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After Surgery

Most women will experience breast pain, discomfort, and fatigue during the first 24 to 48 hours after surgery. The breasts are usually swollen, bruised, and sensitive after augmentation surgery. Pain medications may be prescribed to help alleviate discomfort. Most women are able to resume normal daily activities within a week and strenuous activities within a month or two. A burning sensation may occur in the nipples during the first two weeks after surgery; swelling and increased sensitivity may last for up to a month. Stitches will usually be removed seven to 10 days after surgery.

Surgical scars will be firm and pink for up to two months after surgery. Scars will generally remain the same size for several months and may even appear to widen. Scars will fade after several months but will remain indefinitely.

Women over 40 years of age should continue having annual mammograms to screen for breast cancer after breast augmentation surgery. Because of the implant, several special mammography views must be taken to allow visualization of both the breast tissue and the implant. Diagnostic mammography is usually performed on women with breast implants rather than screening mammography. The x-rays used for mammographic imaging of the breasts cannot penetrate silicone or saline implants well enough to image the overlying or underlying breast tissue. Therefore, some breast tissue (approximately 25%) will not be seen on the mammogram, as it will be covered up by the implant. Because of the possibility of silent rupture of silicone breast implants, the FDA recommends that women with these implants receive MRI breast screening three years after implantation and every two years thereafter.

Side Effects

The most common side effect of breast implant surgery is capsular contracture: the scar or capsule around the implant begins to tighten and squeezes down on the soft implant, causing the breast to feel hard. Capsular contracture may be treated with additional surgery to remove the scar tissue. Occasionally, patients with capsular contracture may have to have the breast implant removed and replaced with a new one. However, a recent study shows that the likelihood of capsular contracture may be reduced if implants are treated with antibacterial agents during surgery.

Another risk associated with breast implants is the possibility of rupture. If a saline-filled breast implant ruptures, the patient and physician will know because the implant will deflate and the saline solution leaks into the body immediately or over a period of days. The implant will lose its original size or shape. On the other hand, silicone-filled implant ruptures are called silent rupture because the patient and physician must not know that a rupture has occurred. Thus, the FDA recommends that patients with silicone-filled implants received an MRI three years after implantation and then every two years thereafter to screen for a rupture. However, some patients will experience symptoms of a rupture, including hard knots or lumps surrounding the implant or in the armpit, change or loss of size or shape of the breast or implant, pain, tingling, swelling, numbness, burning, or hardening of the breast.

Health experts do not know all of the reasons that breast implants might rupture. However, according to the FDA, some of the causes include:

Other possible side effects of breast implants include:

• Calcium deposits in the breast tissue around the implant (usually non-cancerous but occasionally have to be surgically removed to assure they do not indicate cancer)
• Infection around the implant
• Hematoma or seroma (blood or fluid trapped in the wound)
• Delay in healing
• Shifting of implant (further surgery may be necessary)
• Temporary or permanent changes in the feeling of the nipple or breast (some women report areas of increased or decreased sensitivity or numbness near the incision)

Other less common factors that could affect breast appearance include:

• Incorrect implant size
• Visible scars
• Uneven appearance
• Wrinkling of the implant

Breast implants may deflate or rupture from injury to the breast or through normal wear over time. Saline implants deflate quickly and surgery is usually done immediately to remove or replace the implant. Saline (salt water) is absorbed naturally by the body and does not pose any health risks. Approximately 50% of implants need some type of modification or replacement after five or 10 years.

Nursing After Breast Augmentation

Breast-feeding is possible in most instances after breast augmentation surgery unless implants were placed to rebuild the contour of the breast following breast removal with mastectomy (as part of treatment for breast cancer). Women who have breast reconstruction often have the nipple and areola (dark pigmented region around the nipple) re-grafted on the breast, but because the glands and milk ducts were removed during surgery, they are unable to produce milk. On the other hand, women who have breast-fed within a year before augmentation may produce some milk for a few days following surgery. Though this may be uncomfortable, it can be treated with medications prescribed by a physician.

Additional Resources and References

• The American Society of Plastic Surgeons provides information on breast augmentation at http://www.plasticsurgery.org/
• The FDA provides information on breast implants at http://www.fda.gov
• To find a plastic surgeon or to determine whether a surgeon is board-certified, please visit http://www.imaginis.com/breasthealth/reconstruction.asp#find_surgeon
• To learn more about breast reconstruction after mastectomy, please visit http://www.imaginis.com/breasthealth/reconstruction.asp

Updated: July 28, 2008

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