Breast Enlargement Surgery – Possible Complications & How to Avoid Them

Breast Enlargement Surgery – Possible Complications

Hello. My name is Adrian Richards, and I’m going to be talking today about some of the complications that can occur following breast augmentation enlargement surgery. So, it’s important to remember that with all breast enlargement, it’s a very commonly performed operation. It’s generally very safe nowadays in the UK. As with any surgery, problems can occur. It’s important that you go into surgery being very aware of these.

Complications can basically be divided into early complications and late complications. So I’ll start off talking about the early ones, which typically occur within 48 hours of the operation.

So the main complication that occurs during that time is bleeding, and this is because the surgeon has to divide blood vessels and create a cavity for the implant to go in. If one of these blood vessels becomes reopened, the vessel will bleed and blood can collect around the implant. You will notice if this happens. It’s normally very obvious if it happens, and the breasts will suddenly enlarge and become very firm and uncomfortable.

Now it doesn’t really cause any long-term problems, but the difficulty is that you will need to be taken back to the operating theatre, and your surgeon will need to find the bleeding blood vessel and cauterize it. So long-term, no significant problems, but it’s a nuisance. You’ll need another anaesthetic normally within the first 48 hours of surgery. And you need to be very clear with your surgeon that if this does occur, that it will be covered within the package.

After 48 hours, the complication that can occur, normally about a week to 10 days, is infection. You’ll notice this by you generally feel unwell, a bit fluey, high temperature, and the breasts may become swollen and hot. Now, you should have had antibiotics in your operating times. I typically will give you an IV dose of antibiotics just before you have the operation so you have a high concentration in your blood during the operation, and then two further doses of IV antibiotics after the operation. Now, if you do develop any of these symptoms of potential infection, it’s very important you contact the surgeon immediately, because the earlier we can treat with IV antibiotics, the more likely we are to better resolve the infection.

So, you’ll probably need to be readmitted and have intravenous antibiotics straight into one of your veins. Now, people who do get infections, approximately 50% of patients can keep their implant, and the infection will resolve with antibiotics. But the other 50% need the implant removed, normally for a period of approximately three months before the implant is reinserted.

So, how can you reduce the risk of infection? Well, I perform 250 implants a year, and I would typically see zero to one infection a year. How can it be reduced? I said before, very good surgical technique. The second thing is IV antibiotics during the first 24 hours in surgery. And the thing that I think is very important is that the surgery is performed in a laminar air flow theatre. This is a special latest type of theatre where the air is changed every two minutes. So any potential bugs are flushed out within two minutes, and most implant operations, particularly hip implant operations, are performed in laminar air flow theatres. So do ask your surgeon about that.

What problems can you get after two weeks, after three weeks? Well the most common one is capsular contracture. So with the furry, textured implants that we use now, this is much reduced. But typically 3% to 4% of patients will get some hardening of their implants. No one knows why this occurs. It tends to occur more in smokers. No one really knows why.

How can you reduce the risk of this? Well, the main thing is to have the latest implants, and the Allergan type of implants have got the lowest recorded capsular contracture of 2%. So I would advocate that you think about those. Discuss with your surgeon his capsular contracture rate. If you do get a capsule, are you covered to have this removed? The normal treatment, if you do get a capsule, one of the breasts goes hard, is to release or remove the capsule and replace the implant.

Another problem you can get, but you probably shouldn’t really get, is rippling, and this occurs when implants are placed too close to the skin. So, if you’re very, very thin, have under two centimetres of natural breast tissue, we normally place the implant under the muscle, and this is so we’ve got an extra layer between the implant and the skin. Because if the covering gets less than one centimetre, you can get rippling, which is characterised by gentle undulation, normally in the upper pole of the breast. So to get around that, you don’t normally get it if you’ve got over two centimetres of thickness. If you are very slim and don’t have very much breast tissue, you need to think about submuscular placement of the implant, possibly a firmer implant. So an implant that’s got a higher, the silicone is more cohesive is much less likely to get rippling.

So overall, complications are very rare. Most patients are generally very fit and healthy, so the anaesthetic complications related to anaesthetics are extremely rare. You do need to think about the possible complications of haematoma, infection, capsular contracture, and rippling, and have a frank and open discussion with your surgeon about the risks of these, and also if they do occur, who is responsible for covering the cost of any further surgery. Thank you.