Medically reviewed by Dr. John Rosdeutscher – Written by Sine Thieme
How Safe Is a Breast Augmentation?
Breast augmentation surgery is, and has been for many years, the most popular cosmetic procedure in the United States (over 300,000 procedures per year, with dips in 2020-2021 due to the pandemic). It is a routine operation for plastic surgeons, typically performed under IV sedation, with a relatively easy and swift recovery.
What’s different for breast augmentations vs other cosmetic surgeries is the use of implants. Both saline and silicone implants are FDA-approved for use in breast augmentations, but there are some differences worth pointing out. Below we go over the risks and side effects of breast augmentation surgery as well as the breast implants themselves.
Are Breast Implants Safe?
Let’s talk about the implants first – after all, without implants there is no breast augmentation! Should you get breast implants? Is saline or silicone safer? A particular style? How and when do I need to get monitored after surgery? Let’s tackle all these questions about breast implant safety.
There are two general classes of breast implants: silicone gel-filled, and saline-filled. Both are FDA-approved and considered very safe for use in breast augmentations.
Saline Implant Safety
Saline breast implants are FDA-approved for the use in cosmetic breast augmentation in women age 18 and older (there is no age restriction for reconstruction surgery). They are a very safe implant choice because they are filled with a harmless solution. All implants are at risk of rupture, but in the case of saline implants the only consequence is the leaking of sterile saltwater into the body, which is harmless and easily absorbed and expelled.
Monitoring: A woman with a ruptured saline implant is immediately aware of the situation by the change in breast size, making the use of any additional monitoring unnecessary. This event is also called deflation of the implant.
Silicone Implant Safety
Silicone breast implants are FDA-approved for women age 22 and older (also with an exception for reconstruction surgery at any age). The FDA restricted the use of silicone implants in cosmetic surgeries between 1992 and 2006 to allow for further research of any potential connection to disease. Upon extensive studies it found no connection and subsequently reinstated silicone implants for use in breast augmentations of all kinds.
Monitoring: A woman with a ruptured shell of a silicone implant is typically unaware of the situation. This event is called a silent rupture and undetectable by looking in the mirror or even a physical evaluation. As of 2021, the FDA requires additional monitoring to detect silent ruptures. The FDA requires an MRI or ultrasound at 5-6 years after implantation, then every 2-3 years. To make this easy for our patients, NuBody Concepts is equipped with the necessary devices to perform this monitoring service for breast augmentation patients in Nashville and Memphis.
Structured Implant Safety
Also known by its brand name IDEAL, the structured implant belongs in the saline implant category. It was FDA-approved for use in breast augmentations in 2014 after being developed and extensively tested with the clinical expertise of plastic surgeons.
Possible Complications and Side Effects
Like any surgical procedure, breast augmentation surgery has its own risks and complications, but it doesn’t mean they are a particularly risky procedure compared to other surgeries. It should also be noted that breast implants are not meant to be lifetime devices. The longer you have implants, the more likely it is that you may experience complications.
Some of the risks and adverse outcomes include:
- Pain & sensation: Breast pain, pain in the chest wall, changes in nipple and breast sensation, or pain and bleeding at the incision site
- Capsular contracture: This happens when the scar tissue around the implant thickens and squeezes the implant
- Wrinkling or rippling of implant: This is more common for saline implants and the least common for highly-cohesive gel implants.
- Implant rupture and deflation: A ruptured implant is not dangerous. Saline implants deflate, whereas a silicone implant rupture might go undetected, which is why the FDA requires regular monitoring. In either case the implant should be removed or replaced.
- Breast feeding: For some women, breast surgery may affect the ability to breastfeed, although in many cases women are able to breastfeed safely and normally with breast implants.
The FDA has not identified any connection between any type of breast implant and connective tissue disease, breast cancer, or reproductive complications.
However, the FDA has identified an association between breast implants and a very low but increased likelihood of being diagnosed with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). This is a type of non-Hodgkin’s lymphoma that can develop in the fluid or scar tissue around the implant. Please note that this is a cancer of the immune system, not breast cancer.
Furthermore, BIA-ALCL occurs more frequently (though still rare) in patients who have breast implants with textured surfaces than those with smooth implants. Learn more about BIA-ALCL on the American Society of Plastic Surgeons website.
General Risks of Breast Surgery
All surgical procedures carry a risk of complications, no matter what the procedure. This is also true for breast augmentation surgery. Below we briefly outline those risks that are not specifically associated with implants (which we’ve addressed above).
Any healing of an open wound can result in infection, potentially causing persistent pain, abnormal swelling or redness, skin that feels warm to the touch, and fever. If any of these symptoms appear after your surgery, call your surgeon’s nurse or after hours line for advice.
Hematoma are caused by excessive, uncontrolled bleeding under the skin. It is important to disclose all your medical history to your surgeon so that certain medications and supplements you may be taking can be avoided, and to otherwise carefully follow the pre-op instructions you are given.
Adverse Reaction to Anesthesia
Nausea and dizziness are very common symptoms following the administration of anesthesia. Typically these go away within a day of surgery, but some patients may experience longer-lasting symptoms. Smokers are especially susceptible to adverse reactions to anesthesia of any kind.
Loss of Sensation
A temporary change or loss of sensation may occur in or around the surgical site, especially around the nipples. This typically resolves over time but in rare cases can be permanent.
Asymmetry or other Unsatisfactory Results
The rate of satisfaction with breast augmentation is generally very high with a 97% “worth it” rating on Realself. However, all cosmetic surgery may result in asymmetric outcomes, particularly since no body is perfectly symmetrical. Volume differences can be most easily adjusted in saline implants with the simple injection of more or less saline. It is also possible to get different sizes of silicone implants to adjust for preexisting asymmetry.
Preparing for Your Breast Augmentation
Before Your Surgery
Before you decide to have breast augmentation surgery, consider the following:
- Implants may not completely prevent sagging: your plastic surgeon may recommend an additional breast lift procedure in order to treat sagging breasts.
- Implants may not last long-term: the average lifespan of an implant is around 10 years. There is a risk of an implant rupturing, which may require additional surgeries to fix. Your skin will also continue to age – weight loss or gain over the years will affect the appearance of your breasts.
- Mammograms complications: Due to the breast augmentation, you may require additional mammogram views during your routine check-up.
- Insurance & Payment: typically, health insurance will not cover cosmetic breast augmentation. Unless it is a post-mastectomy procedure, you will typically be required to cover the cost. (NuBody Concepts does not process insurance payments.)
- Implant Removal: removing implants will often leave your chest muscles stretched, sagging, and wrinkled. In order to restore your breasts’ appearance if you decide to have your implants removed, you may need a breast implant replacement or breast lift.
- Future screenings required for Silicone implants: the FDA recommends having regular check-ups to ensure pre-filled silicone implants haven’t ruptured over the years. Typically your surgeon will recommend a breast MRI or an ultrasound for checkups. Talk to your plastic surgeon about the specific type of imaging needed for routine monitoring of your implant health.
- Discuss your expectations: Why do you want breast implants? What are your goals for your appearance? This is a great time for you to discuss risks and benefits of a breast augmentation.
After Your Surgery
Following your surgery, the most important way you can avoid complications is to carefully follow your cosmetic surgeon’s post-op instructions. If you are given a compression garment, wear it diligently. Do not engage in strenuous physical activity before your surgeon has cleared you for it. Follow all wound dressing and showering instructions.
We hope that we’ve given you a better understanding about the safety and risks of breast implants as well as breast augmentation surgery. Please don’t hesitate to contact us if you have any other questions.