In this guide8 sections
If you have been thinking about having breast implants, the chances are you will already have learnt a great deal about the different types of breast implants, breast implant incisions and choosing the best size of the implant. We believe one of the most critical areas to bear in mind is ensuring high standards of breast implant safety. The vast majority of women who have this procedure are delighted with their breast implant results and have never encountered any issues during or after the procedure. Having said that, there are several potential breast implant risks to be aware of. Here at Centre for Surgery, we take patient safety very seriously and have emphasised the most important safety considerations concerning breast augmentation below.
All breast augmentation procedures at Centre for Surgery are performed by GMC-registered plastic surgeons, at our CQC-regulated Baker Street facility, under TIVA (Total Intravenous Anaesthesia) as a day case.
Why is it important to consider the safety of breast implants?
Deciding to undertake any form of surgery, including breast implant surgery, should not be undertaken lightly. Although breast augmentation is a straightforward procedure to carry out, there are several important factors to consider about the nature of breast implants themselves:
- Breast implants are not designed to last for the lifetime of an individual. Approximately 10 to 15 years after your first procedure, we recommend having a consultation with your surgeon to discuss breast implant removal or breast implant replacement.
- Breast implant rupture is rare with the latest generation implants but is still a potential risk with any implant. Although implant rupture is not a dangerous condition, it is essential to have corrective breast surgery to remove and/or replace the implant.
- Silicone breast implants benefit from regular surveillance. The US Food and Drug Administration recommends an ultrasound or MRI scan five to six years after surgery and every two to three years after that; our guide to breast implant checks explains how often to have your implants checked and which scan to choose.
- Breast cancer screening using mammography can sometimes be more challenging to interpret in the presence of breast implants. With improvements in x-ray technology, the risk of missing breast cancer in the presence of implants has markedly reduced over time.
Capsular contracture
Capsular contracture is used to describe excessively tight scar tissue that develops around the breast implant, which often results in pain and discomfort. Severe grades of capsular contracture can deform the underlying breast, resulting in an abnormal breast shape. This is one of the most common risks associated with breast implants, though only around 1–2% of patients ever require treatment for it. Although capsular contracture is not a dangerous condition, it is a recognised complication of breast implant surgery and will require corrective breast surgery in more significant cases.
The reasons why capsular contracture develops are still uncertain, though the leading theory points to a low-grade bacterial biofilm response, and several other factors act in combination to increase the chances of the condition developing. Some studies have suggested it may be more commonly seen after revision breast surgery. Other studies demonstrate a link between patients who have had subglandular breast augmentation and the later development of capsular contracture. Our dedicated guide on capsular contracture causes, symptoms and treatments covers the full picture, including the Baker grading system and every treatment option.
Breast implant rupture
It is important to remember that breast implants are not designed to last for the lifetime of an individual patient. Breast implants have a finite lifespan with a small risk of implant rupture with the increasing age of the implant. Rupture of a modern silicone implant is usually not dangerous. The gel is highly cohesive, so it generally stays within the implant or the scar capsule around it, and many ruptures cause no symptoms at all. Occasionally silicone escapes beyond the capsule and forms lumps in the breast or in the lymph nodes of the armpit, which is one reason a ruptured implant should be removed, with or without replacement, rather than left in place.
BIA-ALCL
BIA-ALCL is an extremely rare risk associated with breast implants. It is a form of non-Hodgkin’s lymphoma that most commonly develops in the scar tissue and fluid surrounding the implant. BIA-ALCL is most commonly linked with heavily textured breast implants, and no confirmed cases have been reported in the medical literature involving only smooth implants.
Here at Centre for Surgery, we do not use heavily textured breast implants, having moved to smooth and microtextured options as standard since 2018. We use Silimed implants exclusively — including their polyurethane and True Texture surface options. For the full picture on BIA-ALCL symptoms, risk factors, diagnosis and treatment, see our dedicated guide: BIA-ALCL and Breast Implants. For how Silimed compares with other brands, see our guide to choosing the best breast implants.
Other Risks of Breast Augmentation Surgery
Alongside the implant-specific risks above, breast augmentation carries the general risks of any operation, plus a few that are specific to breast surgery. Most are uncommon, and your surgeon will go through each of them with you at consultation. Your risk is lower if you are in good health and don’t smoke; we ask patients to stop smoking for four weeks before and four weeks after surgery.
- Bleeding and haematoma: a collection of blood around the implant, usually within the first 24 to 48 hours. It is treated by returning to theatre to wash out the pocket, and the implant can usually be kept.
- Infection: increasing pain, redness or warmth around the breast, or feeling generally unwell, should be assessed by your surgeon urgently. Implants are inserted using a “no-touch” technique to reduce this risk.
- Seroma: a build-up of fluid around the implant in the weeks after surgery. Small seromas usually settle on their own; larger ones may need draining. Swelling that appears months or years later is different and should always be checked (see BIA-ALCL above).
- Implant malposition: an implant sitting too high, too low or too far to the side, which may need revision surgery to correct.
- Changes in nipple sensation: the nipples can become more or less sensitive. This is usually temporary but is occasionally permanent.
- Scarring: breast augmentation scars fade over 12 to 18 months but don’t disappear completely, and some people form raised or stretched scars.
- Anaesthetic risks: serious reactions, including allergy to medicines, are rare. Your anaesthetist will review your medical history before surgery.
- Breastfeeding: many women breastfeed normally after breast augmentation, but some find it more difficult.
Breast implant illness
Some women report symptoms that they attribute to their implants, including tiredness, joint and muscle pain, rashes and difficulty concentrating (“brain fog”). This is often called breast implant illness. It isn’t a recognised medical diagnosis and there is no test for it, but the symptoms are real to the person experiencing them, and some women report improvement after their implants are taken out. If you are concerned, speak to your surgeon about the options, including breast implant removal.
Corrective breast surgery
Breast implants will eventually need to be either removed or replaced with new ones. Revision breast surgery is commonly carried out at our Baker Street clinic in central London. Revision surgery is generally a very safe procedure, although, as with any surgery, there are always risks involved. The risk of complications developing is minimised as long as you are healthy without any significant chronic medical conditions such as diabetes, heart disease, high blood pressure or obesity.
Revision breast surgery may be associated with a slightly higher risk of capsular contracture. It is, therefore, vital to follow all your surgeon’s post-operative instructions in full to minimise the risk of this occurring.
Frequently Asked Questions About Breast Implant Safety
Are breast implants generally safe?
Yes. Breast augmentation is one of the most commonly performed and well-studied cosmetic procedures, with a low overall complication rate when carried out by an experienced consultant plastic surgeon at a properly regulated facility. As with any surgery, risks exist, which is why understanding them properly matters.
What is the biggest breast implant safety consideration?
There isn’t a single biggest risk — capsular contracture, rupture, and (for textured implants specifically) BIA-ALCL are the three most discussed, each with a different likelihood and management pathway, covered in detail above.
How often should breast implants be checked?
Keep an eye on any change in shape, firmness or sensation, and see your surgeon if anything changes. At a review, your surgeon will examine you and arrange an ultrasound or MRI scan only if it’s needed. Our guide to breast implant checks explains what a review involves and when to book one.
Book your London breast implant surgery today
Once you have decided to proceed with breast implants, the next step is to contact us and book a consultation with an expert breast surgeon. Our modern Baker Street clinic in central London is home to some of the top UK plastic surgeons with expertise in all types of breast surgery, including corrective breast surgery.
