10% of women who have breast augmentation surgery will have rehab rations within the first 10 years and 20% of patients who have breast augmentation surgery will have a second procedure by 10 years. The most common reason for a secondary procedures, is increasing the size of the implants, but this varies. sometimes implants failed to drop down and the pocket needs to be adjusted. The incidence of having implants bottom out is directly related to the skill and experience of the surgeon. to minimize the chance of having that complication, you should very carefully screen when interviewing plastic surgeons. generally speaking, I recommend all patients have multiple in person consultations before scheduling surgery. During each consultation, ask each provider to open up their portfolio and show you their entire collection of before, and after pictures of previous patients, who had similar body and breast characteristics to your own. an experienced plastic sturgeon should have no difficulty showing you the before and after pictures of at least 50 previous patients. Ask providers to show you as many long-term follow ups as possible. You should ask each provider specifically what their own revision rates are, including how often they see patients implants. It’s not uncommon for patients to seek help from other plastic surgeons when they have undesirable outcomes from a surgical procedure. For this reason, some providers may not be aware that they are leaving patients with undesirable outcomes because the patients don’t follow up with them. Doctors who have consistent problems will know about it and it’s not wrong to ask specifically how many patients have had each of the complications you were concerned about. There are a few variables that increase the chance of having capsular contractions. The best way to avoid capsular contractions is to use meticulous sterility(all plastic surgeons do this) and to minimize the amount of blood around the implant by being meticulous about cauterizing areas that are bleeding during surgery. Sub pectoral augmentation also reduces the chance of capsular contraction in comparison to placing the implants above the pectoralis muscle. Overall, I think breast augmentation is a pretty straightforward procedure with consistent high patient satisfaction and a relatively low complication rate. Choosing providers does make a big difference. Look for plastic surgeons who do a lot of breast augmentation surgery. It’s also important to understand your own candidacy for the procedure. For example, women who have a divergent breasts or breast that sit far apart, are going to have this look emphasized or enhanced by having augmentation. Your candidacy, for the procedure should’ve been discussed thoroughly during the consultation, including the provider, showing you ample examples of previous patients who had very similar breast characteristics to your own. The most serious early complication is generally an infection, and is often equates to augmentation failure with losing the implant. Infections after breast augmentation is relatively low. The most significant long-term complication is chronic capsular contraction, which can also lead to implant failure with need of removing implants. Best, Mats Hagstrom, MD