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CICATRIX * OPTIMA 1720 HOWARD AVE, SUITE 364 WINDSOR, ON N8X 5A6 TEL/FAX: 519.971 0971 |
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Possible Complications
Bleeding: Any type of surgery may result in bleeding in the operated area. This may be due to a temporary increase in blood pressure such as occurs due to coughing. It can also occur from the effects of medication like aspirin or anti-inflammatory drugs. The incidence of a hematoma (collection of blood) following breast augmentation if approximately 1%. A hematoma most commonly occurs within the first 24 hours after surgery. A patient often describes a disporportionate amount of pain on one side of the breast.
Bleeding is usually manifested by acute swelling of the area, discolouration of the skin, pain and a feeling of tension.
Surgical treatment of a hematoma involves removing the stitches, and evacuating the clotted bood. The incision is then re-stitched and another dressing applied.
Post-operative swelling: Some swelling after your operation is normal. Time is the most important factor in reducing swelling. It is not unusual to have asymmetric postoperative swelling. It is important to understand that perfect symmetry following a plastic surgical procedure on the breasts is not possible.
Prolonged discoloration: If your bruise easily, discoloration may remain for several weeks after surgery. You should advise your doctor of any past history of bleeding disorder. In rare cases, discoloration may be permanent. This condition is probably caused by extensive bruising with subsequent deposition of blood pigments into the skin itself.
Implant failure: This can occur immediately or several years after augmentation. A faulty valve or rupture of the implant shell are the most common causes of deflation. A 1% deflation rate per implant per year is a reliable estimate for implant deflation.
Undesirable scarring: Prominent, unsightly scars (thick, red, ropy, itchy, and painful): The normal healing of wounds is a physiological process which continues to take place in the depths of the tissues for many months before final resolution. At first, the surgical scar is almost invisible. Then it becomes red and somewhat elevated for about 3 months. It then becomes paler, softer and flatter and reaches its resolved state in 6 to 12 months. Aesthetic surgery has its limitations. Any time the skin is opened a scar of some kind results. This may be a good scar (fine white line) or a conspicuous one, but there is always a scar of some sort.
Each individual’s healing is different. Some form fine white lines while others will form heavier ones. The surgeon has no influence on the actual formation of a scar. Factors that can influence the quality of healing include smoking, infection, and bleeding. The complete mechanisms of wound healing are not yet fully understood. Thus, the factors that may lead to formation of a conspicuous scar are not yet known.
Very heavy (hypertrophic) scars or keloids (scars which escape the confines of the original wound) are uncommon. They are found most frequently on the front of the chest, abdomen, and shoulder area. Dark skinned peoples (particularly those of African, Asian or Mediterranean descent) are more susceptible to the development of hypertrophic scars.
Sun exposure of a new scar should be avoided for the first year following your operation. An immature scar exposed to sun may become more visible and pigmented.
Despite meticulous technique and attentive post-operative management, a small percentage of patients will develop some undesirable scaring. The scars may become wider over a period of several weeks or months or possibly exhibit a true hypertrophy (red, raised, itchy, painful). These scars can be treated by a variety of methods including local pressure, massage, cortisone injections, topical creams, and surgical revision. Rarely, hypertrophic scars are permanent and will not respond to treatment.
Capsular contracture: The most common “complication” in breast augmentation is capsular contracture. The reason for the quotations is that while we list it here in the complications section, it is not a true complication. Rather it is an inherent risk of the breast augmentation procedure.
Rates of capsular contracture have been reported ranging from 0.5% to 20%.
Rippling and wrinkling: visible changes, such as wrinkling or rippling of breast implants, have been reported in up to 20% of implants.
Infection: Any surgical wound can become infected. An infection usually will become apparent a few days after the surgery. The signs are: pain, redness, heat and swelling. Superficial wound infections involving the skin are treated with antibiotics and dressing changes. On rare occasions, an infection may involve the implant pocket. Formal drainage in the operating room will be needed to control these more significant infections. The implant often has to be removed and the infection allowed to settle for a period of several months before another breast augmentation procedure can be planned.
You will be given a prophylactic antibiotic when undergoing your breast augmentation. In addition you will be sent home with a prescription for antibiotics for 4-5 days.
Inability to close the eyes: It may be difficult for you to completely close your eyes during the early post-operative period, especially while the swelling persists. Drying of the corneal surface can be prevented by using ointments and lubricating drops. If you are sensitive to light, you should wear dark glasses. If there is a skin shortage on the eyelids, a skin graft may be necessary.
Change in nipple sensation: changes in nipple sensation occur temporarily in most patients, but in approximately 15% these changes can be permanent. The type of incision has no bearing on this complication and it has been reported with implants under the muscle or under the breast itself.
Excessive tearing: A small percentage of patients experience excessive tearing during the immediate postoperative phase because of mechanical alteration in the tear collecting mechanism or obstruction in the ductal system. This condition usually subsides in a matter of days. If this persists consultation with an opthalmologist may be indicated.
Asymmetry: Absolutely perfect symmetry is not possible.
Drooping of the upper eyelid (ptosis/lazy eye): This may due to damage to the elevating mechanism of the eye. If this persists, consultation with an opthalmologist may be indicated.
Inflammation of veins on the breast (Mondon’s disease): This is not a common complication. Occasionally a tender cord representing the inflamed vein can be palpated. It usually is self limiting and no treatment is necessary.
Pneumothorax (air in chest cavity): This is a rare complication.
Other risks and complications include chronic pain, uncertain life span of the implant, possible compromised detection of early breast cancer, possible effects on nursing, possibility of late calcification.
Some of the complications of these operations can cause the need for further surgery. Some of the complications can cause prolonged illness, poor healing wounds, scarring and permanent disability.
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