Frequent Asked Questions

Breast Augmentation Complications: FAQs

  1. Is it easy to tell if a breast implant ruptures?
  2. Is a breast lift necessary after breast implant removal?
  3. What is symmastia (uniboob)?
  4. What is capsular contracture?
  5. What are keloids?
  6. What is bottoming out?
  7. Are the costs associated with breast augmentation complications included in the total surgery cost?
  8. What is implant displacement?
  9. What is a hematoma or a seroma?
  10. Is it a big deal if a suture pops and the incision opens slightly?
  11. What are the signs of an infection after breast augmentation surgery?
  12. Is arm numbness a possible complication of breast augmentation surgery?
  13. When should post-breast-augmentation asymmetry resolve?
  14. What is galactorrhea?
  15. What is double-bubble?
  16. What is Mondor's Cord?
  17. Do ripples or wrinkles in breast implants go away?
  18. Is breast implant replacement a minor surgery?
  19. Do breast implants cause arthritis or lupus?
  20. Can saline implants become contaminated with fungus?
  21. Can the silicone shell of a saline implant cause silicone toxicity or silicosis?
  22. How can I prevent stretch marks after breast augmentation surgery?
  23. Can breast implants cause anaplastic large cell lymphoma (ALCL)?
  24. What are the risks of breast reconstruction surgery?

1. Is it easy to tell if a breast implant ruptures?

It can be easy to tell if a saline-filled breast implant ruptures, because it typically deflates within four hours of the rupture. Silicone ruptures, however, can be silent. These implants deflate in a more gradual fashion. If you have silicone gel breast implants, you will need to have magnetic resonance imaging (MRI) exams of your breasts three years postoperatively, then every two years, to check for these silent ruptures.

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2. Is a breast lift necessary after breast implant removal?

More than likely, yes, you will need a breast lift (mastopexy) following breast implant removal. The increased weight and size of the implant can stretch your breast envelope and breast tissue, resulting in sagging breasts that need a pick-me-up. This is especially true if you had larger breast implants.

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3. What is symmastia (uniboob)?

Symmastia, or synmastia, occurs when your two breast implants end up touching each other in the middle of your chest. This complication can happen if the surgeon creates pockets for the implants that are too close together in an effort to create more cleavage.

Symmastia usually becomes apparent within a few days to weeks after your surgery.

The only way to correct symmastia is with revision breast augmentation surgery.

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4. What is capsular contracture?

Capsular contracture occurs when scar tissue forms around the breast implant, contracting and squeezing it. There is no way to predict who will develop capsular contracture, or when it will occur. Capsular contracture occurs in about 5 percent of women.

Most women start experiencing symptoms of capsular contracture around three months after their breast implant surgery. Learn more about the risks, as well as how to prevent and treat capsular contracture, in our article devoted to this complication.

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5. What are keloids?

Keloids are lumps of fibrous tissue that form at the site of an incision or injury. They are essentially overgrowths of scar tissue that have formed outside the barrier of the original wound or injury. Keloids may look thick, rope-like or rounded and tend to be darker than the surrounding skin. These troublesome scars do not always heal properly. If you are prone to developing keloids or other problematic scars, discuss ways to prevent or treat them with your surgeon before your breast augmentation.

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6. What is bottoming out?

Bottoming out occurs when the lower halves of your breasts go south and cross your inframammary crease (the fold line just under your breasts where they meet your chest).

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7. Are the costs associated with breast augmentation complications included in the total surgery cost?

There is no uniform answer to this question. It depends on the complication, its cause and your surgeon's policy. Protect yourself by finding out your surgeon's policy before you book your breast augmentation surgery.

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8. What is implant displacement?

Implant displacement — when your breast implant slips from its original and desired position — can occur right after your surgery or months down the road. The reasons that implant displacement may occur are numerous. It could be caused by the effects of gravity, capsular contracture, weakening of the chest muscles, poor healing, surgical error, or the mere weight of your breast implants. It can take many forms. Your breast implant may migrate into your armpits, known as lateral displacement; it may shift downward, which is known as "bottoming out"; or your implants may shift toward one another and touch over the midline of the chest, which is referred to as synmastia (or more informally as "uniboob"). Breast implants may also ride high on your chest. Read more about your risk for implant displacement here.

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9. What is a hematoma or a seroma?

A hematoma is a pocket of solid, clotted or liquid blood in the tissues. A seroma is a pocket of clear or slightly bloody fluid in the tissues. Both may occur after breast augmentation surgery. If you have a hematoma or a seroma, you will notice a very swollen and tender area that may appear dark. It may feel hard, or like a pocket of liquid. If you have any concerns, call your surgeon immediately.

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10. Is it a big deal if a suture pops and the incision opens slightly?

If your sutures are out and your wound re-opens, it is a big deal. Otherwise, probably not. Usually one suture coming loose or "popping" won't make too much of a difference if it occurs a few days after your surgery. If your wound is starting to open, call your surgeon. He or she may ask you to come in to be re-stitched, or you may need to keep the incision covered and see if it heals by itself. Don't touch your open incision unless you have washed your hands thoroughly with an antibacterial soap.

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11. What are the signs of an infection after breast augmentation surgery?

A temperature higher than 101 degrees Fahrenheit could be a sign of infection. Other signs may include pain, chills and redness of the entire breast. Call your surgeon immediately if you notice any of these signs.

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12. Is arm numbness a possible complication of breast augmentation surgery?

It could be. You may be experiencing loss of sensitivity due to pressure from swelling around your implants. If you had a transaxillary (armpit) incision, a nerve may have been severed, which could result in numbness. Discuss any arm numbness with your breast surgeon.

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13. When should post-breast-augmentation asymmetry resolve?

No two breasts are ever 100 percent symmetrical. That said, if one of your breasts is significantly higher or lower than the other six months after your breast augmentation, you may need revision breast surgery. Discuss your concerns with your surgeon and find out your options.

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14. What is galactorrhea?

Galactorrhea is a breast implant complication characterized by the spontaneous production of breast milk when you aren't pregnant or breastfeeding. It usually stops on its own. Some cases of galactorrhea may need treatment. If clear milky fluid exits your nipples after breast augmentation surgery, tell your surgeon.

He or she may want to examine you. Any foul smelling, yellowish or greenish discharge from the nipples may be a sign of an infection.

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15. What is double-bubble?

"Double-bubble" can occur when an implant is placed under the muscle(s) of a woman who has sagging breasts. In this scenario, the real breast tissue is low enough to look like one set of breasts and the implants look like another set. Double-bubble can also occur after pregnancy. A woman's breast tissue may sag with the excess weight of pregnancy, but the implant remains where it was originally placed. If you develop double-bubble, discuss your treatment options with your surgeon.

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16. What is Mondor's Cord?

Also called Mondor's Disease, Mondor's Cord is an inflammation of an epigastric vein of the chest. It presents as a bulging vein under your breast lobe on your abdomen and breast.

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17. Do ripples or wrinkles in breast implants go away?

Unfortunately, ripples do not go away. Breast implant rippling is the term for indentations at the edges of the breast implant that look like scallops. Rippling may be visible, especially among women with little breast tissue who choose over-the-muscle implant placement. Rippling may also occur in women who have significant breast tissue if the implant shifts.

Silicone-gel-filled breast implants tend to ripple and wrinkle less than saline-filled breast implants. Some women who experience rippling problems choose to switch to silicone implants. Discuss your concerns with your surgeon.

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18. Is breast implant replacement a minor surgery?

Sometimes yes, and sometimes no. The answer depends on the specifics of your surgery. The major part of the original operation is the creation of the pocket. If the pocket is already there, your surgeon just opens the pocket, takes the old implant out and puts in a new one. It gets dicey if the original silicone implant has ruptures, because removing the errant gel from the pocket takes time.

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19. Do breast implants cause arthritis or lupus?

The Institute of Medicine investigated reports that silicone and other types of breast implants were linked to development of autoimmune problems and other conditions. It found no evidence of such a link. For more on this story, check out our complete coverage of the history of silicone implants.

If you have recently had your breast augmentation surgery, your body has been through a trauma and is trying to heal. This can make you feel tired and ill. You may also be experiencing postsurgical depression. Please see our section on Postoperative Depression for more information on this topic.

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20. Can saline implants become contaminated with fungus?

While it is theoretically possible for saline breast implants to become contaminated, it is extremely uncommon given today's clean and sterile surgical techniques. Find out more about this in our detailed article on saline breast implant contamination.

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21. Can the silicone shell of a saline implant cause silicone toxicity or silicosis?

No. Silicosis is a disease of the lungs caused by inhaling silica particles. Silica is a mineral that contains silicon, the element that is also in the elastomer polymer that is called silicone. Those affected by silicosis get it by working in factories or industries that create a lot of silica dust, not from breast implants.

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22. How can I prevent stretch marks after breast augmentation surgery?

The elasticity of skin varies from person to person. Some individuals never develop stretch marks and others may be prone to them. Moisturizing the skin with shea nut butter or olive oil may help prevent stretch marks. Retin A (tretinoin) may help erase red lines or early stretch marks. Ask your surgeon for advice if you are concerned about your risk of stretch marks, or if you have already developed them.

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23. Can breast implants cause anaplastic large cell lymphoma (ALCL)?

There may be a small increased risk of this rare cancer in women with breast implants. ALCL is not breast cancer; it is a lymphoma (a type of blood cancer) that affects white blood cells called T cells. The Food and Drug Administration is in the process of developing a national registry to track cases of ALCL among women with breast implants. At this point, there have been 60 cases worldwide among 5 to 10 million women with breast implants.

There are more questions than answers when it comes to ALCL and breast implants right now. Do not panic. This cancer is not as aggressive when it occurs in the presence of breast implants. The best way to protect your health is to talk to your surgeon if you have any questions or develop persistent swelling and/or pain around your implant.

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24. What are the risks of breast reconstruction surgery?

Breast reconstruction poses many of the same risks as breast augmentation, including general surgery risks such as infection and anesthesiology complications as well as aesthetic complications such as asymmetry. If the procedure involves a tissue flap transfer, breast reconstruction risks also include the potential for infection and loss of sensation at the donor site as well as tissue death in the flap itself. In addition, breast reconstruction recovery time is typically longer if a tissue flap is involved rather than a breast implant.

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