Breast augmentation is a wonderful procedure that does a great job of enhancing a woman’s breast size. Because it takes an implant to achieve this result, however, there are distinct risks associated with a synthetic enhancement method. Such complications include the typical surgical risks of bleeding and infection but an implant brings to the forefront other distinct risks including implant and breast asymmetry, hardening of the implant capsule, and dissatisfaction with breast size and shape.
The complication rate from breast augmentation surgery, while not common, is not rare. In looking at revisional surgery rates from breast implant manufacturers, who have collected a lot of data due to their own registries and FDA study requirements, the re-operation rate within the first three years is a surprising 30%. Now this number reflects every conceivable reason for reoperation from typical surgical problems, implant-related complications, to cosmetic appearance concerns. This takes into account all types of patients and all types of surgeons performing breast augmentation. While my own practice experience does not reflect this high a number, it is a sobering statistic that patients should have an understanding about it.
The most common reason in my experience for breast augmentation reoperation is of a cosmetic nature, specifically breast asymmetry. This can happen because the implants end up in different positions making the breasts look different or the breasts were asymmetric to start with and the implants have merely magnified that difference. This is why it is critical for one to know before breast augmentation if such differences exist. There may be some minor differences in the procedure that can help avoid this problem or, at the least, it helps manage after surgery expectations.
Suffice it to say that with a national average of a 30% revision rate after breast augmentation, perfect breast symmetry after breast augmentation should not be an expected outcome for many women. I prefer to think of breast augmentation as ‘sister’ surgery, not ‘twin’ surgery. Most of the time, these breast differences are not dramatic but subtle differences will exist. Whether these breast differences are worthy of revisional surgery requires an in-depth discussion with your plastic surgeon.
Dr. Barry Eppley
Indianapolis, Indiana