Introduction The breast augmentation surgery is a common procedure to enhance the appearance of the breasts, while enlarging their dimensions and improving their shape. This intervention is also used to correct breast asymmetries and mild breast ptosis. The silicone gel implants covered by a polyurethane layer were introduced at the beginning of the 1970s. They have the advantage of a lower risk of capsular contracture. The capsular contracture is a potential long-term complication of the breast augmentation procedure. In time, cicatricial tissue is formed around the implant. The tissue is both thick and hard, hence giving the impression of the scar tissue hardening in the area around the implants. It has been proven that the polyurethane can suffer micro-fragmentation or dissolving into the surrounding tissues. This is why polyurethane is no longer used to produce breast implants. In an attempt to reduce the development of the capsular contracture, the textured elastomeric capsules have been introduced. In the 1990s, the multilayer implants capsules appeared. These significantly reduced the possibility of the micro exteriorizations of the silicone particles through the pores of the implant. In addition, the silicone gel is cohesive, and does not flow into the body, even if the implant breaks or suffers a rupture. Silicone gel implants or saline solution implants? The saline solution implants have the advantage that if they break, the filling will be completely absorbed by the body, and it is relatively risk-free for the patients. Still, the saline solution doesn’t have the same thickness as the silicone gel. Therefore, it won’t imitate the feeling of a natural mammary gland. The main risk associated with using saline solution implants is the spontaneous deflation of the implant which can occur when the implant breaks or leaks. The silicone gel implants have the advantage of a consistency similar to the mammary gland. In 1992, the suspicion that the silicone implants can lead autoimmune diseases has led to their elimination from the American market. Further studies have demonstrated that the silicone implants actually have a low rate of complications, sometimes even lower than the saline solution implants. It has also been shown that the autoimmune and other neurological or systemic afflictions are no more frequent in women who have breast implants as compared to women who did not have a breast augmentation procedure. The complications of the breast augmentation procedure with breast implants There are a few complications that can occur after any type of surgery, including the breast enhancement procedure. However, there are specific risks that are strictly associated with the breast implants surgery. Among the general risks are hematoma, infection, changes in the sensitivity of the nipple and areola, bad scarring (hypertrophic or keloid scars) etc. When it comes to the special complications that can only occur after this type of surgery, there are the rippling effect and the capsular contracture. Contour irregularities of the breasts region are determined by the formation of a scar tissue hardening in the area around the implant. This is called the capsular contracture, and it can change the shape and the consistency of the implant. If the capsular contracture is accentuated, the firmness when feeling the area of the breasts and the distortions that appear are quite impressive and easy to spot. Sometimes a capsulotomy procedure is performed. This means that the hardened tissue will be sectioned in order to provoke a relaxation of the tissue and help with the disappearance of the distortions. In other cases, the capsulectomy procedure will be mandatory. This means that the hardened tissue will be completely removed from around the implant and typically, the implant will also be removed and replaced with a new one. Contour irregularities can also occur due to the rippling effect, a situation that is more common when the patient has decided on implants which are too big. In these cases, there isn’t enough breast tissue to cover it, or the placement of the implant was sub-glandular instead of under the pectoral muscle. Conclusion Despite quite an extensive list of potential complications, the breast augmentation procedure is still one of the safest cosmetic surgery interventions, and can guarantee some very predictable and satisfying results. The extremely small rate of complications makes this procedure one of the most frequently performed interventions in the plastic surgery world. The capsular contracture characterized by the scar tissue hardening in the area around the implant. Capsular contracture occurs when the scar that is forming around the implant starts to get thick and hard and it stretched the implant. This makes the breast become hard and even painful. Sometimes a tingling sensation can be felt inside the breasts. This complication can appear even years after the surgery and is usually treated with a corrective surgical procedure, either the capsulotomy or the capsulectomy, depending on how severe the case. In many cases, the removal of the breast implant and its replacement with a new breast implant will be mandatory, so keep this in mind when budgeting for the breast augmentation surgery. Having breast implants comes with benefits and some long-term responsibilities. When you make the decision to undergo surgery for enhancing the appearance of your breasts with implants, it is important to consider the capsular contracture and its implications. Revision surgery is sometimes mandatory. Even though capsular contracture is not a fatal condition, it is recommended to see your plastic surgeon as soon as you think there may be something different about your breasts.