Risks of breast augmentation

Nowadays, breast augmentation is a routine procedure. Nevertheless, as with any surgery, some risks and complications can not be completely ruled out. In general, there are two types of risks:

  • Risks for complications occurring during breast surgery (intraoperatively)
  • Risks for complications that occur after the operation (postoperatively)

The postoperative complications are in turn subdivided into early complications, late complications and aesthetic problems.

Intraoperative risks

Breast augmentation is usually performed under general anesthesia, which is why the usual anesthesia risks have to be reckoned with, which the anesthesiologist explains in a previous consultation. Since breast augmentation is performed only in patients with a stable general condition and the duration of surgery is relatively short, this risk of complications is very low.
During breast augmentation there is always the risk of injuring surrounding structures (eg sensitive nerve fibers). The most common intraoperative risk associated with breast augmentation is the injury to the pectoral muscle that occasionally occurs in the positioning of the breast implant.

Postoperative early complications

In the early phase after surgery, there is a risk of rebleeding and bruising (hematoma). Furthermore, wound infections can occur as after any surgical procedure. The wound infection may be superficial, which then shows as redness over the wound. For superficial wound infection frequent dressing changes and under certain circumstances the administration of an antibiotic to avoid (prophylaxis) of a deep wound infection should be done. In rare cases, it can also lead to a deep wound infection with abscess formation, which may require removal of the implants.

Postoperative late complications

The most significant and common complication of breast augmentation is capsular contracture. Studies have shown that 90% of capsule fibrosis occurs within the first year after surgery.

In capsular fibrosis, the body forms a connective tissue envelope (capsule) around the inserted implant as a foreign body reaction, regardless of the type of implant. This capsule may harden, which in turn may lead to implant deformation and may require surgical intervention to dislodge the capsule or even removal of the implants.

Although breast implants can withstand extreme stress today, there is always a risk that the implants may be damaged by greater external exposure (eg in a car accident) and require reoperation.

Aesthetic problems

After breast augmentation there is always the risk of a wound healing disorder. In particular, in women who are used large implants in relation to the breast volume, the risk for the emergence of the seam (seam dehiscence) is increased. Despite wound plasters and pressure bandages, seam scar can leave behind a noticeable scar. Permanent tension or pressure can also cause stretch marks on the chest.

Among the risks of breast augmentation, the different forms of dislocation and deformities of the implants must be mentioned. The breast implants may rotate over time or shift longitudinally or transversely, for example. Often it comes after a breast augmentation for implant wrinkling ( Rippling ). This means that there is a wrinkling of the breast implants, which is both visible and palpable. The so-called waterfall deformity occurs especially in patients with flabby skin. Although the implant sits correctly, the tissue moves down over the implant so that two arches appear in the profile. Even with the double bubble phenomenon, there is a double contour on the chest after surgery. In contrast to the waterfall deformation, however, the second arch is between the nipple and the lower breast crease instead of the nipple.

In addition, bottoming-out is still a risk of breast augmentation. The breast implants hang down here, so that the nipples are raised. This occurs especially in patients with small breast tissue. In general it can be said that these deformations and dislocations of the implants are not dangerous, but significantly reduce the aesthetic result of the procedure.


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