Breast augmentation is a commonly performed and generally safe operation, but like all surgery it carries risks. These include general surgical risks such as bleeding, infection and blood clots, and implant-specific risks such as capsular contracture, rupture, rippling and implant malposition. Breast implants are not lifetime devices, so further surgery may be needed in future. Understanding these risks, and how they are reduced, is an essential part of making an informed decision.
General surgical risks
- Bleeding (haematoma): a collection of blood around the implant, usually in the first 24 to 48 hours, which may need a return to theatre.
- Infection: can occur early or, less commonly, months later; an infected implant may need to be removed.
- Blood clots (VTE): deep vein thrombosis or a clot on the lung; the risk is reduced by early walking, hydration and, where appropriate, compression stockings.
- Anaesthetic risks: general anaesthesia carries small risks, which your anaesthetist will discuss; some patients are suitable for local anaesthetic.
- Wound healing and scarring: scars can occasionally widen, thicken or heal slowly, especially in smokers.
Implant-specific risks
- Capsular contracture: the body forms a capsule of scar tissue around every implant; if it tightens, the breast can become firm, misshapen or painful.
- Rupture: the implant shell can tear over time; with modern cohesive gel this is often ‘silent’ and detected on a scan.
- Rippling and palpability: visible or palpable implant edges, more likely in slim patients with thin tissues.
- Malposition: the implant can sit too high, too low, too far to the side or rotate.
- Asymmetry: pre-existing differences may remain or become more noticeable.
- Changes in nipple sensation: increased, reduced or altered sensation, usually temporary but occasionally long lasting.
BIA-ALCL and breast implant illness
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare type of lymphoma that develops in the fluid or capsule around an implant. It has mainly been linked with textured implants and usually presents years later as sudden swelling of one breast. It is generally treatable when detected early, which is why any late swelling should be assessed. Some women report symptoms such as fatigue or joint pain that they attribute to their implants, often called breast implant illness. It is not fully understood, and Mr Nassab will discuss current guidance openly.
How risks are reduced
Careful patient selection, detailed measurement, choosing implants that suit your tissues, meticulous surgical technique, antibiotic protocols and minimal handling of the implant all help reduce complications. Surgery takes place in CQC-registered hospitals, and implants are recorded on the national Breast and Cosmetic Implant Registry so patients can be traced if any safety concern arises. Stopping smoking, maintaining a stable weight and following aftercare instructions also make a real difference. You can read more in our guide on smoking and cosmetic surgery.
What is normal after surgery
Swelling, bruising, tightness, a high and firm appearance, and some difference between the two sides in the first weeks are all expected. Shooting pains, itching and altered nipple sensation are common as nerves recover. Implants typically soften and settle into a more natural position over three to six months.
When to seek help
Know which symptoms need action and how quickly:
- One breast swelling rapidly or becoming tense: contact the surgical team urgently.
- Fever, spreading redness or wound discharge: contact the team the same day.
- Calf pain or one-sided leg swelling: same-day GP appointment or NHS 111.
- Chest pain or breathlessness: call 999.
- New swelling, a lump or a change in shape years later: arrange a review with your surgeon or GP.
Long-term considerations
Many women with implants will need further surgery at some point, whether for a complication, a change in the breasts after pregnancy or weight change, or a wish to change size. Tell staff you have implants when attending breast screening. Breast augmentation costs from £8,500 and the £150 consultation is separate. Cosmetic surgery is only for adults aged 18 and over. If you are weighing up suitability, see who is a good candidate for breast augmentation.
Frequently Asked Questions
What is the most common complication of breast augmentation?
Capsular contracture is one of the more common longer-term reasons for further surgery. Early complications such as haematoma and infection are less common.
Do breast implants need replacing?
Implants are not lifetime devices. Many last for many years, but they should be replaced or removed if a problem develops.
Can women with implants still have mammograms?
Yes. Tell the screening team you have implants so they can use appropriate techniques.
How is a silent rupture detected?
Usually with an ultrasound or MRI scan, often arranged because of a change in shape, firmness or discomfort.
Is BIA-ALCL linked to all implants?
It has mainly been associated with textured implants. Any late, unexplained swelling of the breast should be assessed.
Related Guides
- Breast Asymmetry Correction Recovery
- Breast Asymmetry Correction: Risks and Safety
- Breast Asymmetry Correction: Questions to Ask
- Is Breast Augmentation Painful?
- The Inframammary Fold Explained
- Who Is a Good Candidate for Breast Augmentation?
- Breast Augmentation: Questions to Ask Your Surgeon
- Choosing a Breast Augmentation Surgeon in the UK
