Important Things To Know

Breast Enlargement, Augmentation and Implants Complications and Side Effects

In spite of due care the results of cosmetic surgery are not as predictable as we expect. Every procedure involves obvious inherent risks. Every patient can be dissatisfied with some aspect of the results of their operation. Your aesthetic result cannot be guaranteed as surgery is not an exact science. A happy outcome is when the benefits outweigh the drawbacks and limitations.

The surgeon cannot predict the following:

Genetic characteristics

The patient’s tissue that allows excessive stretching even with well-considered size of implants and surgery options.

Rapid descent

Some patients tissue may be unable to hold the implants in their position and the implants move down on the chest wall. The scar rides up on the breast which looks bottom heavy. This is regardless of wearing adequate support bras. Drooping of the nipple, areola and breast tissue, even after a breast lift, will be accelerated in patients who have poor tissue. This is unpredictable and revision surgery may be required to correct this. It is important to wear good supportive bras especially during strenuous activity.

Detectability

The implant edge may become palpable and obvious with crinkling, particularly with weight loss.

Stretch marks

1:500 cases. If you already have stretch marks on your body you are susceptible to this risk.

Nipples and Areolas

They may change in size, shape and colour after augmentation. Slight breast asymmetry in the nipple areola complex position is magnified with breast augmentation. Breast augmentation can distort the nipple areola complex and it can enlarge a lax area.

Asymmetry

Chest wall and breast asymmetry may not be obvious at the time of consultation but after augmentation, with equal size implants, asymmetry may become more obvious.

Capsular contracture

2% chance in sub pectoral pocket and 4% in sub glandular pocket. This is the hardening of the capsule around the implant. If the hardening does not bother you, no intervention is required. In some instance, the hardening can cause deformity, pain and other symptoms; in which case a procedure will be required to adjust the capsule and replace the implant. A polyurethane shell implant may be used to reduce the risk of this complication to less than 1%.

Scars

Thickening, hyperpigmentation, puckering and keloid formation occurs in a small percentage of patients. The scar location is at best a very good estimate. It is impossible to site this perfectly at both the consultation or at the time of surgery. As the scar heals and the breast shape softens, the incision may change position.
If you have tattoos in the area, Dr Chan will do his best to avoid making incisions that affect your tattoo, however it may be impossible to avoid.

Inflammatory and infective conditions

Very rare.
If you have a pre-existing blood disorder or immunity issues, you must advise Dr Chan prior to booking your consultation.

Sudden haemorrhage

early or late: 1% chance.

Seroma

Pocket of fluid formation is a 2 % chance.
Can occur spontaneously or after trauma. If you feel one breast is swollen more than the other, have a breast ultrasound or MRI (with a referral from your GP)

Implant rupture

Although silicone implant prosthesis have improved tremendously with the advancement of ‘cohesive gel’, implants can still rupture and leak and silicone can migrate through breast tissue. This is, however, rare at about 1:1000 implants.

Nerve damage

Permanent nipple numbness: 1:500, with higher risk associated with areola (nipple) incisions.
Some localised numbness and sharp pulling sensations are common after surgery. Each breast will feel different, and each patient will have varying degrees of these symptoms. Most of the numbness and abnormal sensations do settle within the first year.

Privacy

The benefit of cosmetic surgery involves privacy. The objective is established in a private contract between the patient and the surgeon. Maintaining the privacy protects the anticipated outcome The privacy contract is broken when the patient enters into conversations with a third party, seeking comments and assurances. This will lead to disappointment and dissatisfaction.
We cannot keep your procedure private from your chosen support person, as they will need to understand their role in your post-surgery care.

Tightness

This will ease as the breast tissue envelope relaxes to accommodate the implants. Some patients have thicker skin or tighter chest muscles which may take longer for their tissue to relax over time.

Swelling

Swelling is often uneven and may subside more quickly on one side. Most swelling will be resolved in 2-3 weeks.

Detectability, Wrinkling, Palpability

Many implants wrinkle in the body. You may feel some wrinkling and may feel the implant, and/or an ultrasound may detect an implant fold. This does not indicate a need for further surgery. Detectability depends considerably on subcutaneous fat. A completely natural looking and feeling result is possible only with greater than 15 mm of subcutaneous fat.

Extremely slim body and thin tissue

These patients are not suitable to have implants because of extreme detectability, unnaturalness and weakness of tissue.

Active breast deformities

Sub pectoral placement causes 1:20 patients to develop an active breast due to the adhesion of the scar tissue between the breast implant and the pectoral muscle. With the muscle action there is associated movement of the breast. This can be very obvious in the gym etc. An active breast is usually permanent.

Veins

Pre operative breast veins can become more apparent post operatively in the breast skin across the chest. It can become very disconcerting for patients, especially those with fairer skin. Patients have chosen to use bronzing powder and other products like fake tan to assist with covering up veins in the breast area. This is at your discretion.

Asymmetry

Where there is noticeable asymmetry of the nipple and areolar, breast shape and position, correction cannot be achieved with only breast augmentation. Other procedures may be necessary and should be discussed. Correction of unequal breast sizes with different size implants is an attempt to improve the results. It is not accurate and cannot achieve perfect symmetry.

Even when looking for asymmetry in physical examination and reviewing photos, asymmetry can still go undetected until after the operation. It can typically be far more obvious.

“Your breasts are sisters, not twins”

Recovery

The healing of each side of the breasts is always different due to the biological variations in the nerve supply and your individual response. The breasts will naturally feel different.

Cleavage

Skinny patients are unable to achieve a good cleavage with breast augmentation. The space between the breasts remains wide.

Symmastia

Is the joining together of the breasts in the middle and the loss of cleavage. Patients with soft subcutaneous tissue and large implants risk symmastia.

Double Bubble

Can occur where the base of the natural breast is smaller than the base of the implant i.e. smaller breast on top of bigger implant.

Granulomas

1 in 2000 patients who has silicone Implants may develop granulomas. This does not cause nay harm or danger to you, however you may request the removal or replacement of implant due to its looks or feel.

Breast checks

It is recommended that you attend a specialist clinic for breast scanning because some clinics do not carry out competent checks on patients with implants.

Breast-feeding

Pregnancy can alter the normal size and shape of your breasts with or without augmentation. Breast implants will not affect your ability to breast-feed. Often after breast feeding the breast needs lifting to correct droop.

Activity

Movements should be within your comfort limit. You are encouraged to move your arms the day after surgery. Wash your hair and have a shower and gently increase your arm movements. Regular exercise can be commenced at two weeks.

Subpectoral Placement

After surgery you may find it difficult to continue with push ups, chin ups or any pectoral major exercises.

Over-activity

In the first 2 weeks can lead to an incision wound rupture.

Choosing your size

There are a percentage of patients who will be unhappy, whatever size they choose, for what ever reason.

Rotation

It is very rare for implants to turn around or flip.

Mondor’s Band

Are extremely rare 1: 1000. They are an uncomfortable vertical band that stretches under the skin from below the incision to the navel. These bands spontaneously resolve in 3 months without treatment.

Partners

Are important and need to be involved in the understanding of side effects and anticipated results. You are encouraged to bring your partner to accompany you at consultation as we would like to address his concerns too. When you are in a relationship you must inform your partner that you have breast implants to avoid losing trust within the relationship. Partners objection can lead to distress that may manifest as real physical pain in the breast.

Career Change

Requirements for breast augmentation specific to your career may change as your career changes.

Unacceptable new body image

You may discover larger breasts may not be to your liking after all. They may feel too heavy, are obvious and may attract unwanted attention.

Unacceptable foreign body

Over a period of time there is a 1% chance of you developing an aversion to the presence of a foreign object in your body. You may request its removal.

Secondary effects

When complications occur you may risk significant adverse effects in your life. Eg, social, sexual, physical, financial and emotional areas. Ambitions for cosmetic surgery to achieve social and modelling, professional goals may not be achieved.

Additional risks for those who is undergoing Revision Breast Augmentation

Asymmetry

This is particularly so for Revision Breast Enlargement. Perfect symmetry can not be guaranteed as the first surgery
has alterd the anatomy. This is less so for Dr Chan’s own patients because Dr Chan usually only need to redo very minor
revisions which most of the time is out of his control, however when Dr Chan revise other surgeon’s work – this will be
an issue as Dr Chan can only work with what he has to start with.

Loose Skin

This can occurs with any revision breast augmentation especially so when patients are down sizing. The skin has
already been stretched previously and when changing size, it is unpredictable of how much the skin will retract.

Ptosis

Ptosis of the breast might be an issue after revision breast enlargement surgery because again how the skin and breast
tissue/parenchyma will change is totally unpredictable.

Difficult Surgery

It is much harder/difficult surgery with revision breast augmentation. It is more prone to bleeding as the tissue is
more vascular. Rare occasions, you might need a drain at the end of the surgery.

Improvement Not Perfection

The whole idea of surgery is aiming for improvement not perfection.

These will be reviewed at your consultation so please feel free to discuss any queries with Dr Chan and your consultant

1300 37 24 26