Breast Uplift Specific Risks

In any discussion or recitation of risks, not every conceivable risk or potential consequence can be mentioned. The ones that are touched on are those that occur with some relative frequency.

Besides the general risks associated with any surgical procedure, there are the risks that are unique to that surgery. In the case of Mastopexy (breast uplift), among the specific risks are:

Unfavorable Scarring – Regardless of which mastopexy pattern or design is used, thick, wide, or raised scarring can occur. The causes are not clear, although hereditary predisposition plays a role, & some people are more prone to this kind of scarring than others. The scars can be treated in a number of ways to try to improve them, including scar revision surgery.

Skin Loss/Slough – A problem with blood supply to an area of skin, including the nipple, can occur. The reasons are not always clear. However, it is far more likely to occur in smokers!

Asymmetry – Breasts, like most paired structures of the human body, are not naturally exactly the same (not mirror-images of one another). Surgery cannot make them exactly the same, although the surgeon may try to improve symmetry. Patients should expect some degree of asymmetry.

Interference with Breast-Feeding – If you have breast-fed before, breast implants should not interfere with breast-feeding in the future.

Residual Drooping – While the goal of mastopexy is to lift the breasts, patients should expect some degree of drooping to remain. This issue should be discussed before surgery, so that expectations are realistic.

When implants are used, the risks are the same as for breast enlargement (augmentation mammaplasty), namely:

Capsular Contracture (Hardening/Encapsulation) – A veil of scar tissue naturally forms around the breast implant after surgery. If that scar tissue thickens and tightens, it is called “capsular contracture”. It can result in a breast that feels hard and may look distorted. If this does not respond to non-surgical methods of treatment such as regular breast massage and compression, surgical release may be necessary.

Interference with Mammography – The position of the breast implant may make interpretation of a standard screening mammogram more difficult. Therefore, with breast implants, it is important to go to an experienced mammography center where the needed special mammogram views can be done, and where ultrasound examinations are available as well. There is, however, no evidence of a relationship between implants and breast cancer!

Leak or Rupture – Like any man-made device, breast implants can and do break. How often is not exactly known, but one manufacturer studied saline-inflatable implant breakage over the past 13 years and found the incidence to be less than 1%. And silicone-gel implants break less frequently than the saline. If a saline-inflatable implant breaks or leaks, the breast will "go flat", usually over a period of about a week. The saline (sterile salt-water) is absorbed into your system. If a silicone-gel implant breaks, and the silicone stays within the scar capsule that has been formed, you may not be aware that it has broken until it is discovered in a mammogram or ultrasound exam. If, however, the scar capsule breaks as well, the silicone can move into the adjacent tissue or even migrate to other contiguous areas, where the body surrounds it with scar tissue. Broken implants should be removed and replaced. Sometimes with silicone gel, it is not possible to remove all of it.

Rippling – This phenomenon is palpable and even visible ripples (seen as lines or grooves of the breast) appear to be most prominent in textured (rough surface) implants – especially those that are saline-inflatable – but also silicone-gel filled ones, as well. It is probably a function of the thickness of the implant shell. In an attempt to avoid this visibly unpleasant phenomenon, we prefer implants with a smooth surface. They tend to ripple much less.

Autoimmune Effects – Beginning in the early 1990's, there was some concern about a possible causal relationship between silicone and a group of disorders of the immune system called "connective tissue disorders". Since that time, however, major scientific studies undertaken to examine any possible relationship have consistently not shown any. They concluded that silicone gel either in implants or that which escapes from a broken implant is unrelated to autoimmune disorders and symptoms.

For additional information concerning risks specific to breast uplift, please consult with your own plastic surgeon, or the websites for ASPS (The American Society of Plastic Surgeons) or ASAPS (The American Society for Aesthetic Plastic Surgery).