What are the risks associated with breast augmentation?

Breast augmentation is a fairly simple and safe procedure. However, as with all surgical procedures, there are risks involved. Most women who undergo breast augmentation have no complications or problems in connection with the surgery. As there has been a very public debate going on in recent years on the safety of breast augmentation, it is appropriate to address any and all risks associated with this surgery. Anyone considering this surgery is encouraged to review all the risk factors and discuss them with the surgeon.

  1. The most common complication of breast augmentation is capsular contracture, which occurs when the tissue surrounding the implant tightens and contracts, making the implant seem to harden. This can be alleviated using several methods, i.e. replacing the implant or in rare occurrences, removing it entirely. This happens in approximately 4–7% of patients.
  2. As with most surgeries, bleeding following surgery can cause pain and swelling. If the bleeding is persistent, the incision may have to be reopened to release blood or stop the bleeding.
  3. A very low percentage of women contract an internal infection in the tissue surrounding the implant. In these rare occurrences, the infection usually occurs within the first week after surgery. The implant must be removed for a few months while the infection is cured with prescription medication, after which the implant can be replaced.
  4. Very few women experience rare changes after the surgery such as increased sensitivity of the nipple, decreased sensitivity of the nipple or even numbness. Some experience numbness in the skin around the incision. Usually these symptoms disappear with time but can, in very few instances, be permanent.
  5. There is no research that indicates breast augmentation can affect fertility, gestation periods or the ability to breastfeed. If you have breastfed within the year prior to breast augmentation, however, you may start to produce milk in the days following the surgery. This can cause discomfort but can be prevented with medication.
  6. On rare occasion, an implant can rupture or leak. This can occur during an accident or even extreme physical exertion. If the implant is very mature, the shell it is more likely to rupture and leak. If the implant is saline, the fluid is released into the body within a few hours and dissolves with no resulting damage. If it is a silicon implant, there are two possible results. If the implant shell bursts but the surrounding tissue is sealed, you may not notice a difference. However, if the surrounding tissue splits open as well, which can happen with extreme exertion, the silicon can escape into other areas of the body, settling into small closed compartments within and surrounding the breast. This causes the breast to become to misshapen. In both cases, the implant is removed, but if silicon has leaked into surrounding body tissue it may be impossible to remove it all.

Although no research indicated that breast augmentation increases the risk for cancer, the presence of an implant does call for different breast cancer screening techniques. When you go for your mammogram, you must make it clear that you have impants.


What do I need to have in mind before deciding on breast augmentation?

Breast augmentation can improve your appearance and self-esteem but will not make you perfect. Before deciding on breast augmentation, be sure to carefully consider your expectations of the surgery and discuss them openly with the surgeon. It is important to realize that your breasts will possibly not be perfect and to be realistic about expectations.


What type of implant is best?

Implants used in augmentation are soft silicone shells filled either will silicone gel or saline and are stronger and more permanent. . Silicone implants are more commonly used in Iceland because they generally create a more desirable shape. By placing the implant under the breast skin or muscle, the surgeon can increase the size of the breast by a cup size or more. Regardless of what kind of implant is used, it is impossible to guarantee that no complications will occur

How do I prepare for breast augmentation?

During the initial interview, the surgeon will assess your reasoning for wanting breast augmentation and if your health will allow it. It is important to have considered and clarified your reasons to want the surgery in an open and honest manner. You must also prepare yourself for the surgeon’s candid and rational review of your options and the risks you would face. You should notify the surgeon of any hereditary breast diseases in your family, if you smoke and what if any prescription medications and health supplements you take.


Where is the surgery performed?

The surgery is performed at in an operating theatre at Domus Medica Medical Centre in Reykjavík. Dr. Stefánsson and Dr. Einarsson‘s offices are on the 4th floor and operating rooms on the 6th floor.


Will I require anaesthesia?

Breast augmentation surgery is always performed under general anaesthesia. The anaesthetic is administered by an anaesthesiologist who is present during the surgery until a few hours after you have woken up. Anaesthesia has improved greatly in recent years, resulting in safer surgeries with shorter recovery times and lowered likelihood of nausea.


What happens during the surgery?

Before undergoing the surgery, you need to speak to the surgeon about the details of the procedure in order to ensure yourself as well as the surgeon that you understand what will happen. The implants are placed either directly under the gland or under the muscle. The method used to insert the implant and place it correctly depends on your body type. Usually an incision is made under the breast, although it can be next to the nipple or under the arm. Through this incision, the surgeon makes a compartment for the implant under the gland or under the muscle and places the implant inside. The surgeon makes every effort to minimise visible scarring. If capsular contracture does occur, it is much less noticeable if the implant is placed under the muscle, although this method causes more discomfort following the surgery for one or two days.


How long does the surgery take?

Breast augmentation usually takes one to two hours. Waking up from anaesthesia can take an additional hour or two, making the time required for the procedure about four hours.


How will I feel immediately following the surgery?

After the surgery, you will be tired and feel pain around the incisions. This pain can usually be managed with pain medication. Most women that undergo breast augmentation are back on their feet within a few days. The breasts are bandaged after surgery and these bandages are removed within a few days. You may experience stinging in the nipple area in the two weeks following surgery which will lessen as the bruising and swelling subside and the incisions heal. You may have some swelling for three to five weeks after surgery. Usually the incisions are closed with absorbable sutures that disintegrate and do not need to be removed.


How long will it take to fully recover?

Usually you can return to work within a few days depending on the type of work you do. It is essential to follow the surgeon’s recommendations regarding exercise and movement. It is likely that your breasts will be tender for the first three weeks following surgery and you will not want them touched. After that time, the sensitivity has usually declined and touching them is perfectly safe. The incisions are visible for at least six weeks following surgery and the scar is usually red. After that, the incisions may seem to get wider but they eventually become paler although they will never disappear entirely. Keeping the scars away from sunlight is imperative while they are still red.


What expectations can I have regarding the change to my appearance?

The satisfaction levels after plastic surgery are high amongst women who make a well-informed and thought out decision to have the procedure. In many cases women are completely delighted. Remember however that breast augmentation is not without risk, so it is important to allow the surgeon to monitor you closely after the surgery so as to be able to react quickly if problems do arise. Your decision to have breast augmentation is highly personal and may not be fully understood by everyone around you. The important thing is that you are happy with the decision and that it provides the results that you wanted. Breast augmentation does not hinder breastfeeding later in life.