarring or large growths such as keloids would be considered unusual. Read more about this in our guide on what breast surgery scars look like.

How can unusual scarring be prevented?

Some of the measures you can take to minimise scarring after breast surgery include:

  • wearing a support bra
  • using creams and silicone treatments
  • massaging the area
  • drinking plenty of water
  • eating and living healthily

Read our guide on how to reduce scars after breast surgery for further advice.

What can be done to fix unusual scarring?

This depends on the type of scars you develop. Some can be treated at home with silicone tape or special scar treatment creams, massage or other moisturisers, but some may need surgical intervention to correct them. There are a number of different surgical procedures offered to minimise the appearance of unusual scarring. Talk to us for more information on how we can help.

What is capsular contracture and will I get it?

Capsular contracture is a form of scarring in the breast tissue surrounding the implant, which can then harden and contract. About 5% of women get it, but it can’t be predicted when it will occur. Capsular contracture can be corrected by removing the implant and the scar tissue, then reinserting the implant. You can read more about implant problems and the treatments for them here.

Will I get scar tissue inside my breast?

There is a chance this can happen with breast implants, yes. You may also get capsular contracture, though this is rare. However, many people also don’t get scar tissue inside the breast — it depends on the individual.

What if I have a weeping wound?

Your incisions should be under a dressing for the first few days (or up to a week) or covered with a surgical glue. If, after a week, your wound is still weeping, then ask your surgeon for further advice.

What if I have bleeding after my breast enlargement?

Your incision may bleed if you disturb the wound or open it up. This can be avoided by following your surgeon’s aftercare instructions on activity and exercise. If your incision starts bleeding again (either before or after the stitches have been removed), contact your surgeon for further advice.

What is a hematoma or a seroma?

A hematoma occurs when blood becomes trapped under the surface of a wound, it can look like a bruise and range from a small marble size to a tennis ball. Some haematomas are elongated along the site of the wound. Seromas are filled with clear fluid and feel like a soft lump with liquid under the skin.

Both hematomas and seromas need medical attention, even though in many cases the liquid in small seromas and hematomas is likely to be absorbed back into the body. Depending on the size and location, they will need to be checked with an ultrasound and possibly removed with surgery.

What happens if my breast implants leak?

This depends on the type of implant you have. If you have saline-filled implants, they may leak into the surrounding breast tissue. If this happens, you will need to have it drained and then the implant removed (and reinserted, if that’s what you want). If you have silicone gel-filled implants, the gel will often lie inert without leaking into the surrounding tissue.

What can cause a rupture or leak in a breast implant?

The most common reason why a breast implant may leak or rupture is wear and tear to the implant over time, causing the surface of the implant to break.

How will I know if I have a rupture or leak?

If one of your implants has ruptured you may experience a variety of signs and symptoms, depending on the type of implant used. If your saline implant has ruptured then one breast will seem smaller due to liquid leaking into the body, and you may even be able to see the edge of the implant shell. Silicone implant rupture can only really be properly diagnosed with an MRI or ultrasound scan as in many cases the implant will maintain its shape.

There are associated symptoms with ruptures in both saline and silicone implants which include redness and inflammation, pain and discomfort in the breasts, and/or lumps and bumps in the breast. See our guide on how to tell if your breast implant has ruptured for more information.

How can ruptures or leaks be prevented?

As the main cause of ruptures is wear and tear there is not a lot you can do to prevent this. Having good quality implants to start with obviously helps, and having your implants replaced after a period of time is important to minimise the risk of breakage through wear and tear. Manufacturers say that breast implants last for around 10 years on average, but some may need replacing sooner. For further advice on when you should have your implants replaced, speak to your surgeon.

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Potential complications after breast augmentation – FAQs