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Mr Andrew Yelland
Consultant Breast Onco-plastic & Cosmetic Surgeon

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Breast Augmentation Risk & Complications

Any surgery carries a degree of risk, particularly if conducted under general anaesthetic.

AFTER THE SURGERY

Your surgeon, anaesthesiologist, and nursing staff will monitor your condition before, during, and after surgery to reduce the risk of complication and respond to any need that arises.

After surgery it is important to move around as much as is comfortable, and stay hydrated, in order to reduce your risk of thrombophlebitis (blood clot formation).

Get emergency medical help if you have sudden shortness of breath, chest pain, dizziness, or tender, warm, and swollen legs, these can be signs of a blood clot.

INFECTION

Antibiotics may be prescribed pre and post-surgery to reduce your risk of infection.

Some soreness and redness of your incisions is normal but any spread of inflammation, increase in heat or tenderness of the breasts, or fever, headache, and fluid seepage should be investigated immediately to prevent any infection spreading or causing permanent damage.

ANAPLASTIC LARGE CELL LYMPHOMA

For information regarding Anaplastic Large Cell Lymphoma (ALCL) please see the advice from the Association of Breast Surgery or the British Association of Plastic and Reconstructive Surgery website.

FURTHER SURGERY

You will usually need to have further surgery if there are problems with the implant, although this may be able to be replaced later.

Capsular contracture also requires further surgery as might excessive scarring.

Your surgeon will usually wait four to six months for the implants to settle down before you make any decisions regarding correction of any asymmetry in the breast or nipples.

Some breast augmentation packages may also cover the costs of additional surgeries in some cases and this should be discussed with your surgeon before you have your breast implants.

Costs may only cover the procedure itself, however, and not account for fees for anaesthesiologists or your stay in hospital.

CAPSULAR CONTRACTURE

Breast augmentation surgery involving implants carries the risk of capsular contracture where the formation of excessive scar tissue around the implant can cause the implant to be squeezed and become misshapen or ruptured.

Textured implants can help to prevent this from happening as can following the guidance on restrictions of movement/stretching after surgery.

CHANGES IN SENSATION

Every effort will be made during breast augmentation surgery to retain your touch sensation in the nipple and breast tissue.

For some transwomen, the appearance of the breasts is the highest priority and this can mean that procedures with a higher risk of reducing or removing sensation are chosen.

Making sure that you discuss your options is of paramount importance as removal and transplantation of the nipple and the nerves associated with it cannot, normally, be reversed.

Nerve damage can occur due to trauma during surgery, particularly where areolar incisions are made and implants inserted in this fashion rather than through the axillary incision or inframammary fold (beneath the breast).

Sensation may not just be lost or reduced, however, as some find that sensation intensifies after surgery, sometimes to an uncomfortable degree.

APPEARANCE OF THE BREASTS

It is possible that after your breast augmentation surgery your breasts may appear asymmetrical either in the breast size, shape, or position, or in terms of nipple placement.

It is important to remember that your breasts, initial appearance will change as the swelling goes down and that any discrepancies may resolve themselves.

Many transwomen undergoing breast augmentation do, however, have more than one MTF surgery to achieve their desired look with nipple repositioning, tattooing, or implant removal and replacement commonly desired (or required) over the following months and years.

Skin wrinkling is more likely to occur if you are thin or have little breast tissue to cover the implant making it important to follow the full course of hormone therapy if appropriate or choose a suitably sized implant.

Rupture or leakage or the implant is more likely if too large an implant is chosen, although an experience surgeon should guide you through your options and help you make a suitable choice for your body type.

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