Factor in medical risks in breast lift

Dear Dr. Roach: My fiancee wants to have her breasts lifted, as they are starting to sag. Also, she wants to get them augmented a cup larger. What are your thoughts on this subject? Also, what are the medical risks involved for either procedure? — Anon.

I have had many patients ask my opinion about cosmetic surgery. It’s up to the person to decide whether he or she wants it. Most women who undergo mastopexy (lifting procedure) or implantation (augmentation) are happy with their results and do not have complications. However, the risks of a complication are not zero — any surgery can have complications. The immediate postoperative risk in an augmentation with implant is less than 1 percent for a local hematoma (blood collection), less than 0.5 percent for infection, and much less than 1 percent for a serious adverse event like a leg blood clot. In a recent study, the reported overall complication rate was 10 percent (pain and nipple numbness are among the most common), and the vast majority of women would repeat the surgery.

However, breast implants do not last forever, with the average being about 10 years. The implants can rupture, and the Food and Drug Administration estimates that 10 to 20 percent of women will need their implants removed or replaced within 10 years. 86 percent of women felt the appearance was at least acceptable at two years after augmentation, but only 54 percent at the five-year mark. You and your fiancee also should consider the financial costs of the procedure, including the possibility of reoperation years from now, which generally is not covered by insurance. The cosmetic results after reoperation are never as good. Many surgeons have representative pictures on their websites, but be sure to look at how the breast looks after removal of an implant.