As with every surgery, there are many risks and complications that can occur. Your surgeon will explain breast implant risks, and it’s important that you follow your surgeon’s aftercare guidance to optimise your recovery.
Some breast implant risks include loss or changes in breast sensation, asymmetry, bruising, swelling, scarring, inflammation, redness, infection, bleeding, soreness and pain. Your surgeon will advise you of the post-recovery process and elaborate on some of the more common risks, as well as discussing potential rarer risks.
In what’s known as the ‘drop and fluff’ process, breast implants will begin to soften as the chest tissues stretch, and the implants settle in their pocket into their final position. This process can take several months and is normal. Until then, the breasts may remain firm and sit high on the chest and may look unnaturally full in the upper pole of the breast.
The ‘drop and fluff process’ happens whether you have saline or silicone, or round or teardrop implants, but you could expect that textured implants will drop less than smooth implants.
Breast implants placed partially under the muscle take longer to settle than those placed over the muscle. It’s also not uncommon for one breast to drop faster than the other.
The ‘drop’ refers to when the skin stretches and the muscles start to relax, causing the implants to shift downward and outward. The ‘fluff’ refers to when the implants fill out the lower pole of the breast, taking on a more natural teardrop shape. Your surgeon may recommend that you wear a breast band or strap and give you breast massage techniques to practice during this phase.
If you’re worried about how high the breasts are riding or the breasts appear particularly tight, you may have developed capsular contracture.
A capsular contracture can present itself at any point after a breast enlargement surgery, though usually occurs within the first two years of the operation. This concern develops as scar tissue starts to develop around the implant.
A capsule will develop around all implants, but in some cases, it can become problematic and become firmer and painful. Just one breast may be affected, but it can also happen to both.
There will be signs and symptoms that may indicate whether a capsular contracture is developing and how severe it is. Early signs are usually firmness, but if the breast starts to become distorted and painful, it may require surgery.
Your capsular contracture will be graded depending on its severity, but if it’s not too late, merely massaging the breast daily may reverse and prevent it from worsening.
If you do require surgery, a capsulectomy will be performed. There are varying degrees and approaches to this revision operation which will depend on your situation. The general approach is that the scar tissue will be released, the capsule will be removed, and the implant will be replaced. If you do not wish for the implant to be replaced, you may desire a breast lift.
It’s possible that a capsular contraction can reoccur, though several possibilities and factors can influence this that are not within the patient’s or surgeon’s control. Your surgeon may recommend certain steps and adopt a specific approach to minimise risks.
Despite the excellent quality of many implants, there’s still a possibility of unexpected rupture when the implant tears or splits which can cause the breast to shrink, change shape, or size. Silicone implants pose more significant risks as the body generally doesn’t tolerate silicone well. As a result, patients can develop granulomas and lumps, or their breasts may deflate (saline) and reduce in size. On the other hand, saline will be metabolised by the body and will pass as urine.
Most reputable clinics prefer to avoid silicone implants. At 111 Harley St., we use a ProgressiveGel Ultima Silicone Gel that reduces many risks.
Rippling of the skin on the breasts or seeing the implants through the breasts can occur when the skin is weak and is unable to support the implants. Such instances can occur when the implants are too large, and it’s more common when implants are placed over the muscle. Palpability can also occur when there was a lack of pre-existing breast tissue. You may feel the ripple of the implant, or even be able to see it if your skin is thin or has a loss of elasticity. Your skin may be more prone to a loss of elasticity with weight fluctuations, pregnancy, ageing and genetics.
Bottoming out occurs when the implant drops below the natural breast crease producing an unwanted line. It’s more likely to occur when implants are placed over the muscle. Pregnancy increases the risks of these occurrences, as well as for opting for an implant that is too large.
Bottoming out and the double bubble effect can usually be differentiated because with ‘bottoming out’, the nipple or areola might be visible above the bra or bikini.
This complication can look similar to ‘bottoming out’, however, it occurs when the implant is pushed upwards or if the pocket is not strong enough to support the implant and the breast tissue sits below the implant giving the appearance of two breasts or breast folds.
The pocket for the implant may have been made below the existing inframammary fold, and the weight of the implant creates a new fold whereby there is skin or a ‘bubble’ poking out in between the two folds.
Smooth implants can be more prone to displacement. Textured implants feel a little firmer and can be both round or teardrop-shaped. The texture helps the implant adhere better to the breast tissue. Using a textured implant reduces the risk of capsular contracture and ‘bottoming out’. The type of implant we often use at 111 Harley St. has a nanotexture which means it has the benefits of the textured implant but is less prone to displacement, and some of the implants we use can rotate freely.
If the incisions don’t heal well, it’s possible to develop necrosis or extrusion of the implant. Both wound healing problems can occur when the implants are too large, or the skin is too thin, and they put unnecessary strain on the skin leading to an infection. Necrosis refers to the accumulation of damaged breast tissue that usually results from injury.
Extrusion can occur due to necrosis (death of the tissue), or when there are wound healing issues. It’s a relatively rare risk and causes the implant to become exposed through the skin or incision.
It’s important to follow your surgeon’s guidance following surgery to minimise breast implant risks and wound healing problems.
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