Breast Implant Reconstruction Risks and Complications

Breast implant reconstruction surgery — like mastectomy or any other surgical procedure — has potential risks and complications. Understanding some of the potential problems with breast implants after mastectomy can help you decide whether breast implant reconstruction is right for you, and help you make choices about the type of implant shape, filling, and placement.

Possible problems with breast reconstruction after mastectomy may include:

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  bleeding

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  bad reactions to anesthesia

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  infection

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  wound healing issues like hematoma (blood collecting in a surgical wound) or seroma (clear fluid collecting in a surgical wound)

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  unexpected scarring

Problems with breast implants after mastectomy may include:

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  rupture

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  displacement

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  capsular contracture

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  breast implant illness

Sometimes a bacterial infection can develop in the tissue around a breast implant or tissue expander days or weeks after breast implant reconstruction surgery. Symptoms of an infection can include a high fever, breast pain, redness, and swelling. Tell your surgeon if you have any of these symptoms. Your surgeon may prescribe antibiotics, but antibiotics don’t always clear an infection. You may need surgery to clean out the infected tissue and either replace or remove the implant or tissue expander.

Learn more about infection after breast implant reconstruction.

After breast implant reconstruction, there may be tissue expander complications or problems with the breast implants. For example, the breast skin might not heal properly. When the blood vessels that supply blood to the tissue are damaged, it’s often because the skin gets thinned out too much when tissue is removed during mastectomy. If there isn’t enough blood flow to the skin, areas of the skin on one or both breasts can wither and scab. This breakdown and eventual death of tissue is called necrosis.

Signs that you might be developing necrosis of the breast skin include the skin turning dark blue or black and developing scabs, open wounds, or both. You also may get a fever or feel sick. It’s important to work with your care team to make sure you get treatment quickly if you develop necrosis.

Learn more about breast skin necrosis related to mastectomy.

Capsular contracture happens when the normal scar tissue that forms around a breast implant tightens around and squeezes the implant. This condition can cause chronic pain, distort the shape of the breast, and raise the implant higher on the chest. Signs of capsular contracture can start to appear as early as a few months after breast implant reconstruction surgery or years later.

Learn more about capsular contracture.

Dynamic distortion (also called animation deformity) is a possible complication that happens with implants placed under part or all of the chest (pectoralis) muscle, called under-the-muscle or subpectoral placement. Problems with breast implants under the chest muscle tend to happen because after breast tissue is removed during mastectomy, the skin is in closer contact with the underlying chest muscle. As the tissues heal, the skin tends to stick to the chest muscle. So when you flex your chest muscle, your breasts might move in unnatural-looking ways. For example, they may appear to pop upward and outward or to shift down. It can sometimes cause pain, and some people say it makes them feel self-conscious.

There are surgeries that correct problems with breast implants under the chest muscle, including prepectoral revision and flap reconstruction.

Surgeons remove the implants from under the chest muscle and place new implants directly under the skin on top of the chest muscle (called over-the-muscle or prepectoral implant placement). To provide support for the implants and keep them from showing through the skin, surgeons may wrap or cover them in a cellular dermal matrix (a soft tissue substitute made from human or animal skin).

Surgeons remove the implants and replace them with your own tissue transplanted from another place on your body, such as the belly, buttocks, or thigh. A tissue flap provides a layer of living tissue between the skin and the chest muscle, eliminating dynamic distortion.

There’s a small risk that a breast implant might shift out of the correct position in the breast after some time. Implants can shift because of an error in how they are placed during breast implant reconstruction, gravity, and problems with the breast skin.

Breast implants can flip from front to back or rotate around like a wheel within the implant pocket, causing distortion in the shape of the breast, pain, or both. Implant flipping can happen when the pocket around the implant is larger than the implant or if there is trauma to the chest.

Learn more about breast implant displacement.

Implants can rupture because of damage caused by surgical instruments, a needle insertion during a biopsy, how old the implant is, or other factors.

Learn more about breast implant rupture.

BIA-ALCL is a rare form of T-cell lymphoma (cancer of the immune system) that can develop in the scar tissue and fluid surrounding a breast implant. BIA-ALCL is not breast cancer, and seems to only affect people with textured implants that are saline- or silicone gel-filled. In some cases, it can spread throughout the body.

Learn more about breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Breast implant illness (BII) is a term describing a wide range of symptoms that are linked to breast implants of any type. Symptoms can include joint and muscle pain, chronic fatigue, memory and concentration problems, breathing problems, sleep disturbance, rashes and skin problems, dry mouth and dry eyes, anxiety, depression, headaches, hair loss, and gastrointestinal problems.

Learn more about breast implant illness (BII).

Read Breastcancer.org’s Special Report on Breast Implant Illness and BIA-ALCL.