Breast augmentation is a common operation with a well-described set of risks, and the two that most often lead to further surgery are capsular contracture and implant rupture. Neither is rare enough to leave out of the conversation, and both are reasons this is a decision with a long tail rather than a one-off event.
Australian regulators take implant safety seriously enough to maintain a national registry. Your device details are reported to the Australian Breast Device Registry unless you opt out, and the Therapeutic Goods Administration publishes a breast implant hub for consumers.
Risks specific to implants
| Risk | What it means |
|---|---|
| Capsular contracture | The scar capsule around the implant tightens, making the breast firm, high or painful. A leading reason for revision. More here |
| Rupture | Failure of the implant shell. With cohesive silicone it may cause no symptoms at all. Signs and what happens next |
| Rippling and palpable edges | More likely where soft tissue cover is thin or the implant is large for the frame |
| Malposition | The implant sits too low, too high or too far to the side, or the two do not match |
| Rotation | Relevant to anatomical implants, which change breast shape if they turn |
| Animation | Movement or flattening of the breast when the chest muscle contracts, with implants under the muscle |
| BIA-ALCL | A rare cancer of the immune system arising in the capsule, associated chiefly with textured implants. Dedicated page |
| Reported systemic symptoms | Some patients report fatigue, joint pain and brain fog and attribute them to their implants. What is known |
Risks of the operation itself
- Bleeding or a collection of blood around the implant, occasionally needing a return to theatre
- Infection, which with an implant in place can mean removing the device to clear it
- Changed or lost nipple sensation, usually temporary but sometimes permanent
- Wound healing problems and widened scars, made considerably more likely by nicotine
- Asymmetry, since no two breasts start the same
- Anaesthetic risks, and blood clots in the leg or lung
Dr Kumar requires complete abstinence from all nicotine, not just smoking, for six weeks before and after surgery. It is the single modifiable factor that most affects wound healing.
The risk that is easiest to underestimate
Implants are not a one-off purchase. Over a lifetime, a proportion of patients will need further surgery — for contracture, rupture, malposition, or because the breast changes around the implant with age, weight or pregnancy. Planning for augmentation sensibly means accepting that further operations, and further cost, are a realistic possibility rather than a remote one.
Choosing an implant that suits your tissue rather than the largest one that will fit is the decision most within your control. See choosing implant size.
Effect on screening
Implants obscure some breast tissue on mammography whichever plane they sit in. This does not prevent screening, but you should tell the radiographer you have implants so that appropriate views are taken, and continue with screening as recommended for your age.
How risk is reduced
- An accredited private hospital, with a specialist anaesthetist
- Nicotine abstinence, and attention to anything affecting wound healing
- Implant selection matched to your measurements and tissue cover
- A cooling-off period of at least seven days before booking, so the decision is not made in one appointment
- Twelve months of structured follow-up rather than a single post-operative check
Common questions
What is the most common complication? Capsular contracture is the most common reason for revision surgery.
Do implants cause breast cancer? Implants are not considered a cause of breast cancer. BIA-ALCL is a different disease — a lymphoma arising in the capsule — and is rare.
Will I know if one ruptures? Not necessarily with cohesive silicone, which is why follow-up matters.
Can risks be removed by choosing a good surgeon? They can be reduced. They cannot be removed, and any surgeon promising otherwise should be treated with caution.
Next step
Risk is discussed properly at consultation, with your own anatomy and history in front of you, and again at the second appointment after the cooling-off period. Bring a GP referral — it is required to see Dr Kumar. Call 1300 267 726. More about breast augmentation and recovery.
The initial consultation with Dr Kumar is $400, with a Medicare rebate of approximately $88 where you have a GP referral. Surgical fees are quoted individually after your consultation, in a written itemised quote.
All surgery carries risks, and individual results will vary. Read more about the risks of surgery here. A GP referral is required to see Dr Kumar.
Dr Rohit Kumar (MED0001630444) Registered medical practitioner, specialist plastic surgeon (specialist registration in surgery – plastic surgery).
