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Recovery and risks
Implants are not lifetime devices. At 10 years, 81.8% of Natrelle augmentation patients still had an original implant and 94.2% were satisfied. After breast reduction, breast-related pain all or most of the time fell fro
Recovery
After augmentation, patients may go home once stable, typically after about an hour, in a support bra or band worn around the clock. In Tebbetts's series of 627, 96% returned to normal activities within 24 hours of partial retropectoral augmentation.[1][2]
Acute pain after augmentation usually eases in 1 to 5 days; soreness and swelling last a few weeks. Bleeding into the implant pocket is possible in the first several days. In 225 augmentation patients, mean pain was 5.9 of 10 and mean time off work 6.6 days.[1][2]
A thin drain may be placed. Week 1 limits activity; in weeks 2 to 3 many return to work; in weeks 4 to 5 the support bra continues; from week 6 normal activity resumes as the surgeon allows.[1]
Swelling and bruising can hide the final result, and full recovery after reduction can take several months. Scars are permanent and fade over time.[1][2]
Implants need monitoring for as long as they are in place. MRI is the most effective test for silent rupture of silicone implants, and ultrasound is an acceptable alternative. As many as 1 in 5 primary augmentation patients needed implant removal within 10 years.[1][2][3]
Without replacement the breast may show dimpling, puckering, sagging or chest wall concavity. Large implants placed over the muscle carry more risk of deformity after removal.[1]
Risks
Scar tissue tightens around the implant, graded Baker I to IV; grades III and IV may need another operation. At 10 years, Baker III/IV contracture was 12.1% after primary augmentation with MemoryGel, and capsular contracture was 18.9% after augmentation with Natrelle.[1][2][3]
Saline implants deflate visibly; silicone ruptures are usually silent. At 10 years, rupture was 24.2% of primary augmentation patients with MemoryGel and 13.0% of patients in the Natrelle MRI cohort.[1][2][3]
In the Core Studies, 20 to 40% of augmentation patients had a reoperation in the first 8 to 10 years. With MemoryGel primary augmentation, 25.5% had a reoperation and 11.6% an implant removal by 10 years.[1][2]
A T-cell lymphoma in the fluid or capsule around the implant, not breast cancer. As of 30 June 2024 the FDA had 1,380 case reports and 64 deaths; 73% of cases had textured implants, with a median 8 years from implant to diagnosis. A Dutch study estimated 1 case per 6,920 women with implants by age 75.[1][2][3]
Patients report fatigue, brain fog, joint pain and other symptoms; it is not a formal diagnosis. The FDA counted 10,318 reports from 2008 to mid-2024, fatigue in 41.1%; 687 of 785 reports that gave the outcome said symptoms improved after removal.[1][2]
The FDA has reports of squamous cell carcinoma, lymphomas other than BIA-ALCL and sarcomas in or around the scar capsule of breast implants.[1]
After augmentation, 39.1% reported nipple numbness and 2.3% persistent numbness. Across 11 studies, 82.25% of women with implants breastfed, with lower odds than women without implants (odds ratio 0.45).[1][2]
In the BRAVO study of 179 reductions, 43% had a complication; delayed wound healing was the most common and rose with resection weight and smoking. Combined augmentation and lift had a 13.1% pooled complication rate.[1][2]
How long results last
Implants are not lifetime devices. At 10 years, 81.8% of Natrelle augmentation patients still had an original implant and 94.2% were satisfied. After breast reduction, breast-related pain all or most of the time fell from 50% of patients to under 10%. Fat transfer kept 58% of the injected volume on average.[1][2][3]