Breast implant surgery is one of the safest elective procedures performed today, with a perioperative mortality rate that is effectively zero. A study of nearly 100,000 breast implant surgeries recorded no deaths attributable to the procedure itself. That said, “not deadly” and “not dangerous” are different things. While the surgery itself carries very low immediate risk, breast implants are long-term medical devices that come with a meaningful chance of complications, additional surgeries, and ongoing monitoring over the years and decades you have them.
Immediate Surgical Risks
The short-term complications of breast augmentation are uncommon and typically manageable. Infection is the most frequent major complication, occurring in roughly 0.5% to 1.1% of procedures depending on the technique used. Hematoma (a collection of blood near the surgical site) is the other primary early concern. Both usually require medical attention but resolve with treatment.
General anesthesia carries its own risk, estimated at about 1 in 250,000 for healthy patients without other medical conditions. One older estimate placed the mortality rate for cosmetic breast surgery specifically at 1 in 72,000, though more recent and larger data sets suggest the true number is even lower. For practical purposes, the risk of dying from breast implant surgery is vanishingly small.
Reoperation Rates Are Higher Than Most People Expect
This is where the risk picture shifts. Breast implants are not permanent devices, and the chance you’ll need at least one additional surgery is substantial. About 10% of patients require reoperation within two years of their initial procedure. By six to ten years, that number climbs to roughly 20%. In longer-term studies of specific implant lines, reoperation rates reached 28% to 36% at the ten-year mark.
The most common reason for reoperation is capsular contracture, a condition where the scar tissue your body naturally forms around the implant tightens and hardens. In a ten-year study comparing implant types, 65% of patients with smooth implants developed capsular contracture, compared to 11% with textured implants. Not all cases require surgery, but severe contracture causes visible distortion, discomfort, and firmness that typically needs surgical correction.
Other reasons for reoperation include implant rupture, shifting position, asymmetry, and patient dissatisfaction with the cosmetic result.
Implant Rupture Over Time
All breast implants will eventually fail. The question is when, not if. Saline implants tend to rupture sooner, with 7% to 10% failing within ten years of placement. The average saline implant ruptures around 5.6 years after insertion. When a saline implant breaks, the saltwater filling leaks out and your body absorbs it harmlessly, but the implant visibly deflates.
Silicone implants last longer on average, with ruptures diagnosed at a mean of 12 years after insertion. Newer cohesive gel (sometimes called “gummy bear”) implants perform better still, with only 1.1% rupturing at six years. The catch with silicone is that ruptures are often “silent.” The thick gel stays in place rather than deflating, so you may not notice anything is wrong. MRI studies have found silent rupture rates of 9% to 12% at eight years after implantation, which is why imaging surveillance is recommended.
Cancer Risks Linked to Implants
Two rare cancers have been associated with breast implants. The more established one is BIA-ALCL (breast implant-associated anaplastic large cell lymphoma), a cancer of the immune system that develops in the scar tissue capsule around the implant. As of 2022, 1,130 women worldwide had been diagnosed with BIA-ALCL, and at least 59 had died from it.
The critical detail: this cancer is linked almost exclusively to textured implants. Smooth implants carry effectively zero risk. Among textured implants, one specific product line (Allergan Biocell, now banned) accounted for roughly 91% of worldwide cases despite representing only about 5% of implants sold in the U.S. For women who received those particular implants, lifetime risk estimates run as high as 1 in 100. For other textured implants, risk exists but is lower and less precisely defined.
The FDA has also identified a smaller number of cases of squamous cell carcinoma developing in the capsule around breast implants. Only 19 cases had appeared in published literature as of early 2023, with an additional 24 reports filed with the FDA. These occurred with both textured and smooth implants, and with both saline and silicone fills. The typical time between implant placement and diagnosis ranged from 7 to 42 years, and swelling or breast pain was the most common symptom, appearing in 90% of cases.
Breast Implant Illness
Many women with breast implants report a constellation of systemic symptoms that has come to be called breast implant illness, or BII. The FDA tracks these reports and has published data on the most commonly reported symptoms: fatigue (41% of reports), joint problems (31%), anxiety (23%), brain fog (23%), autoimmune conditions (23%), hair loss (20%), depression (17%), rashes (17%), and weight changes (17%).
BII is not currently a formal medical diagnosis. There are no specific tests or recognized criteria to identify it, and the medical community has not reached consensus on whether breast implants directly cause these symptoms or whether the association reflects other factors. What is clear is that a meaningful number of women experience these symptoms and that some report improvement after implant removal. The lack of a formal diagnosis does not mean the symptoms aren’t real, but it does mean that predicting who will be affected, or by how much, is not yet possible.
Effects on Breast Cancer Screening
Breast implants can obscure breast tissue on mammograms, potentially making it harder to detect breast cancer early. To address this, a technique called Eklund displacement views is used: the implant is pushed back against the chest wall while breast tissue is pulled forward so it can be imaged more clearly. If you have implants, let your mammography facility know when scheduling so they can allow extra time and use the appropriate technique.
Ongoing Monitoring Recommendations
The FDA recommends that women with silicone implants get their first screening ultrasound or MRI five to six years after placement, then every two to three years after that. This is specifically to check for silent ruptures, which you’re unlikely to detect on your own. Saline implant ruptures are self-evident because the implant deflates, so routine imaging is less critical for those.
For women who have had BIA-ALCL diagnosed and treated, follow-up imaging is typically recommended every three to six months for the first two years after tumor removal, then continued for several years. No official treatment guidelines yet exist for the rarer squamous cell carcinoma cases, though the same general monitoring framework is being used as a starting point.
Putting the Risks in Perspective
Breast implant surgery is not dangerous in the way most people mean when they search that question. You are extremely unlikely to die or suffer a life-threatening complication from the procedure itself. The real risks are slower and subtler: a roughly 1-in-4 to 1-in-3 chance of needing another surgery within a decade, the certainty that implants will eventually need replacement, a small but real association with rare cancers (particularly with textured implants), and the possibility of systemic symptoms that are still not fully understood. These are not reasons to panic, but they are reasons to think of breast implants as an ongoing commitment rather than a one-time procedure.