Breast augmentation continues to be popular amongst patients and plastic surgeons alike due to its immediate and highly successful results for most patients. As the operation is widely satisfying and associated with a fairly rapid recovery, patients can begin to enjoy the benefits of breast augmentation quite quickly.
Despite the tremendous benefits of breast augmentation, it is important to remember that it is an operation that involves an implant. As such, there are some risks and potential complications that do exist and no one is immune from them. While not to throw cold water on a hot fire, so to speak, it is important that potential patients understand that risks exist and not every result is perfect. Some of that is due to the fact that many women’s breasts are not perfect to start out with in terms of symmetry and other differences between them. In addition, the surgery involves two sites that are right next to each other for comparison.
In appreciating potential complications after breast augmentation, a recent paper was published in the September 2009 issue of the journal Plastic and Reconstructive Surgery on this very subject from Denmark. Looking at over 5,000 women over an 8 year period that had breast augmentation, they looked at the incidence of complications at different time periods (0 to 30 days, 0 to 3 years, and 0 to 5 years) focusing on issues of infection, hematoma, asymmetry, and capsular contracture. They report a 17% incidence of an adverse event and a near 5% rate of surgery-requiring complications. The following complications rates were reported: hematoma 1.2%, infection 1.2%, asymmetry 5.2% and significant capsular contracture of 5.2%. Displacement and/or asymmetry and capsular contracture were the most frequent indications for reoperation.
While this report was from a different country with multiple surgeons (including slightly different techniques and implants) and all types of patients being treated (not an homogenous population), the data is from a registry which is very common in these smaller Scandinavian countries. (Some would argue that Denmark is not part of Scandinavia but that is a different discussion) As a result, this is good pooled data from which to draw some conclusions. It does address the important patient concern of….what are my chances of needing further surgery from a complication?
These reported breast augmentation outcomes correspond fairly well with what is reported in other studies. It is also almost exactly what I tell my Indianapolis breast augmentation patients. The risk of hematoma and infection are very low (1%) and will occur almost within the first 30 days after surgery. The most common complication thereafter is one of an aesthetic nature which is breast asymmetry or some malpositioning of the implant (s) which is around 5% to 7%. (in essence it is not common but it is not rare either) Todays rates of capsular contracture, in the short term (less than 10 years which is short compared to a lifetime) are very low with submuscular implant placement and are around 1%. Over 10 years or longer, they may likely be somewhat higher.
Breast augmentation is a tremendous psychologically uplifting operation for women who want it. In this state of sometimes near euphoria, however, it is important to remember that there are some complications which can occur. None of them ‘ruin’ the final outcome and most of the time they are completely solveable without significant long-term adverse outcomes.
Dr. Barry Eppley
Indianapolis, Indiana