Why do some breast augmentations look great…and others not so? Why do some people have problems after surgery and many others don’t? The final result in any breast augmentation is an amalgamation of four factors: the size and shape of the implant, one’s native breast anatomy and tissue characteristics, the body’s response to the insult of surgery and the healing response around this new ‘foreign-body’ and the method or techniques used by the plastic surgeon. The reality is that all of these are significant factors that influence the breast augmentation result and no one has greater importance over the other. Thus, while breast augmentation seems outwardly to be a fairly simple operation, any one of these four factors can be responsible for an undesired outcome.
How likely are breast augmentation problems to occur? That answer depends on how you want to look at that question. In my Indianapolis plastic surgery practice, I like to focus that answer on the likelihood that you may have to go back to surgery to fix some sort of problem. Breast augmentation problems can include bleeding or a hematoma, infection, implant asymmetry, capsular contracture, implant rupture, or unhappiness with the size or shape of the result. If it is a problem that doesn’t merit more surgery, then it’s not a significant problem. Therefore, the real question is how likely am I going to have to need another surgery after my initial breast augmentation?
Few plastic surgeons really know their actual statistics of reoperation unless they are specifically tracked for a reason. It is human nature amongst surgeons to believe, for any procedure, that you have had less problems than what actually has occurred. People remember the good and block out the bad. We all do it, including plastic surgeons.
One sobering answer to this question is to look at the manufacturer’s (Mentor and Allergan) statistics which are freely available. They often are provided to you in a pamphlet from the company at the time of your consult. Or go online and find them on their websites. This is not hidden information. Considering every conceivable reason for reoperation, the occurrence from one manufacturer is around 30% in the first three years after breast augmentation surgery! In interpreting that statistic it is important to consider that many problems are surgical and those occur early. Whether it be an immediate bleeding problem that requires drainage or whether one is dissatisfied with implant size or position, these issues will be dealt with in hours to months after the initial surgery. This doesn’t mean that such a rate of problems continue for a lifetime.
Fortunately, many revision breast augmentation surgeries are for aesthetic problems and are far less in magnitude than the original surgery. In my experience, implant position and asymmetry is the most common problem. Because breasts come in pairs, they will be judged by their similarity after surgery…even if they weren’t symmetric before. Adjusting the too high or too low position of an implant to match the ‘good one’ is my most common reason for reoperation.
Breast augmentation is a wonderful operation that can be life-changing for some women. Because it is an operation whose results are primarily created by an implant, there are certain inherent risks that come with placing a large foreign object into your body. Having to adjust or replace that device is not a rare phenomenon. Every women should be aware of this risk so should further surgery someday be needed, it will not come as a total surprise.
Dr. Barry Eppley
Indianapolis, Indiana