It is important to be aware:
Like any medical device, people with breast implants can experience complications associated with the surgery to insert them (e.g. infection or bleeding) or with the breast implant itself (e.g. rupture).
Complications can occur during the immediate period after surgery (e.g. bleeding) or months or years later (e.g. capsular contracture where scar tissue that has formed around the implant hardens and squeezes the implant).
In very rare cases, breast implants can cause an immune cell cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).
Other complications can include:
It can be difficult to estimate the risk of developing complications from breast implants because we do not know the exact number of implants inserted and information on complications has not been recorded for every person with an implant in a single database
The Australian Breast Device Registry (ABDR) currently collects information on people who have had a breast implant procedure. For 5,886 people who had revision (a second) surgery for a breast implant in 2018, complications recorded from least to most common were:
Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare T cell non-Hodgkin lymphoma that develops around breast implants. It is a cancer of the immune system, not a breast cancer.
Symptoms of BIA-ALCL usually include sudden swelling (due to a build-up of fluid around the implant) or pain in a breast or the armpit, and occasionally a lump or rash.
Most cases of BIA-ALCL recorded so far have developed on average 7-8 years after original insertion of the implant (range 3 -14 years after original insertion).
BIA-ALCL can be diagnosed by taking a sample of fluid (if present) or tissue from the breast using ultrasound (known as Fine Needle Aspiration), or can be diagnosed by histopathology of capsule tissue after implant removal. It cannot be diagnosed by a blood test.
If diagnosed early, surgical removal of the implant and capsule is generally curative, i.e. no further treatment such as chemo is required.
Breast implants can be classified in different ways, by the:
Some complications are more common with different types of implants, and also more common depending on the reason for surgery in the first place, i.e. cosmetic augmentation or mastectomy reconstruction.
For example, smooth implants may be more likely to move position compared to some textured implants; and saline implants may be more likely to rupture than silicone implants.
The risk of developing BIA-ALCL has also been found to increase with the grade (roughness of texturing) of the implant:
There are a few options to find out your implant type:
Knowing the type of implant you have can help you understand the risks, but it is not essential. Most experts are now recommending people with implants have regular follow-up by their GP or surgeon every 12 months to assess for complications, this is regardless of the type of implant or reason for its insertion.
Everyone with a breast implant should regularly self-examine their breasts, implants and armpits for any changes, including any unusual swelling or lumps, change in the shape or feel of your breasts, or any nipple and skin changes.
If you’re unsure how to examine your breasts, these websites have useful information:
If you notice any changes or you have concerns (including about BIA-ALCL), see your GP. If you are still under the care of your surgeon, for example you are still followed-up by your surgeon after reconstructive surgery, you can also see them.
Everyone with a breast implant should see their GP or surgeon every 12 months for clinical review, regardless of whether you have noticed any breast changes or what type of implant you have. Clinical review will usually include being asked some questions about whether you have any symptoms or have noticed any changes and an examination of your breasts, implants and armpits. In some cases, the doctor may order an ultrasound.
People who are eligible for breast cancer screening through BreastScreen NSW (women aged 50-74 years) should attend for their mammogram when called. Mammograms are safe to be done with breast implants, just tell a staff member or indicate on any forms that you have a breast implant.
BreastScreen NSW has more information at BreastScreen NSW - Screening and Breast Implants.
Experts are not recommending removal of breast implants where there are no symptoms or signs anything is wrong. This is because:
The best course of action is to continue to regularly self-examine your breasts, monitor for any changes and see your GP or surgeon every 12 months for a review, or earlier if you have concerns.
It is always best to see your GP for advice before consulting a surgeon offering ‘easy’ removal of breast implants.
It is ok to get a second opinion if you still feel unsure or are not satisfied with the information given to you by your GP or surgeon. Bringing a partner, family member or friend to your appointment to support you, ask questions or take notes may help.