Educational Content: This article is for informational purposes only. Always consult a board-certified plastic surgeon before making any decisions about breast augmentation.
Every surgical procedure carries risk. Understanding the specific risks associated with breast augmentation — and what can be done to minimize them — is essential for informed consent and realistic planning.
Capsular Contracture
Capsular contracture is the most common complication of breast augmentation, occurring in approximately 10–15% of patients over the lifetime of the implant. It occurs when the scar tissue capsule that naturally forms around the implant thickens and tightens, distorting the implant's shape and potentially causing discomfort. It is graded on the Baker scale from I (normal, soft) to IV (very hard, painful, significantly distorted).
Risk factors include hematoma post-surgery, bacterial contamination (addressed by 14-point no-touch surgical techniques), and potentially biofilm. Treatment typically requires surgical removal of the capsule and implant replacement.
Implant Rupture
Saline rupture is obvious — the implant deflates visibly within hours to days and the saline is harmlessly absorbed. Silicone rupture is often silent — the implant shell breaks but the cohesive gel typically stays contained within the capsule. Silent silicone rupture is why the FDA recommends periodic MRI screening for silicone implant patients.
Modern fifth-generation cohesive gel implants ('gummy bear') have the lowest rupture rates of any current implant technology.
BIA-ALCL and Breast Implant Illness
BIA-ALCL is a rare lymphoma associated primarily with textured implants. The FDA recalled certain textured implants (Allergan BIOCELL). Smooth implants have not been associated with BIA-ALCL. Breast Implant Illness (BII) is a patient-reported collection of symptoms — fatigue, cognitive difficulties, joint pain — the scientific evidence for which remains inconclusive. Patients experiencing these symptoms should discuss them with their surgeon and primary care physician.
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