Possible complications after breast augmentation

Although complications after breast augmentation are rare, it is important to understand that, like any surgery, there are potential risks. These will be thoroughly discussed with you during your initial consultation.

• Weighing up the pros and cons
  • What is Informed Consent?
  • Guarantees and periodic inspections
• Hull formation
  • Treatment of capsular contraction
• Abnormal milk flow
  • Causes of galactorrhea
  • Treatment of galactorrhea
• Late complications
  • Treatment of late seroma

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As with any surgery, it’s essential to weigh the benefits of breast implants against the potential risks of complications.

Breast implants are not suitable for people with certain conditions, such as untreated infections, a compromised immune system, previous scarring issues, vascular insufficiency, allergy or intolerance to foreign bodies.

Those who have had unsuccessful experiences with breast prostheses in the past, have existing breast health issues, or psychological instability should also reconsider this option.

Open communication with your surgeon is crucial to understand these risks and making a well-informed decision.

Compare alternatives, benefits and possible complications before breast augmentation

AS FROM WHEN CAN YOU JUDGE ON THE RESULT OF A BREAST AUGMENTATION? 

The result of a breast augmentation can be judged after 6 months. Only then the swelling will have gone down completely and the breast muscle will have adapted to the new shape of the breasts.

Although complications are rare, they can occur. The most significant risks include:

• Hematoma or Edema: These issues can arise in the implant area. If a hematoma or edema persists, a puncture may be necessary, taking every precaution to avoid damaging the breast implants.
• Serous Effusion: This can occur without infection, requiring prolonged drainage.
• Nipple Sensitivity: After surgery, temporary loss or heightened sensitivity of the nipple is common. In rare cases, this altered sensitivity may become permanent.

Other potential risks include infection, capsule formation (hard scar tissue around the implant), skin folding or wrinkling, and healing difficulties.

It is essential to follow medical recommendations diligently to minimize these risks and ensure optimal recovery.

Informed consent before breast augmentation

Informed consent is an agreement given by the patient after being informed of the risks, benefits, and alternatives of a procedure, such as the implantation of breast implants.

To ensure our patients are thoroughly informed during the informed consent process, several steps are necessary.

First, the doctor will clearly explain the procedure, the associated risks, the benefits, and any possible alternatives. Our team ensures that you have ample opportunity to ask any questions you may have, and we are committed to providing satisfactory answers to each one.

After your consultations and before your surgery, the surgeon will provide you with a form to sign. This form is not a waiver but a document confirming that you have been fully informed about the surgical procedure and its risks. By signing, you acknowledge your understanding and give your consent to proceed with the implantation of your breast prostheses.

Checks on breast implants

Additionally, we want to emphasize that our plastic surgeons exclusively use breast implants that come with a 10-year manufacturer’s warranty (according to their criteria).

For safety and health reasons, it is recommended to replace breast implants after 10 years. Over time, they can undergo natural wear and tear, which may lead to deterioration and increase the risk of leakage or rupture.

Risks of capsular contraction associated with breast implants

Breast implants are designed to closely resemble the look and feel of natural breasts. However, the body can sometimes perceive them as foreign objects and respond by forming a capsule of scar tissue around them.

This capsule is made up of scar tissue that can harden and contract the breast prostheses, causing discomfort and pain. Additionally, this capsular contracture can alter the appearance of the breasts, making them harder and potentially changing their shape.

It’s important to understand that the risk of capsular contracture varies with different types of breast implants. Therefore, it is crucial to thoroughly discuss the various options and their associated risks with your surgeon before making a decision.

How to treat capsular contraction?

Treatment for capsular contracture may involve surgery to remove the scar tissue capsule and replace the breast implants, which could incur additional costs.

In some cases, removing the capsule may allow for a slight increase in implant size due to the expanded pocket created by the capsule.

If you suspect that you are experiencing capsular contracture, it’s important to consult your surgeon. They will assess your condition and discuss the appropriate treatment options with you.

Risk of galactorrhea after breast augmentation

Galactorrhea, a milky discharge from the breasts, can occasionally occur after breast augmentation. This is a rare phenomenon, especially when it occurs without pregnancy, breastfeeding, or hormonal treatment.

A recent study observed 8 cases of galactorrhea among 832 women who underwent breast augmentation with implants.

In all instances, the discharge ceased within eight weeks, and the breasts remained supple one year post-surgery.

What causes galactorrhea?

Prolactin, the hormone responsible for milk production, is typically secreted by the pituitary gland under the control of the hypothalamus. It can be triggered by irritation of the chest wall, nipple stimulation, or psychological stress.

Breast augmentation surgery, burns, herpes, and spinal cord trauma are known to potentially cause hyperprolactinemia and galactorrhea.

Additionally, inserting implants through the areola and the expansion of the chest by the prosthesis could also stimulate prolactin production.

However, a recent study found no abnormalities in prolactin secretion in 15 women, both before and after breast prosthesis implantation.

How is galactorrhea treated?

When dealing with galactorrhea following breast surgery, our approach focuses on addressing any factors contributing to excessive prolactin production.

For some patients, this complication resolves spontaneously within 1 to 3 weeks. However, in more persistent cases, the formation of galactoceles (milk-filled cysts) may occur, necessitating drainage.

Underlying causes such as kidney issues, pituitary tumors, or hypothyroidism should be considered if galactorrhea persists. Elevated prolactin levels may warrant an MRI scan for further evaluation. Treatment options may include medication to suppress lactation if a milk-filled cyst develops, aiming to resolve the issue effectively.

Risk of late seroma after breast prosthesis insertion

Late seroma is an uncommon complication occurring more than a year after surgery, marked by an abnormal increase in breast volume in one or both breasts.

It affects approximately 1% of cases and can be associated with several factors, such as a delayed hematoma, secondary capsule tear, infection, implant rupture, edema, or breast tumor.

Regular gynecological consultations, along with periodic ultrasounds or mammograms, are crucial for monitoring and ensuring optimal postoperative progress.

Doctor JM O’Donoghue:

“Late seromas are a factor of anxiety for many patients and pose a diagnostic problem for the surgeon, sometimes leading to delays in appropriate therapy.“

Treatment of late seroma

In most instances, late seroma is benign, indicating there’s no serious disease or underlying medical issue causing this delayed complication.

For such cases, simple drainage is often effective as a treatment. Drainage involves removing excess fluid from the breast through a medical procedure. Typically performed on an outpatient basis, it does not usually require hospitalization.

However, surgical intervention may be necessary in certain situations, such as when late seroma recurs. Surgery might also be needed if the seroma is linked to infection, breast implant rupture, or capsular contracture (formation of a shell around the implant).

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