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Your guide to breast augmentation or reduction

Surgeon performing breast surgery

Failed breast enlargement or reduction procedures can leave permanent psychological as well as physical scars. As many as one in three of all breast enlargement procedures will require further surgery within ten years of the first operation to put right complications, such as:

  • Scar tissue
  • Sagging implant or
  • Ruptured implant

Seeking an explanation and redress for the suffering and harm caused by a failed or sub-standard procedure may not always be straightforward. Specialist legal knowledge and experience of the issues involved in a particular case are required to bring to account those responsible for this failure.

Deciding to make a civil claim for clinical negligence may not be easy

Your Legal Friend has many  years of experience in successfully resolving different types of clinical negligence cases. Our specialist knowledge of both legal and medical issues means we can help you: 

  • Find out the reason why something went wrong with a breast augmentation or reduction procedure.
  • Obtain financial  compensation for the injury or harm caused. 

Breast enlargement - still the most popular type of cosmetic procedure

  • More than 30,000 breast enlargement procedures are carried out in the UK every year.          (NHS Direct)
  • Demand for breast reduction is up by 3% since 2014.          (British Association of Aesthetic Plastic Surgeons – BAAPS, Jan 2015)
  • Demand for breast augmentation increased by 13% to  11,123 women from 2012 to 2013.          (BAAPS, Feb 2014)

Breast enlargement surgery – what exactly happens?

Breast augmentation or enlargement surgery, which is carried out under a local anaesthetic, involves inserting an implant immediately behind the breast tissue or muscle via a small incision hidden in the natural fold under the breast.

The implant pushes and projects the natural breast tissue forward to give a fuller and larger appearance. 

Complications of breast enlargement

As with any type of surgery, a breast enlargement procedure can result in a number of complications, which may relate to the operation itself or occur later because of a problem with the implants. In many cases, further surgery may be needed to treat problems that have developed.

  • Breast implant failure or rupture – a split caused by:

   - outer shell weakening over time

   - damage during the operation

   - flaw in the implant

   - injury to the breast

It is not always possible to tell if a breast implant has ruptured. Signs can include:

   - lumpiness

   - swelling

   - redness

   - tenderness in the breast.

Saline (salt water) implant - any leakage should not cause problems as saline is a sterile, salt-water solution which the body is able to safely absorb.

Silicone implants - a silicone leakage may cause problems, such as siliconomas or a gel bleed

Siliconomas: silicone may spread outside of the scar capsule and into the breast, leading to the development of small, tender lumps known as siliconomas, which may need to be removed if they cause significant pain. In rare cases, the silicone can spread to the muscles under the breast, lymph nodes (glands) under the armpit or around the nerves of the arm.

Gel bleed: occurs to some degree in all breast implants when small molecules of silicone separate from the surface of the implant and are taken up into the surrounding tissues or lymph nodes.

PIP implants - PIP implants, which were made in France, were banned in the UK in 2010 after it was revealed they not only contained industrial silicone rather than medical-grade fillers but also had a rupture rate of more than 25% – higher than other types of implants.

Around 47,000 women in the UK are believed to have received the implants, of which 95% were fitted in private clinics, while the remaining 5% were used by the NHS, mostly for breast reconstruction following cancer.

Despite widespread reports of a possible link with a rare type of cancer, worldwide research has so far found no substances in PIP implants that cause cancer. 

Official UK government advice is that there is no need to have the implants removed unless they have ruptured, or you feel any anxiety about leaving them in place.

  • Infections / bleeding - relatively rare after breast implant surgery but a greater risk is possible in breast reconstruction following a mastectomy (breast removal). A severe infection may mean the implant has to be removed to prevent further complications developing and waiting a few months before reinserting it.
  • Loss of sensation in the nipple or surrounding tissue - around one in seven women find their nipples are less sensitive or have no sensation at all. Sometimes there is increased and painful sensitivity, which can last between 3 – 6 months.
  • Breast feeding – a baby will not experience any side effects because of breast    implants and breastfeeding should continue normally although slightly less breast milk may be produced.
  • Seroma – following surgery, it is common for fluid or blood to build up around an implant, which may need to be drained.
  • Capsular contracture - fibrous scar tissue forms around the implant, which is a natural part of the healing process. Over time, the scar tissue will begin to shrink, which can tighten and squeeze the implant, making the breast feel hard accompanied by discomfort or pain.
  • Scarring - some degree of scarring will show but is relatively mild in most cases. More severe scarring may be red, lumpy, thick and  painful but will improve gradually as the scarring begins to fade. In some instances, it can take several years before there is a noticeable improvement.
  • Creasing and folds - creases, kinks, folds or ripples may be evident on the skin of the breast.  Thistends to be more common in women with very small breasts.

Complications of breast reduction

All forms of surgery involve some degree of risk including:

  • Adverse reaction to the anaesthetic
  • Excessive bleeding
  • Blood clotting
  • Infection

Complications specific to breast reduction surgery can include:

Permanent scarring – caused by the commonly used ‘anchor’ technique, which leaves three separate scars:

1        Around the nipple

2        From the nipple to the crease below the breast (most significant scar)

3        From the breast bone to the armpit along the crease below the breast

Uneven shape - breasts will change shape after reduction surgery, sometimes leading to looking slightly lopsided or lumpy with uneven nipples.

Wound healing problems – are commonafter breast reduction surgery, particularly after use of the anchor procedure where the vertical and horizontal scars meet.Most problems are minor and can be simply managed and treated. More severe wound complications, such as infection, skin loss and wound separation, may take longer to heal.Some excess skin left around the scars may need to be surgically removed after a few months.

Loss of nipple sensation – can occur and the nipples may also lose their ability to become erect because the nerve supply to the nipple was damaged during surgery.

A disrupted blood supply very rarely causes a nipple to die and detach but is more likely to occur in heavy smokers or those who suffer from poor circulation.

Inability to breastfeed – may be the result of an operation involving the separation of the nipples from the milk ducts.

Haematoma – generally occurs within the first 24 hours after the operation when there is bleeding inside the breast tissue, which becomes swollen and painful. Another operation may be needed to drain the blood and stop the bleeding.

Breast enlargement or reduction – do I have a claim for negligence?

Long term injury or permanent damage caused by complications involved in a botched or failed procedure may be grounds for a clinical negligence claim, especially, if the injury arose as a result of an unacceptable standard of surgery or poor after-care. We will also consider whether you were given the opportunity to properly consent to the surgery that you underwent.

The most common types of negligence claim involve:

  • Rupture or leak in defective breast implants - suffering from the physical harm or the anxiety and stress caused
  • Excessive or avoidable scarring – harm, injury or suffering from a breast enlargement or reduction procedure.

Other claims may involve: 

  • Nerve damage
  • Infections
  • Anaesthetic complications
  • Poor cosmetic effect
  • Post-surgical infection arising from poor after-care

How Your Legal Friend can help you

As experienced clinical negligence specialists, we are determined to help you find out why your breast enlargement or reduction procedure has gone wrong and why the surgical team failed to provide you with the expected standard of care.

We ensure your case is properly investigated and your voice heard in order to bring the hospital, health trust or medical practitioner to account for the harm and suffering they have caused, and to prevent others from suffering in a similar way.

Your Legal Friend is committed to ensuring victims of clinical negligence obtain answers and receive appropriate compensation so that their future medical treatment and care needs are properly met.