What are the complications of breast implants?

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Last updated: May 14, 2025 • View editorial policy

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From the Guidelines

Breast implant complications can occur both shortly after surgery and years later, and it is essential to monitor for these complications through self-exams and professional follow-ups, with MRI or ultrasound recommended 5-6 years after silicone implant placement and every 2-3 years thereafter, as suggested by the FDA 1.

Common Complications

Some common complications of breast implants include:

  • Infection, which typically develops within days to weeks after surgery and may require antibiotics like cephalexin 500mg four times daily for 7-14 days, or implant removal in severe cases
  • Bleeding, poor wound healing, and implant malposition, which can occur shortly after surgery
  • Capsular contracture, where scar tissue around the implant becomes hard and painful, affecting 10-20% of patients and may require surgical revision
  • Implant rupture, which occurs in approximately 10% of silicone implants within 10 years and requires replacement

Rare but Serious Complications

Other complications include:

  • Breast implant illness (BII), a collection of symptoms like fatigue, joint pain, and cognitive issues that some women attribute to their implants
  • Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare cancer associated primarily with textured implants, which is thought to arise from a chronic inflammatory stimulus in the context of underlying host genetic factors and susceptibilities 1

Diagnostic Imaging

Diagnostic imaging, such as MRI or ultrasound, is essential for evaluating implant integrity and detecting complications, with the FDA recommending MRI to evaluate for rupture in symptomatic patients with silicone breast implants 1

Recommendations

Regular monitoring and follow-ups are crucial to detect and manage breast implant complications, and patients should be informed of the potential risks and benefits of breast implants, including the risk of BIA-ALCL and other complications, as outlined in the FDA's "Patient Decision Checklist" 1.

From the Research

Complications of Breast Implants

  • Capsular contracture is the most common complication following implant-based breast surgery, with an overall incidence of 10.6% 2
  • Risk factors for capsular contracture include the use of smooth implants, subglandular placement, silicone-filled implants, and previous radiotherapy to the breast 2
  • Other complications associated with implant-based breast reconstruction include hematoma, implant infection, seroma, skin envelope necrosis, rupture, malposition, animation and contour deformities, implant-associated anaplastic large cell lymphoma, and breast implant illness 3

Prevention and Management of Complications

  • Preventative measures for short-term complications include meticulous sterile technique and antibiotic irrigation, adequate drainage, and critical evaluation of mastectomy flaps 3
  • Management of short-term complications requires early recognition and aggressive treatment to prevent reconstructive failure and long-term complications such as capsular contracture 3
  • Interventions that decrease the rate of capsular contracture include antibiotic prophylaxis or irrigation, acellular dermal matrix, leukotriene inhibitors, and surgical techniques 4

Capsular Contracture

  • Capsular contracture is a multifactorial fibrotic process, and the precise cause is still unknown 2, 5
  • The incidence of capsular contracture is lower with the use of textured implants, submuscular placement, and polyurethane-coated implants 2
  • Symptomatic capsular contracture is usually managed surgically, but recent research has focused on preventing capsular contracture from occurring or treating it with autologous fat transfer 2

Future Perspectives

  • Further research is needed to uncover the underlying mechanisms of capsular contracture and develop preventive measures and treatments for this complication 5, 6
  • Efforts should focus on minimizing the risk of capsular contracture through improved implant materials, surgical techniques, and infection prevention 6
  • Understanding the physiology of capsular formation and its associated pathologies is crucial for healthcare providers involved in implant-based breast surgery 6

References

1
Guideline

Guideline Directed Topic Overview

Dr.Oracle Medical Advisory Board & Editors, 2025

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Professional Medical Disclaimer

This information is intended for healthcare professionals. Any medical decision-making should rely on clinical judgment and independently verified information. The content provided herein does not replace professional discretion and should be considered supplementary to established clinical guidelines. Healthcare providers should verify all information against primary literature and current practice standards before application in patient care. Dr.Oracle assumes no liability for clinical decisions based on this content.

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