What are the complications of breast augmentation?

Fortunately, they are very rare, but this underlines the essential importance of the quality of the surgical procedure and the implant.

A distinction is made between complications related to the surgical procedure and complications related to the implant.

Complications associated with the surgical procedure:
- Alteration of areola sensitivity: this may occur in the first few months, but in the vast majority of cases it eventually subsides.

- Hematoma : or the formation of a blood clot around the prosthesis, is an early complication that can occur within the first few hours. If it does occur, it is perfectly treatable when the patient returns to the operating room during the same hospital stay.

- Infection : extremely rare in aesthetic breast augmentation, it requires antibiotics and may, in rare cases, lead to the removal of one or both implants for one to 2 months (the time required before a new prosthesis can be fitted without risk).

Complications associated with implants:
- Formation of "folds" or a "wave" appearance : As implants are flexible, it is possible for their envelope to wrinkle and for these folds to be perceptible to the touch, or even visible under the skin in certain positions, giving a wave-like appearance. To avoid this, we prefer to choose denser implants and lace them up when patients are very thin behind the muscle.

- Shells": The human body's normal and constant physiological reaction to the presence of a foreign body is to isolate it from the surrounding tissue by forming a hermetic membrane around the implant, known as a "periprosthetic capsule".

Normally, this membrane is thin, supple and imperceptible, but sometimes the reaction amplifies and the capsule thickens, becoming known as a "shell". The majority of shell cases are linked to a crack in the implant with silicone diffusion. Some cases remain unexplained. However,new-generation implants coated with polyurethane foam have reduced the risk of shells to less than 1%.

- Rupture : As we have seen, implants cannot be considered definitive. Eventually, the envelope may lose its watertightness. This may involve simple porosity, punctiform openings, microcracks or even real breaches. Very rarely, this may be the result of violent trauma or accidental puncture; much more often, it is the result of progressive wear of the wall due to age.

In all cases, this results in the possible release of the prosthesis filler, with different consequences depending on the nature of the filler:

- with physiological saline, partial or total deflation occurs, often rapidly

- with silicone gel (non-absorbable), which remains contained within the membrane that isolates the prosthesis.

This can lead to the appearance of a shell, but it can also be of no consequence and go completely unnoticed.

Prosthetic rupture requires implant replacement surgery.

- Rotation: Rotation of a standard textured "anatomical" prosthesis is not an uncommon complication, and can occur in up to 5% of cases. It requires revision surgery. Only anatomical implants covered with polyurethane foam can avoid this phenomenon.