Breast Implant Complications

A breast implant complication is one of many different medical concerns that arise after a surgeon places synthetic breast implants in the chest. While many women see successful results after receiving silicone or saline breast implants, it is not uncommon for complications to arise in the months (or even years) after breast augmentation. In fact, over time, implants will all develop complications. Implants are not designed to be lifetime devices and degrade with the silicone shell weakening and failing. This happens in all cases and the average lifespan of an implant shell is under 15 years. However, complications are also related to how the body reacts to implants. The body uniformly fights any foreign material and while the degree of that fighting may vary, it happens in all patients, without exception. These two failure points are uniform and through this guide, you can learn more about the different concerns and complications of breast implants, both localized and systemic, allowing you to make more informed decisions for your body, health, and well-being.

Dr. Sean Boutros is an award-winning and board-certified plastic surgeon based in Houston, Texas. Dr. Boutros has received training at world-renowned institutes under several world leaders in plastic surgery, providing him a base of skills and artistry. However, it is the innovation and advances in the field of plastic surgery on which he has built his reputation on.

If you are interested in working with Dr. Boutros, we invite you to schedule a consultation by contacting us online or calling (713) 804-6926.

About Breast Implant Complications

Breast implant complications are medical concerns that develop after the insertion of silicone or saline breast implants. These complications can range from common concerns such as capsular contracture to rare diseases such as breast implant-associated anaplastic large cell lymphoma. These different complications arise from several factors, such as your body’s immune system response, the type of implants placed, the area in which your surgeon places them, and more. Every woman who receives implants will develop complications, but most patients will not develop early complications. This 100% incidence makes it vital for patients to understand the risks of undergoing these procedures.

Capsular Contracture

Capsular contracture is a common complication many women experience when undergoing breast augmentation and reconstruction using implants, with up to 51.7% of women in studies experiencing it. ⁽¹⁾ When breast implants are placed in the chest, the body forms a thick, fibrous capsule around them as a natural immune response. Capsular contracture occurs when this capsule shrinks and tightens, and it can lead to a distorted appearance, a hardened breast feel, as well as pain or discomfort within the chest. ⁽²⁾

While the development of capsular contracture is multifactorial, it primarily results from chronic inflammatory reactions, specifically when the patient’s immune system overresponds to the implant foreign body. Another leading theory for its development is bacterial biofilm formation on the implant itself.

A biofilm is defined as bacteria that adhere to a prosthetic surface and to each other through an extracellular matrix, or a network of macromolecules and other proteins. These bacteria may enter the breast pocket through implant insertion by the surgeon, from the skin’s surface, or may be present in the breast gland tissue itself. While certain bacteria can easily be addressed using antibiotics, biofilms can continue to persist despite treatment, leading to the patient’s body eliciting an immune response as it fights the potential infection. ⁽²⁾

Breast Implant Malpositioning

Breast implant malpositioning is a concern where the implant itself moves or shifts away from the location the surgeon originally placed it in. A basic fundamental is that implants are typically mobile in the body which means even if placed in a certain position, they may not stay there. It can lead to the implant sitting too high, too low, or too far to the side on the chest wall, as well as rotating out of place. This concern can occur at any time during a patient’s postoperative period.

Implants can shift:

Several factors can cause breast implant malpositioning, including the surgeon improperly placing the implant during the procedure, sustaining trauma to the rib’s connective tissue sheath (perichondrium), dissection errors during the initial placement, postoperative massages, or excess activity. ⁽¹⁾ However, other factors can also contribute to malpositioning, such as the natural contours of the patient’s chest wall, the amount of soft tissue in the region, and more. ⁽³⁾

Additionally, malpositioning can be classified according to 3 grades of severity, each of which can apply to the different axes that may occur (lateral, medial, superior, inferior). These include:

Many patients who possess grade 1 or grade 2 malpositioning choose not to proceed with surgery unless they have other concerns, such as volume changes, sensory irregularities, a lack of upper pole fullness, or the exchanging of implants. However, most patients who possess grade 3 malpositioning typically undergo revision procedures. ⁽⁴⁾

Breast Implant-Associated Anaplastic Large Cell Lymphoma

Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL) is a rare form of non-Hodgkin T-cell lymphoma. This is a cancer that forms in the fluid and scar tissue that surrounds placed breast implants. It typically becomes prevalent around one year after initial placement, though most notice it eight to nine years after implantation. When it does occur, it can present itself either in situ or as an infiltrative disease. The in situ variation is confined within a seroma, or a clear pocket of fluid, while the infiltrative disease typically presents itself with lymph node involvement either with or without a palpable breast mass or tumor. ⁽⁵⁾

BIA-ALCL is most commonly associated with the use of textured, or “rough,” breast implants. These implants feature a textured surface to reduce the risk of malpositioning and help implants stay in place. ⁽⁶⁾ Another leading theory is bacteria infiltrating the breast pocket.

Similarly to their role in capsular contracture, bacteria that infiltrate the breast pocket can create a biofilm on the surface of the placed implants. When the amount of bacteria on the implants exceeds a certain threshold, the patient’s immune system will begin to fight it. This then leads to their body developing chronic antigen stimulation, or the body constantly fighting the bacteria, especially if the patient is more genetically susceptible to the disease.

Over time, the T-cells (immune cells) begin to transform, leading to the development of BIA-ALCL. ⁽⁷⁾

Breast Implant Illness

Breast implant illness describes an array of different symptoms experienced by patients who previously received breast implants. These effects have been reported by patients with all types of breast implants, regardless of the filling, shape, surface texture, or duration of time since placement. The incidence rate, cause, and risk factors for breast implant illness are unknown, but it typically includes concerns such as:

It is still unclear what causes breast implant illness, nor is there a universally accepted medical definition or diagnostic test to determine the presence of breast implant illness. However, several leading theories for its development include:

While research is still ongoing, the leading theory for its causation is the presence of bacterial biofilms on the surface of breast implants. Studies have shown that patients reporting these symptoms have developed a bacterial biofilm on their breasts and a greater presence of immune cells in the region. This demonstrates that their bodies have been fighting bacteria in the region, which can explain inflammatory symptoms and responses. ⁽⁹⁾

How Do You Address Breast Implant Complications?

When patients develop these varying concerns and complications, their first thought is how they can address them and restore their comfort. The simplest way to address many of these concerns is to either undergo a breast implant removal. However, we typically recommend avoiding replacing your implants if you have developed concerns such as breast implant illness, capsular contracture, or BIA-ALCL, as the rate of recurrence can be heightened.

Instead, we recommend that patients remove their breast implants and undergo an All Me Augmentation™. This specialized procedure is the brainchild of Dr. Boutros’s p and it enhances the breasts without any implants, synthetic materials, or other foreign substances. It borrows from his extensive background in both cosmetic and reconstruction surgery.

Dr. Boutros can perform this procedure using the Deep Inferior Epigastric Artery Perforator (DIEP) flap method. This technique transfers your body’s own fat and skin to the chest to elevate or restore your breast volume. He typically takes this excess tissue from the lower abdomen, but he will tailor the procedure according to your needs. He specifically designed this procedure to provide women a safer, more natural alternative to implants, especially those experiencing or more prone to implant-related complications.

Cost of an All Me Augmentation in Houston, Texas

Dr. Boutros tailors each All Me Augmentation™ according to his patient’s anatomy, goals, and needs, which means the pricing will vary. Once he has met with you in person to establish each detail of your treatment plan, he will discuss your financial obligations with you.

For more information about pricing, please visit our pricing page. We additionally offer financing for those who qualify.

References

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2. Clark A, Shauly O, Sherrer J, Losken A. Understanding Capsular Contracture: Mechanisms, Management, and Patient Outcomes in Implant-based Breast Augmentation and Reconstruction. Plastic and reconstructive surgery Global open. 2026;14(1):e7407. doi:10.1097/GOX.0000000000007407
3. Meshkin DH, Firriolo JM, Karp NS, Salibian AA. Management of complications following implant-based breast reconstruction: a narrative review. Annals of Translational Medicine. 2023;11(12):416. doi:10.21037/atm-23-1384
4. Pacifico M D, Goddard NV, Harris PA. Classification of Breast Implant Malposition. Aesthetic Surgery Journal. 2024;44(10):1032-1042. Accessed July 24, 2026. https://academic.oup.com/asj/article/44/10/1032/7646030?login=false
5. DePaola NEK, Coggins H. Breast Implant–Associated Anaplastic Large Cell Lymphoma: What We Know. Journal of the Advanced Practitioner in Oncology. 2019;10(1):54. Accessed July 24, 2026. https://pmc.ncbi.nlm.nih.gov/articles/pmc6605706/
6. Naga HI, Mellia JA, Basta MN, et al. Breast Implant–Associated Anaplastic Large-Cell Lymphoma: Updated Systematic Review and Analysis of Treatment Strategies. Plastic & Reconstructive Surgery. Published online July 21, 2022. doi:10.1097/prs.0000000000009538
7. Lajevardi SS, Rastogi P, Isacson D, Deva AK. What are the likely causes of breast implant associated anaplastic large cell lymphoma (BIA-ALCL)? JPRAS Open. 2022;32:34-42. doi:10.1016/j.jpra.2021.11.006
8. Uscher J. What Is Breast Implant Illness? Accessed July 24, 2026. https://www.breastcancer.org/treatment/surgery/breast-reconstruction/types/implant-reconstruction/illness/breast-implant-illness
9. Khan I, Minto RE, Kelley-Patteson C, et al. Biofilm-derived oxylipin 10-HOME–mediated immune response in women with breast implants. Journal of Clinical Investigation. 2023;134(3). doi:10.1172/jci165644