Plastic surgeons study extensively in their field of specialty, and are constantly learning and perfecting the latest techniques to minimize things like bleeding, scarring, and other complications. Choosing a surgeon who is Board Certified by the American Board of Plastic Surgery® or the Royal College of Physicians and Surgeons of Canada®, is the first key to minimizing your risks. Surgeons who belong to the American Society of Plastic Surgeons (ASPS) and the American Society for Aesthetic Plastic Surgery (ASAPS), also have specific, rigorous training. You should also make sure that your procedure is performed in an accredited hospital or surgery-equipped medical office. Those important first steps will get your breast implant journey started on the right foot.
General Surgery Risks
Even with a highly-trained, experienced surgeon, breast implant surgery comes with general risks. “It’s surgery, so that means you can have every surgical risk we can name, from bleeding to allergic reaction,” says Grant Stevens, M.D., F.A.C.S., medical director of Marina Plastic Surgery in Marina del Rey, CA. Whether you’re getting your gull bladder out, having a C-section, or having your ACL tendon repaired, there is a standard set of surgery risks, which your surgeon should review. General surgery risks can include:
• Reaction to the anesthesia (anesthesia problems include blood clots, breathing trouble, abnormal heart rhythm, brain damage, heart attack, stroke, temporary paralysis, and even death)
• Allergic reaction to any medications
• Bleeding
• Bruising
• Scarring
• Infection
• Pain
• Numbness
• Poor healing
The first set of risks can sound scary. “But there’s nothing unique there,” Dr. Stevens says. It’s the standard, and the serious risks are very rare—fractions of a percent, he says.
Implant-Specific Surgery Risks
The second set of risks apply more specifically to breast implant surgery. Again, your surgeon should go over these risks in detail, because they are directly related to implants. Specific risks include:
• Capsular contracture (the most common risk)
• Breast asymmetry
• Seroma (a build-up of fluid)
• Implant deflation or rupture
• Displacement of the implant (implant moving around)
• Skin wrinkling or rippling over the implant
• Implant extrusion (implant pushes through tissue and becomes exposed)
• Partial loss of nipple sensation
• Calcium deposits in the scar tissue
• Removal of the implant
It sounds like a long, frightening list. But keep it in perspective. “If you add up all of the combined risks, your overall risk is still incredibly small,” Dr. Stevens says. One thing that’s key to minimizing your risk is taking a detailed medical history. Your surgeon should be looking for any history that might raise a red flag. For example, obesity increases surgery risks. Previous allergic reactions would be a red flag as well. Smoking and alcohol use can increase healing time, and using certain medications can increase your risk factors as well. You should discuss all of these things with your surgeon ahead of time, and be honest and forthcoming about your medical history and health.
What’s Not a Risk?
Dr. Stevens likes to point out things that are not risks of implant surgery—but have been perceived to be. One of the biggest misconceptions is around the ability to breastfeed. “There is a percentage of women who can’t breastfeed for various reasons. That number isn’t impacted by implants. If you could breastfeed before implants, you can breastfeed after,” he says. (See our article TK about nursing after breast implant surgery).
There is also a lingering misconception about the safety of silicone implants—a discussion that should be put to bed, Dr. Stevens says. “There is still a vestige of the hysteria from 1992 [when the FDA put a moratorium on silicone implants that lasted until 2006]. But the science behind that has been shown to be junk science,” he says. In fact, silicone gel breast implants have been studied more than any other implantable device in the world, he says. The FDA’s Executive Summary of the Update on the Safety of Silicone Gel-Filled Breast Implants (2011), says: “There is no apparent association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems.”
Your surgeon is your best reference for understanding the risks of surgery. A healthy lifestyle and careful attention to pre- and post-operative instructions are your best tools for keeping the risks at bay, and enjoying your breast implants for a long time to come.