Is breast enlargement (augmentation) safe?

In the UK, breast augmentation is the most common cosmetic surgery procedure, although women who’ve had a mastectomy as part of cancer treatment may also have breast augmentation (in which case it is classed as reconstructive surgery).

Breast augmentation involves placing implants into the breasts to make them appear larger or a different shape. The procedure is also known as having breast implants, a boob job, or a mammoplasty.

Women may decide to have breast implants for a number of reasons:

• To enlarge the breasts

• To enhance breast volume

• To correct a size difference

• To rebuild the breast after a mastectomy

This article on breast enlargement (augmentation) is written by Jackie Griffiths, a freelance journalist who writes health, medical, biological, and pharmaceutical articles for national and international journals, newsletters and web sites. 

What are breast augmentation implants?

Breast implants are made of either natural tissue or man-made materials, such as silicone gel or saline. Natural tissue implants are usually only used during reconstructive surgery after a mastectomy, as they have more associated complications and are a more complex procedure.

Implants can be inserted just underneath the breast tissue close to the surface of the skin, or placed underneath the muscle deeper inside the body. Both positions have advantages and disadvantages.

Saline breast implants

Saline breast implants consist of a silicone bag or shell filled with a sterile salt water solution. The salt water is either already inside the implant or can be inserted through a valve after the shell has been fixed in place inside the breast. Saline implants have the advantage that if something goes wrong and the implant ruptures inside the body, the solution can be harmlessly absorbed and excreted by the body. However, they are more prone to ruptures and deflation than silicone implants, and they may not look or feel as realistic, especially if you have small breasts to start with.

Silicone breast implants

Silicone gel breast implants consist of an elastic silicone bag or shell pre-filled with silicone gel. Many studies have been carried out into the safety of silicone gel breast implants, which show that there is no evidence to suggest an increased risk of cancer, connective tissue disease, arthritis, or other autoimmune diseases. Silicone gel breast implants have been used successfully for many years and tend to give a more natural look and feel than saline implants.

You may not be suitable for breast augmentation if:

• you are under the age of eighteen

• you have an infection of any kind

• you are pregnant

• your are breastfeeding

• you have malignant, or pre-malignant, breast cancer that has not been fully treated

Breastfeeding and implants

Having breast implants does not affect your ability to breastfeed, and there is no evidence to show that silicone leaks into the milk. If you are planning to breastfeed at some point in the future you should discuss this with your consultant as it could affect how the operation is performed (for example, entry points and implant positioning).

Breast screening and implants

Breast implants can obscure the view when you have a mammogram. A mammogram is an x-ray screening method for breast cancer, and you should tell your sonographer if you have breast implants so they can decide the best method for screening.

How long do implants last?

Breast implants very rarely last for life. It’s common to have to change them two or three times, or sometimes more often. Depending on individual circumstances, your implants can last for up to fifteen to twenty years, but many women find they have to be changed at around ten years. Some implants break down, wear out, become dislodged, or other complications develop.

Risks of having breast augmentation?

Breast augmentation is a routine operation generally performed without any problems. There are risks associated with having any operation, such as bleeding, infection, and a reaction to the anaesthetic, but these are also rare.

The normal side effects of having a breast augmentation include:

• Sore, tender breasts for a week or more

• Swollen breasts for a week or more

• Inability to drive a car or do some household chores (such as vacuuming) for a limited period of time

• Scars on the breast or under the arms

Although complications can occur with breast augmentation they are rare, and most women are not affected at all. As with any operation and hospital stay, very occasionally people experience an unexpected reaction to the anaesthetic, or develop a blood clot in their leg. Sometimes there is profuse internal bleeding.

With breast augmentation there can be some additional complications, including:

• Capsula contracta – the natural capsule that forms around any implant can become unusually thick and contracted around breast implants. This may need treatment, or the implant may need to be removed

• Rippling and kinking of the skin over the breast

• A difference in size or shape of the breasts

• Unusually large scars, called keloids which can take several years to heal

• Infection around the implant

• Feeling unhappy with the result of surgery (disappointment at the size or shape)

• Fluid build-up around the implant

• Silicone leakage

Please note that silicone rarely leaks, and is usually preceded by a rupture of the implant shell due to impact. If your breast implants do leak the silicone is almost always contained within the natural fibrous capsule that forms around all implants to protect the body. Research shows that silicone leakage is not conclusively linked to any serious health problems.

Profile of the author

Jackie Griffiths writes journal and newsletter articles for companies and non-governmental organisations across the UK. As founder and senior writer at Freelance Copy, she writes top level content for websites and print across a broad range of sectors including health, medical, biological, governmental, and pharmaceutical. 

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