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Breast augmentation, due to its near instant gratification, is what I call a ‘euphoric’ plastic surgery operation. Most women are immensely excited about the prospects of the results and they have painted themselves into that role by envisioning how clothes and other attire will look afterwards. In the wake of this enthusiasm, it is easy to overlook or not hear or read about any possible undesireable outcomes that may result.

Breast augmentation, like all surgery, has inherent risks and complications like bleeding and infection. But any operation that involves the placement of a synthetic implant or material is inherently prone to a higher than traditional rate of surgical complications. An implant introduces a whole new set of potential issues, particularly when the appearance of the outcome is how the operation is graded on the success scale. Breasts compound this issue further because there are two of them…and they are side by side.

If you look at any of the manufacturer’s rates of reoperation, which they know well due to FDA requirements and clinical trials and are published, you will discover an almost shockingly high rate of revisional or secondary breast implant surgeries. One must remember that this collection of data is a very mixed population of surgeons and patients of all ages and types of breast problems. Nonetheless, the manufacturer reported revision rates of primary breast augmentation surgeries is in the range of up to 30%…in the first three years after surgery! These reported revision rates were for every conceivable breast implant problem including infection, bleeding, breast asymmetry, capsular contracture, implant rupture or failure, and unhappiness with the breast size or breast shape.

I don’t present these reported rates to scare or put fear into any potential breast augmentation patients. But some patients do need a reality check in their otherwise enthusiastic but often oblivious psychological state before surgery. I do not experience this high rate of revision rates in my Indianapolis plastic surgery practice, but it is also clear that low risk factors of 1% or 2% revisional needs is not accurate either. A more accurate number is in the range of 3% to 5%. A fairly low risk for sure but not a rare occurrence either.

The pertinent message is that breast augmentation surgery has higher risks than other types of breast surgeries such as reductions and lifts. This is primarily due to the use of an implant to create the result and the highly critical nature of many cosmetic breast patients. Most complications and the need for revisional surgery are, fortunately, usually cosmetic in nature. Most often the issue is of implant positioning and asymmetry as well as breast shape and nipple positioning.

It is important to remember that breast implants can only take what you naturally have and make it larger. They can not really give you completely different breasts even if it appears that they do. It is important to be aware of your presurgical breast shape and any asymmetries. What may appear to be a small difference before surgery can turn into a much bigger difference after.

Because of the not rare need for revisional surgery after breast augmentation, one should have a clear idea as to what one’s financial obligations may be should that need arise.

Dr. Barry Eppley
Indianapolis, Indiana


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