Breast augmentation

These are not complications; they are the breast's normal response to surgery. They appear in the first few days and resolve with standard post-operative care:

• Moderate pain and a feeling of pressure in the chest during the first 48–72 hours, controlled with the prescribed pain relief.
• Breast swelling and edema during the first 2–3 weeks.
• Mild bruising around the incision, which is gradually reabsorbed over 7–14 days.
• A feeling of tightness, especially with submuscular implant placement, which improves as the muscle adapts.
• Temporary changes in breast and nipple sensation (increased or reduced sensitivity), which in most cases return to normal within 3–6 months.
• A scar that is initially pink or red, which matures and fades over the 12–18 months after surgery.
• Temporary asymmetry between the two breasts during the first few weeks, while the implants settle and the swelling goes down.

All of these reactions are part of the normal recovery process. Most patients can return to sedentary activities after one week, office work after 7–10 days and high-impact sports from 6 weeks onward.

There is a second group of issues that, while not serious, can appear during recovery or the first few months and are worth knowing about:

• Seroma: a build-up of fluid around the implant. It usually resolves on its own or with needle drainage in the clinic.
• Significant hematoma requiring surgical drainage, in patients with heavier post-operative bleeding than usual.
• Hypertrophic or keloid scarring, more common in patients with a personal or family predisposition to this type of scarring.
• Persistent breast asymmetry once the result has settled, which may require a minor surgical touch-up.
• Rippling (folds in the implant visible through the skin), more common in very slim patients or those with little breast tissue to cover the implant.
• Prolonged loss of sensation in the nipple and areola, which in a minority of cases may not fully return.
• Implant malposition (lateral displacement, downward shift, or rotation in anatomical implants), which may require revision surgery.
• Delayed healing, especially in patients who smoke, have diabetes or have excessive skin tension.

Most of these situations are managed in the clinic with close follow-up. Only a small proportion require revision surgery.

These are the serious complications, described in the surgical literature with low incidence rates, but which every well-informed patient should know about before signing a consent form:

• Capsular contracture: the body always forms a fibrous capsule around the implant; in a minority of cases this capsule thickens and hardens, changing the shape and feel of the breast. Modern surgical techniques, textured implants and strict asepsis protocols have drastically reduced its incidence.
• Periprosthetic infection, which can appear in the first few days or later on. In the most serious cases the implant has to be removed temporarily.
• Implant rupture or wear over the long term. Modern implants do not have an "expiry date", but they are not permanent devices; they may need to be replaced over the years.
• Deep vein thrombosis and pulmonary embolism, a risk present in any surgery under general anesthesia, which we minimize with antithrombotic prophylaxis and early mobilization.
• Reactions to general anesthesia, assessed and minimized by the anesthesiologist in the preoperative evaluation.
• Necrosis of the skin or nipple-areola complex, a rare complication mainly associated with excessive skin tension or active smoking.
• BIA-ALCL (breast implant-associated anaplastic large cell lymphoma): a very rare condition historically linked to certain macrotextured implants. Patients are informed during the consent process and lifelong clinical follow-up is established.
• Galactorrhea or changes in future breastfeeding: most patients can breastfeed normally after a breast augmentation, but there is a small percentage in whom the ability to breastfeed may be affected.