The risks associated with breast augmentation refer more to the surgery rather than the implants themselves. All these implants have good safety records and i have had great experiences with Mentor and Allergan.
and only have different manufacturers in my opinion. I choose implants based on the service provided to me and my patients. I've seen absolutely no difference in my outcomes except for that short period of time I liked the PIP saline implants (that were doomed for early deflation). All companies have similar warranties and when the data is separated by minimal differences, its meaningless to me. Technique matters much more so know what your surgeon does to minimize your risks.
There are two very important things you should know about the data you have been perusing. First, these data are old. Since the studies, other studies have been done to define better ways of doing the surgery and lowering the risks. For example, the inframammary incision with textured implants, antibiotic irrigation and isolation of the nipple from the wound produces less capsular contractions. Using a larger inframammary incision so that less pressure on the implant is required for insertion reduces the late rupture rate. Choosing the implant based on measurements virtually eliminates need to replace the implant for the wrong size. Secondly, the experience of the surgeon makes a great deal of difference. Those who keep up on the literature and change their technique accordingly have a lower problem rate. The breast implant manufacturer studies are the risks across the board of a large number of surgeons of varying skills and are designed to cover essentially everything that can go wrong. It was also done with the help of the patients who agreed to return for follow up for an extended period of time. Therefore, these data represent what is probably the maximum rate of the problems. The reason for the differences in the manufacturers is that the studies were different and the surgeons different. There are good studies out there (including my own) where all the proper precautions are taken that show a very low (<2%) reoperation rate. Therefore, the most important part of reducing the problems is in choosing the right surgeon with significant experience and knowledge of how to reduce the problems.
The list is extensive, but complications that require reoperation are about 5% in the best of practices. The overwhelming majority of these are done to help patients who develop capsular contracture, an incompletely understood entity.
board certified plastic surgeon who performs hundreds of breast
augmentations each year. Then look at the plastic surgeon's website
after photo galleries to get a sense of who can deliver the results.
Kenneth Hughes, MD
Los Angeles, CA
you for being diligent in educating yourself about this procedure. The numbers
form those core studies are confusing and take many, many hours to sort out and
comprehend; they can even be confusing for physicians. Each of the company’s
studies was performed differently, so you cannot compare them directly (the old
“apples to oranges” analogy). What is important about those studies is that
they give you an idea of the adverse events and unexpected outcomes that can occur; and then to what extent they
occur on a more comprehensive level. Breast augmentation surgery is real
surgery, which is associated with real risks. And breast implants are not
permanent medical devices; they do fail.
surgeon’s practices/experiences can be isolated – if patients move or change
physicians the original surgeon may never be aware of a problem, complication,
or re-operation that has occurred. In a general assembly at the national Aesthetic
Society meeting several years ago, a question was posed about what each
individual surgeon thought their breast augmentation re-operation rate was. The
surgeons were asked to raise their hands. No one raised their hands for 25%, or
20%, or 15%; and few hands went up at the 10% number, and a bunch more at 5%;
and probably half (or more) raised their
hands for <5%. Unless you have great follow-up and calculate the numbers
directly, we (the surgeons) can have a misunderstanding about how frequently
these events occur and how many re-operations result. And naturally, (with no
intent of being deceitful) we probably tend to remember the good over the bad.
You have the studies, you can see the numbers … re-operation rates exceed 15%
and 20% in certain instances. So these studies help to eliminate that ‘perception’
problem and provide data on a broader scale regarding the complications and the
need for re-operations. …And believe me, we as surgeons, are not happy with
these statistics and are constantly trying to do our best to do whatever we can
to reduce the re-operation rate.
experienced surgeon, breast augmentation surgery is safe and the complication
rate is low. The more common complications include asymmetry, malposition,
implant failure, and capsular contracture. More significant problems include
infection or hematoma, both of which occur less than or equal to about 1% of
the time. A thorough consultation should include a discussion of the risks and
complications of surgery, and the surgeon should be able to describe his/her
personal experience with these events as well. And make sure all of your
questions are answered to your satisfaction.
line, you should seek an experienced plastic surgeon that you have a good
relationship with and trust. That will optimize your experience as you move
forward with your breast augmentation journey.
I hope this
helps put things in perspective. Best wishes. Ken Dembny
Don't be scared of the information provided by the companies. This is part of the agreements with the FDA. See an ASAPS member to find a surgeon or consult the Smart Beauty Guide for a surgeon near you. Breast Augmentation should have a less than 1% chance of infection. The most common significant complication in my practice is a hematoma which I had once and it my of course with one of our nurses. It was taken care of immediately and she did well and did not for a capsular contracture. The technique of placement, choice of implant size and patient expectations all play a role in outcomes.
My father started our practice in 1961 and I joined him in 1990. Between us, we have done thousands of breast augmentation procedures. I can't give you exact numbers regarding complications because I have never tallied them up, however, I can say that complications in our practice are extremely rare. Probably the most common complications are asymmetry, implant rupture, and capsular contractures. Asymmetries requiring a second operation occur in less than one percent of my patients. Implants will probably break at some point. Anything man-made does. I have seen some of my dad's patients who have had their implants since the 1970's and are still doing fine. I think the longest that I have seen silicone gel implants last is about 35-40 years and the longest I have seen saline implants last is about 28 years. Still, the implant companies have nice warranties on their implants these days and the quality and durability of the implants has improved so that helps. As for capsular contractures, I think this is a bigger issue when the implants are placed above the chest muscle. My dad put them there for pretty much his entire career because he felt like that was where the breast tissue was and that was where the implants would look and behave more like real breast tissue. While that made sense, I think capsular contractures may be related to bacteria and bacteria live in breast tissue (this is normal). When the implants are placed below the chest muscle, the muscle forms a barrier between the implant and the breast tissue bacteria. Also, as you go about your normal routine, your chest muscle slides over the implants and massages them which helps reduce the risk of capsular contractures. Placing implants under the chest muscle has virtually eliminated capsular contractures in my practice so I almost always put them there (don't tell my dad!). It takes a little longer for the muscle to relax and for the breasts to soften up but I think it is worth the extra time. I hope this information helps.