Immediately following breast augmentation surgery, swelling, pain, bruising and tenderness are common. These complications can last for several weeks and sometimes longer, but should diminish over time. Most complications can be controlled through medication prescribed by the plastic surgeon (e.g., medicine to relieve pain or nausea).

In some cases, there is more postoperative pain for women whose implants were placed behind the chest wall muscle (pectoral muscle). Any symptoms that may indicate an infection, such as fever or redness of the breast, should be evaluated by a physician.

It is recommended that the patient discuss issues such as scarring, pain and recovery times with the plastic surgeon as these vary considerably among individuals. However, most patients find that they are active within 24 to 48 hours. The scarring from the incisions will be pink and hard for several weeks. Afterward, in a process that may take many months, the scars will begin to fade and possibly even appear to widen to some degree. Eventually, most scars will fade but not disappear entirely.

A post-operative bra, compression bandage or athletic bra is often recommended as it provides additional support during recovery. Many women return to work within five to seven days with the strict instructions that they are not to lift more than 10 or 15 pounds. Women should wait at least two weeks before performing aerobic exercise or other strenuous activities that raise the pulse and blood pressure. Avoiding these activities reduces the risk of bleeding, swelling and bruising. Other exercise that includes weightlifting or contact sports should not resume for at least four weeks.

When considering breast implants either for breast augmentation or for reconstructive surgery after breast cancer, the patient should realize that the implants will have to be replaced within five to 10 years, if not earlier. Breast implants are not meant to last forever. Rupture, deflation or other complications are possible.

Implants that rupture, cause scarring or result in other cosmetic problems are the main reason for replacement. However, it is important to note that although insurance companies almost invariably cover reconstructive surgery, the replacement of implants – even those that have ruptured – may or may not be covered under a patient’s policy.

Although some patients may have implants that take 10 years or longer to rupture or deflate, others may experience problems within the first few months. According to the Food and Drug Administration (FDA), some studies have shown that nearly one-third of women who undergo breast augmentation experienced complications that required a reoperation within five years.

If a silicone breast implant does rupture and the silicone gel escapes the capsule, it is possible for the gel to cause lumps, known as granulomas, to form in the breast, chest wall, armpit, arm or rarely, even distant organs such as the liver. It is difficult and at times impossible to remove silicone gel that has migrated to other areas. In addition, silicone implant ruptures may not always cause symptoms (known as “silent rupture”). Therefore, the FDA advises patients with silicone implants to undergo MRI (magnetic resonance imaging) testing at three years after implantation and then every two years thereafter to screen for rupture.

When a saline implant ruptures, the body absorbs the fluid. Still, if a woman suspects that her saline implant has ruptured she should contact her physician. A number of signs and symptoms may indicate that a silicone implant has ruptured. Patients should immediately notify their physician if they experience any of the following:

• Decreased breast size
• A change in the shape of the implant
• Hard lumps in the areas that surround the implants
• An uneven appearance of the breast
• Tingling, swelling, numbness, burning or any changes in sensations