Breast implants are generally very safe, but knowing the potential complications helps you make informed choices. From ruptures to capsular contracture and implant surface differences, understanding what can happen—and what is rare—gives you confidence in managing your implants over time.
Rupture
- Saline ruptures: Immediately noticeable due to deflation.
- Silicone ruptures: Often “silent”; require imaging for detection.
- Risk factors: implant age, size, submuscular placement, seat belts, underwire bras, and dominant side.
- Reconstructive patients and older implants often have higher rupture rates.
Rupture is uncommon but possible; knowing the signs and following imaging recommendations ensures early detection.
Capsular Contracture
- Normal scar tissue forms around every implant; contracture occurs when it tightens excessively.
- Symptoms: firmness, shape distortion, and sometimes pain.
- Incidence: 7% of cosmetic augmentations, 12.7% of reconstructions.
- Only treated surgically if symptomatic.
Most cases are mild and manageable, but awareness helps you address any discomfort promptly.
Implant Surface Types
- Macrotextured implants: Higher risk of BIA-ALCL and thicker capsules; some devices recalled.
- Motiva SilkSurface (semi-smooth): Very low capsular contracture (~0.5%), no reported BIA-ALCL, good tissue integration, and minimal inflammatory response.
- Important note: Dr. Iyengar does not use macrotextured implants in his practice.
Choosing the right surface reduces complication risk while keeping your results safe and natural.
BIA-ALCL
- Rare lymphoma associated almost exclusively with textured implants.
- Usually appears 8–10 years after implantation as unilateral swelling.
- Smooth implants have no confirmed cases.
Being informed about your implant history helps you recognize warning signs and act early, though risk is very low with smooth implants.
Common Reasons for Implant Exchange
- Medical: rupture, capsular contracture, malposition
- Aesthetic: size/shape changes, post-pregnancy changes, surface type changes
- Reoperation rates: 11.7% (augmentation) vs. 25% (reconstruction) at 7 years
Exchanges are sometimes necessary for medical or aesthetic reasons, and careful planning ensures the best outcome.
Breast Implant Illness (BII)
- Some patients report fatigue, joint pain, or brain fog.
- No definitive test exists; some report improvement after explantation.
- Decisions should be guided by shared decision-making rather than fear.
Individualized evaluation helps guide safe decisions without unnecessary worry.
Next steps.
Feel confident in your implants! Schedule a consultation at Iyengar Plastic Surgery to review your implant history, assess any risks, and discuss personalized options for monitoring or revision.
