Of course, because it is actual surgery. The possible complications include bleeding, infection, and poor healing, and occur in well below 1 percent of patients, and in addition, there is possible interference with the sense of touch of the nipples. The chance of complications is even lower in the through-the-navel method.
Bleeding: A few ounces of blood can build up around the implant inside the pocket, making that breast swell and feel more engorged and painful. This is called a "hematoma" and requires a return to the operating room, to rinse everything out, and insert a drain tube, which can be removed in the office a few days later. To decrease this possibility, patients are given a long list of medicines that cause bleeding, which they can avoid for several weeks. The list includes Vitamin E, aspirin, herbals, nicotine, and about 100 other drugs. Lots of women have gotten by without bleeding even though they have not complied with these instructions, but the chances of problems are higher. Also, at the time of the original operation, if there is more bleeding than the average woman, a small drain tube can be inserted as a precaution. Bleeding is more rare with one technique, that is inserting implants in front of the muscle through the navel, (called "TUBA") probably because the pocket is opened by hydraulic expansion rather than by cutting, so there is very little bleeding.
Infection: Infection is even more rare than bleeding. Bacteria are present in your skin pores, hair follicles, and breast ducts. The operative area will be thoroughly cleaned with antiseptic before surgery, and also I give antibiotics just before, during, and after operation, but there is no way to ged rid of every bacteria that could get released from your pores. Your body itself must get rid of any of these bacteria. That is why infection is more likely if there is any nicotine in the system. Many women have successfully had surgery without stopping nicotine, but they did increase their chances of infection. If there is an infection, then there is a return to surgery, and the implants usually (but not always) need to be removed, left out for several months, and then new implants put in at a third surgery. (Implants should not be re-sterilized, so new ones are needed) Obviously, although rare, infection is a big deal, requiring three operations, three recoveries, and three expenses. I tell patients that if their circumstances could not cover an expense almost three times the expense of having the surgery in the first place, they should not have breast enlargement.
The chance of losing the sense of touch in the nipples is around 1 in a 100. Nationally published Journal studies have shown that there is a lower chance of loss of touch with the in-front-of-the-muscle through-the-navel ("TUBA") method than with the other methods. But any woman can lose the sense of touch in the nipples, from just about any kind of breast surgery.
Complications, although rare, are important, because they add expense, pain, and recovery time. Insurance does not usually cover the cost of the expenses, nor does the manufacturer of the implants. Plastic Surgeons handle complication expenses two different ways: some Plastic Surgeons require the patient to pay for surgery for complications, but only those patients who actually have the complications. Other Plastic Surgeons charge every patient a higher fee, so that the patient who actually has the complication does not need to pay for it. If the extra fee charged each patient is high enough, then the patient does not even have to pay for the operating room. I do not use that philosophy.
My own philosophy is that it is unfair for everyone to pay a higher fee when only a few patients are going to have complications, which in most cases are due to random chance, but in many cases are due to that patient failing to follow instructions, such as discontinuing nicotine, or other pre-operative preparations. I do not charge a higher fee for every patient, and only the patient who has the complication pays for it.
What is the greatest danger from breast implant surgery? Having it done by someone who is not properly qualified to do it. Many doctors not certified by the American Board of Plastic Surgery are taking quick weekend courses about breast augmentation, including the through-the-navel method, and then just doing it. It is possible for a patient to die from any type of anesthesia and any kind of surgery. Every person should check out the qualifications of the surgeon and anesthesiologist.
It is highly significant to look at the statistics from surveys done among women with implants. Not only do they reveal that 97 or 98 percent of women with implants would do it again, but also that even most of those few patients who have experienced the rare complications would still do it again!
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