---
title: "Breast Augmentation Risks and Complications"
url: https://drturner.com.au/blogs/breast-augmentation-risks-complications/
date: 2026-06-19
modified: 2026-07-30
author: "Dr Scott J Turner"
description: "Dr Scott J Turner | Specialist Plastic Surgeon (FRACS) Key Takeaways Every surgical procedure carries risk. Most breast augmentation patients recover without significant problems, but proper consent depends on understanding..."
categories:
  - "Breast Augmentation"
  - "Breast Implants"
image: https://drturner.com.au/wp-content/uploads/2024/04/blogplaceholder-img.svg
word_count: 2905
---

# Breast Augmentation Risks and Complications

*[Dr Scott J Turner](https://drturner.com.au/dr-scott-turner-sydney-plastic-surgeon/) | Specialist Plastic Surgeon (FRACS)*

> **Key Takeaways**
>
>
>
>
> - Every surgical procedure carries risk. Most breast augmentation patients recover without significant problems, but proper consent depends on understanding what can go wrong, how it presents, and what management involves.
> - The recognised risks include capsular contracture, implant malposition, asymmetry, rupture, infection, bleeding and fluid collections, sensation change, rippling, scarring, dissatisfaction with size or shape, and the possibility of further surgery.
> - Breast implants are not lifetime devices. The TGA and FDA both note that the longer a patient has implants, the greater the likelihood of a complication that requires revision.
> - Two rare conditions have their own dedicated articles: BIA-ALCL, a lymphoma associated with textured implants, and the symptom cluster patients describe as breast implant illness.
> - Risk profiles are individual. The same procedure carries different risk on different anatomy, medical history and implant choice, so population figures describe groups rather than people.
> - Some symptoms warrant urgent review rather than waiting for a scheduled appointment. Those are listed near the end of this article.
Understanding the risks of an operation is not the same as being talked out of it. The purpose of a risk conversation is to make consent meaningful: to establish what can happen, how likely it is, how it would be recognised, and what would be done about it. A patient who knows what a haematoma feels like is a patient who calls at the right time.

This article sets out the recognised complications of breast augmentation, how each presents, and what management usually involves. For an overview of the operation itself, including implant choices, technique and the consultation pathway, see the page on [breast augmentation surgery](https://drturner.com.au/procedures/breast-body/breast-augmentation/). Patients attending the Queensland rooms can find the same information for [breast augmentation in Brisbane](https://drturner.com.au/locations/brisbane/breast-augmentation/). Every implant placed in Australia is recorded with the Australian Breast Device Registry, which tracks long term device safety and performance nationally.

## The recognised risks at a glance

| Complication | What it is | Usual management |
| ------------ | ---------- | ---------------- |
| Capsular contracture | Scar capsule around the implant tightens or hardens | Monitoring at lower grades; capsulectomy and implant exchange at higher grades |
| Malposition | Implant sits too high, low, lateral or medial | Revision with pocket adjustment, internal support or implant change |
| Asymmetry | Difference in size, shape, fold height or nipple position | Measurement and planning before surgery; revision, staged surgery or fat grafting |
| Rupture | Breach of the implant shell | Imaging assessment, then removal or exchange depending on findings |
| Infection | Bacterial infection early or late after surgery | Antibiotics for mild early cases; drainage or implant removal if severe |
| Haematoma and seroma | Blood or fluid collection around the implant | Observation for small collections; drainage or return to theatre for large ones |
| Sensation change | Altered or reduced nipple and skin sensation | Often settles as nerves recover; can be permanent |
| Rippling | Implant folds visible or palpable through the skin | Implant or pocket change, fat grafting, or acceptance if mild |
| Unsatisfactory outcome | Result does not match expectation | Prevention through planning; revision where anatomically possible |
| Further surgery | Revision, exchange or removal at some future point | Depends on indication |

Each of these has a different likelihood, and the figures quoted in the literature vary considerably between studies, surgical techniques and follow up periods. The number that matters for a decision is the one discussed at consultation against a specific patient's anatomy, history and implant selection.

## Capsular contracture

The body forms a thin capsule of scar tissue around any implanted device. In some patients that capsule tightens, thickens or contracts around the implant. The breast may feel firmer than expected, change shape, sit higher, or become uncomfortable. It can affect one side or both, and it can develop early or years later.

Severity is described using the Baker grading system:

- **Grade I:** the breast is soft and looks normal
- **Grade II:** the breast is slightly firm but looks normal
- **Grade III:** the breast is firm and looks abnormal
- **Grade IV:** the breast is firm, painful and looks abnormal

Grade I and II contracture is commonly monitored rather than treated. Grade III and IV may warrant revision surgery, typically capsulectomy with implant exchange or removal. Contributing factors include bacterial contamination of the implant pocket at the time of surgery, bleeding within the pocket, implant surface characteristics and individual healing response.

A fuller account of grading, causes and treatment options is set out in the article on [what capsular contracture is and how it is treated](https://drturner.com.au/blogs/what-is-capsular-contracture-and-how-can-it-be-treated/).

## Implant malposition

Malposition means the implant is not sitting where it was intended to sit. It may present as an implant that has settled too low, ridden too high, drifted laterally when lying down, or moved toward the midline. Causes include stretch of the implant pocket over time, weak or thin tissue support, capsular contracture pulling the implant out of position, trauma, a mismatch between implant dimensions and the patient's tissue, and asymmetric healing between sides.

Correction depends on the direction of the displacement. Options include pocket adjustment or reinforcement, internal suture support, a change of implant dimensions, or a change of plane. Placement choice affects the likelihood of certain patterns of malposition, which is covered in the article on [implant placement options](https://drturner.com.au/blogs/best-breast-implant-placement-over-the-muscle-under-the-muscle-or-dual-plane/).

## Asymmetry

No two breasts are identical before surgery, and augmentation does not make them so. Differences in volume, fold height, nipple position, chest wall shape and rib prominence are usual, and adding volume can make an existing difference more noticeable rather than less.

Because of this, pre operative assessment should include measurement and documentation of any existing asymmetry, with the patient shown what has been recorded. Where the difference is significant, options include different implant volumes or profiles between sides, adjustment of the inframammary fold, fat grafting, a lift on one side, or a staged approach. What the surgery changes and what it leaves unchanged should both be clear before consent.

## Implant rupture

Rupture means the implant shell has torn or breached. How it presents depends on the implant type.

**Silicone implants.** Rupture is frequently silent, meaning the breast can look and feel unchanged. Modern cohesive gel tends to remain within the capsule rather than dispersing. Where symptoms do occur they can include a change in shape or size, a palpable lump, discomfort, swelling or altered sensation. The FDA recommends MRI as the most effective method of detecting silent rupture, with ultrasound accepted as an alternative for screening patients without symptoms.

**Saline implants.** Deflation is usually obvious, because the saline leaks and the implant loses volume over days to weeks. The saline itself is absorbed without harm, but the shell still requires assessment for removal or exchange.

Management depends on symptoms, imaging findings and the patient's own goals. Device longevity and the evidence around how long implants last are covered in the article on [implant lifespan](https://drturner.com.au/blogs/what-is-the-lifespan-of-breast-implants/).

## Infection

Infection is uncommon but consequential. It can develop in the days or weeks after surgery, or much later through bacterial seeding from elsewhere in the body. Presenting features include increasing rather than settling pain, spreading redness or warmth, swelling, fever or chills, wound discharge, or feeling systemically unwell.

Mild early infection may respond to antibiotics. More established infection can require admission, drainage, or removal of the implant with delayed replacement. Suspected infection should not be self managed or monitored at home. Early review is the conservative course, and an unnecessary review costs far less than a delayed one.

## Bleeding, haematoma and seroma

A haematoma is a collection of blood near or around the implant. A seroma is a collection of clear fluid. Both present with swelling, tightness, bruising, discomfort or new asymmetry, and both are most common in the early post operative period although late seroma can occur.

Small collections often settle without intervention. Larger ones may require aspiration or drainage, and significant post operative bleeding can require a return to theatre. Sudden swelling of one breast after surgery should be treated as urgent and reported immediately rather than held over until the next appointment.

## Changes in nipple and breast sensation

Sensation commonly changes after augmentation. Most often this is reduced or altered feeling in the nipple, the lower pole skin or the area around the incision. In many patients this settles as nerves recover over weeks to months. In some it persists, and it can be permanent.

Altered sensation can affect comfort, sexual response and breastfeeding. Larger implants, revision surgery and certain combinations of incision and placement carry a higher likelihood of persistent change. If nipple sensation or future breastfeeding is important to a patient, that should be raised specifically at consultation, because it can influence implant size, incision choice and plane.

## Scarring and wound healing

Every breast augmentation involves an incision, and every incision leaves a permanent scar. How that scar matures varies with genetics, skin type, incision site, tension across the wound, infection, nicotine use and post operative wound care. Delayed healing increases both scar visibility and infection risk.

Complete avoidance of nicotine through the peri operative period and adherence to the wound care protocol both reduce these risks. Practical scar management is covered in the article on [minimising scars after breast augmentation](https://drturner.com.au/blogs/ways-to-minimise-scars-after-breast-augmentation/).

## Rippling, palpability and implant visibility

Rippling describes folds in the implant shell that can be seen or felt through the overlying tissue. Palpability describes being able to feel the implant edge. Visibility describes the implant outline showing through the skin in certain positions or lighting.

The common contributors are thin soft tissue coverage, low body fat, an implant that is large relative to the tissue available to cover it, subglandular placement, and certain implant types and fill characteristics. Options where it is troublesome include exchange to a different implant profile or fill, a change of plane to increase coverage, or fat grafting to thicken the upper pole. Mild rippling that is only palpable in certain positions is often left alone.

## Dissatisfaction with size or shape

Some patients feel the result is too small, too large, too wide, too projected, or that the breast is not sitting as they expected. This is not always a technical complication. It can reflect a gap between what was expected and what was anatomically achievable with the tissue available.

Prevention sits almost entirely in the planning stage: measurement, discussion of photographs, sizers, an assessment of whether a lift is required alongside implants, and a clear account of what implant selection does and does not change. Revision is sometimes possible but adds cost, risk and a second recovery, which is why the first plan is worth the time it takes. How the size, shape and profile decisions interact is set out in the [implant size, shape and profile guide](https://drturner.com.au/blogs/breast-implant-size-shape-profile-guide/).

## Revision surgery and implant removal

Breast implants are not lifetime devices, and some patients will need further surgery. The reported intervals vary widely across the literature and between individuals, so a single figure for how long implants last is not reliable. What is consistent is the direction: the longer implants have been in place, the greater the likelihood of a complication that requires intervention.

Indications for revision include capsular contracture, rupture, malposition, infection, asymmetry, a wish to change size, and changes to the breast through pregnancy, breastfeeding or weight change. Procedures range from implant exchange, to removal with or without replacement, capsulectomy, pocket revision, a lift, fat grafting or scar revision.

Revision is generally more demanding than the original operation because the tissue planes have been altered and the capsule must be managed. Capsulectomy technique is determined by the clinical indication and the state of the capsule, and not every removal calls for an en bloc approach. What removal and recovery involve is covered in the article on [recovery after breast implant removal](https://drturner.com.au/blogs/recovery-after-breast-implant-removal-procedure/).

## BIA-ALCL

BIA-ALCL is a rare lymphoma of the immune system associated with breast implants, and it is not breast cancer. It arises in the fluid and scar capsule surrounding the implant rather than in breast tissue. Risk has been concentrated in macro textured implants, which have been withdrawn from the Australian market under TGA regulatory action. Risk with smooth implants is substantially lower.

The presentation is characteristically late, typically years after surgery, and most often as persistent one sided swelling or a new fluid collection. Other features include a change in breast size, a lump, discomfort or firmness. Any of these developing well after surgery warrants review, usually with imaging and aspiration of any fluid for testing. Patients without symptoms are not generally advised to have implants removed on the basis of this risk alone.

A full account of symptoms, diagnosis and treatment is in the dedicated article on [BIA-ALCL](https://drturner.com.au/blogs/bia-alcl-symptoms-diagnosis-and-treatment-of-breast-implant-associated-lymphoma/).

## Breast implant illness

Breast implant illness is the term patients use for a group of systemic symptoms they associate with their implants, including fatigue, cognitive difficulty, joint pain, rash and others. The FDA has stated that the causes of these symptoms are not well understood and remain under investigation. Some patients report improvement after implant removal, and outcomes are not consistent between patients.

The clinical position is that these symptoms should be taken seriously and investigated properly. That means assessment to identify or exclude other treatable causes, including thyroid disease, autoimmune conditions, nutritional deficiency, sleep disorders and mood disorders, rather than attributing symptoms to implants by default. The current evidence and the assessment pathway are covered in the article on [breast implant illness](https://drturner.com.au/blogs/latest-update-on-breast-implant-illness-symptoms-and-treatment/).

## How risk is reduced

Most risk reduction happens before the patient reaches theatre.

**At planning.** Patient selection, full medical history, the GP referral required under the Medical Board of Australia cosmetic surgery framework introduced on 1 July 2023, psychological assessment where indicated, complete nicotine cessation, and implant planning based on tissue measurement rather than a requested volume.

**At surgery.** Implant handling discipline including no touch insertion, the contamination reduction principles set out in the fourteen point plan, careful control of bleeding within the pocket, a plane chosen for the patient's tissue rather than by default, an accredited hospital environment, and a specialist anaesthetist.

**Afterwards.** Early wound review, staged return to activity, clearance before resuming upper body exercise, review at three, six and twelve months, and continued surveillance beyond the first year. Attending follow up appointments is a meaningful part of this rather than an administrative formality. What recovery involves week by week is set out in the [breast augmentation recovery guide](https://drturner.com.au/blogs/recovery-after-breast-augmentation-surgery/).

## When to seek urgent review

The following warrant contact with the surgical practice or urgent medical care rather than waiting for a scheduled appointment:

- Sudden swelling of one breast
- Pain that is increasing rather than settling, or not controlled by prescribed medication
- Fever or chills
- Spreading redness, warmth or rash
- Discharge from the wound
- Shortness of breath or chest pain
- Calf pain or swelling
- A sudden change in breast shape
- New swelling of one breast developing years after surgery
- A new lump, persistent fluid collection or unexplained firmness

Shortness of breath, chest pain and calf symptoms should be treated as an emergency. For the remainder, early review is always the safer choice.

## Frequently asked questions

**Which complications occur most often?**

Capsular contracture, malposition, asymmetry, rippling, sensation change and dissatisfaction with size or shape are the issues most frequently raised at follow up. Published rates vary considerably depending on implant type and surface, placement, surgical technique and how long patients are followed, so a single figure is of limited use. What is more useful is understanding which of these a particular patient's anatomy and implant choice makes more or less likely.

**Can breast implants rupture without any warning?**

Yes. Silicone implant rupture is frequently silent, with no change in how the breast looks or feels. The FDA recommends MRI as the most effective imaging for detecting silent rupture, and accepts ultrasound as an alternative for screening in patients without symptoms. Saline implants behave differently, and deflation is usually visible within days to weeks because the saline is absorbed by the body.

**How would I know if I had an infection?**

Pain that increases rather than settles, spreading redness or warmth, swelling, fever or chills, wound discharge, or feeling generally unwell. Most infections present in the first days to weeks, but late infection can occur. These symptoms warrant prompt contact with the practice rather than waiting, because early antibiotic treatment can sometimes avoid the need for implant removal.

**Will I need further surgery at some point?**

Possibly. Implants are not lifetime devices, and the likelihood of needing a revision procedure rises with the length of time they have been in place. Some patients have implants for many years without intervention, and others need revision earlier, so the interval is not predictable at the outset. Common reasons include capsular contracture, rupture, malposition, and changes to the breast through pregnancy or weight change.

**What can I do to reduce my own risk?**

Verify your surgeon's registration and specialty on the AHPRA public register, follow pre operative instructions, stop all nicotine well in advance, disclose your full medical history, allow implant selection to be led by measurement rather than a target volume, use the two consultations and the seven day cooling off period rather than compressing them, and attend every follow up appointment. Risk reduction is shared between the practice and the patient.

Dr Scott J Turner is a Specialist Plastic Surgeon (FRACS) consulting in Sydney and Brisbane. A GP referral is required before an initial surgical consultation under the current Medical Board of Australia framework. To discuss whether breast augmentation is appropriate for you, and what the risks look like against your own anatomy and history, [contact the practice](https://drturner.com.au/contact-us/) to arrange a consultation.