Breast augmentation is one of the most common cosmetic surgeries in the US (second only to liposuction), with more than 364,000 procedures completed in 2021 alone. The reasons for choosing this elective surgery are vast and varied, from personal preferences about appearance to reconstruction after cancer treatment.
Because the technology and materials used in breast augmentation have changed over the years—and news about complications with some implants can become distorted on social media—it can be difficult to sort out the facts. If you are considering your options, preparing for surgery or already living with implants, here’s a roundup of what you need to know.
There isn’t just one type of implant
When you first meet with your surgeon, you’ll discuss the look and feel you’re hoping to achieve, and which type of implants will be most appropriate, based on your breast size and shape and any scar tissue you might have.
There are a number of options, each of which has a different feel and structure, including:
- Silicone-filled implants. These may appear the most natural, according to the American Society of Plastic Surgeons.
- Saline, or salt-water implants. These usually feel firm and look uniform. Since natural breasts tend to be uneven and imperfect, this can potentially make them appear artificial. Your surgeon may still be able to achieve a natural look if the implant isn’t filled too much and the breast isn’t lifted too high.
- “Gummy bear,” or form-stable implants. Made from a thick form of silicon, this type of implant can also feel firmer than a natural breast.
After surgery, it may take a few weeks for the swelling and bruising to go down, and for your breasts to settle into shape. Talk to your provider about whether or not you should wear a compression bra to help your breasts heal correctly. Depending on your implant type, regular massaging can encourage natural movement, rather than stiffness, as your breasts heal.
Implants can affect nipple sensation
You may be concerned that implant surgery can make your nipples less sensitive and interfere with sexual pleasure—and the fact is, the surgery may either increase or decrease nipple sensation. While it is common to feel numbness immediately after surgery, sensation commonly returns after breasts heal, though the change can sometimes be permanent.
If nipple sensation is a priority for you, tell your plastic surgeon as you are planning the procedure. They might be able to avoid surgical techniques and incisions that raise your risk of developing numbness. When weighing your options, consider the size of your implants and whether they’ll be placed above or below your chest muscle, which can also impact sensation.
If you develop temporary numbness after surgery, daily nipple massages may help with the return of sensation.
Implants don’t raise your breast cancer risk
This is one concern you can put to rest: People with implants are not any more likely to develop breast cancer than those with natural breasts. In a study involving more than 4,000 people, cancer stage at the time of diagnosis and survival odds were similar between those with implants and those with natural breasts.
On the other hand, the implants could make it more difficult for radiologists to see cancer on your mammogram screenings. Whether you’ve undergone breast augmentation or not, follow the national breast cancer screening guidelines. If you have implants, technologists will take additional images and adjust your breasts during mammograms to ensure the clearest results possible.
However, they are linked to a different (and far more rare) type of cancer
Having any type of breast implant is linked to an increased risk for a very rare form of cancer, called anaplastic large cell lymphoma (ALCL), according to the U.S. Food and Drug Administration (FDA). ALCL is not breast cancer. Rather, it’s a kind of non-Hodgkin’s lymphoma, or cancer that affects immune cells.
The FDA notes that ALCL risk appears to be higher for people with textured breast implants, though it’s unclear whether it’s related to particular products or textured breast implants in general. The agency continues to collect information on the issue. Textured implants tend to develop more scar tissue, making them less likely to move around inside the breast pocket. ALCL has been detected inside scar tissue, as well as in fluid close to the implant.
As of July 2019, the FDA received reports of 573 cases of ALCL worldwide that were associated with breast implants, as well as reports of 33 deaths linked to the disease. Biocell textured breast implants, made by Allergan, were associated with 481 of those cases, along with at least 12 deaths. As a result, the FDA asked Allergan to recall its Biocell textured breast implants and tissue expanders from the market. The company announced on July 24, 2019 that it would do so voluntarily.
Keep in mind that ALCL is very rare, affecting only a small percentage of the 10 to 11 million people who have breast implants worldwide. Before getting breast implants, talk to your health care provider about the benefits and risks of both textured-surface and smooth-surface implants. If you already have implants, possible warning signs of ALCL may include new swelling, lumps, asymmetry or pain around your implants that develops years (possibly even decades) after your surgery. If you notice these or other changes in the way your breast looks or feels, be sure to talk to your provider about your risk for ALCL and follow recommendations for routine screenings.
Yes, implants can rupture
Implants aren’t meant to last forever. In fact, implants are usually removed 10 to 20 years after the initial surgery, according to the American Society of Plastic Surgeons.
As your implants age, the risk of rupture increases by about 1 percent each year. If a “gummy bear” or silicone implant breaks, it probably won’t change the shape of your breast. However, if a saline implant tears, it will collapse and the fluid will absorb naturally into your body.
Ruptures can cause pain and usually require surgery. To make sure your implants are staying in good condition, follow your surgeon’s guidelines about annual checkups and for doing regular self-checks. The FDA recommends that people with silicone gel implants have an ultrasound or MRI 5-6 years after surgery and then every 2-3 years after that. Contact your surgeon if you experience any changes to the size, shape or feeling of your breasts.
Sources: The Aesthetic Society. The Aesthetic Soc... + 5
- The Aesthetic Society. The Aesthetic Society Releases Annual Statistics Revealing Significant Increases in Face, Breast, and Body in 2021. April 11, 2022.
- International Society of Aesthetic Plastic Surgery (ISAPS). The Latest Global Survey from ISAPS Reports a Significant Rise in Aesthetic Surgery Worldwide. January 9, 2023.
- American Society of Plastic Surgeons. Plastic Surgery Statistics Report 2020. Accessed May 8, 2023.
- American Society of Plastic Surgeons. Breast Augmentation. What types of breast implants are available? Accessed May 8, 2023.
- American Society of Plastic Surgeons. Will you breast implants last a lifetime? April 28, 2021.
- FDA. Breast Implants—Certain Labeling Recommendations to Improve Patient Communication. September 29, 2020.
