A comprehensive guide to breast implant contraindications and risk factors, based on FDA guidelines, ASPS recommendations, and clinical research.
While breast implants can be transformative for many, certain medical conditions, psychological factors, and lifestyle situations may make you an unsuitable candidate. This guide covers evidence-based contraindications and factors to consider before pursuing breast augmentation.
Our calculators help you understand implant sizing, cost factors, and expected outcomes based on your body measurements.
According to guidelines from both the FDA and the American Society of Plastic Surgeons (ASPS), certain medical conditions present absolute or relative contraindications for breast implant surgery. These restrictions exist because implants may either worsen existing conditions, increase surgical risks, or fail to achieve satisfactory results.
These conditions generally disqualify patients from breast implant surgery:
In addition to these absolute contraindications, several other medical conditions are considered relative contraindications, where the surgeon will need to carefully weigh risks versus benefits:
These conditions require careful evaluation and may disqualify candidates depending on severity:
Medical standards for contraindications continue to evolve as long-term implant research reveals more information. According to a 2023 study published in Plastic and Reconstructive Surgery, between 15-20% of breast augmentation candidates have at least one relative contraindication requiring specialized assessment.
The relationship between breast implants and autoimmune disorders remains one of the most heavily researched and debated topics in plastic surgery. Recent FDA investigations and clinical studies have provided new insights that patients with autoimmune conditions should carefully consider.
Research suggests these specific autoimmune conditions may pose greater risks with implants:
Many leading plastic surgeons now recommend against breast implants for patients with these diagnosed conditions, given the emerging evidence from long-term studies and case reports.
Breast Implant Illness (BII) is a constellation of symptoms some women report after receiving implants, including fatigue, joint pain, memory problems, and rashes. While not yet an officially recognized medical diagnosis, the FDA has acknowledged these reports and now requires manufacturers to include BII warnings in patient materials.
A 2023 review in the Annals of Plastic Surgery found that 3-8% of women with breast implants report autoimmune-like symptoms that improve after implant removal, suggesting a possible link in susceptible individuals. Those with family history of autoimmune conditions should undergo additional screening before considering implants.
In their latest guidance, the FDA states: "While the majority of women with breast implants do not experience autoimmune complications, emerging evidence suggests a small but significant increase in risk for women with genetic predispositions to autoimmune disorders. Women with first-degree relatives who have diagnosed autoimmune conditions should be counseled about these potential risks."
If you have an autoimmune disease or strong family history, most surgeons recommend:
Both legal requirements and medical best practices establish age restrictions for breast implant procedures. These guidelines aim to ensure physical readiness and proper informed consent.
These minimum age requirements exist because:
While there is no formal maximum age limit for breast implant surgery, most plastic surgeons consider patients over 65 with greater caution. Advanced age presents several specific concerns:
Advanced age increases risks associated with general anesthesia, particularly in patients with cardiovascular or respiratory conditions common in older populations.
With age, breast tissue loses elasticity and collagen content, potentially compromising implant support and aesthetic outcomes. This may require additional procedures like mastopexy.
Healing capacity diminishes with age, leading to longer recovery periods and increased risk of complications like delayed wound healing or hematoma.
Implants typically need replacement every 10-20 years, requiring older patients to consider future surgeries at advanced ages or plan for eventual implant removal.
Most surgeons agree the ideal age range for initial breast augmentation is between 25-45 years, when tissue quality is optimal, healing capacity is strong, and the benefit-to-risk ratio is most favorable.
Mental health and psychological readiness are crucial factors in determining candidacy for breast implant surgery. The American Society of Plastic Surgeons emphasizes the importance of proper psychological screening, as satisfaction with results depends heavily on expectations and emotional stability.
A 2022 study in the Journal of Plastic and Reconstructive Surgery found that patients with untreated psychological conditions were 3.5 times more likely to report dissatisfaction with their breast augmentation results, despite technically successful surgeries.
Body dysmorphic disorder (BDD) affects approximately 2% of the general population but is significantly more prevalent among individuals seeking cosmetic surgery. Characterized by obsessive preoccupation with perceived physical flaws, BDD presents a strong contraindication for breast implants.
Red flags that may indicate BDD include:
Ethical plastic surgeons perform psychological screening as part of the consultation process. Many utilize standardized assessment tools or refer patients to mental health professionals when psychological contraindications are suspected.
Body mass index (BMI) plays a significant role in determining candidacy for breast implant surgery. While there is no universal BMI cutoff, clinical evidence demonstrates that higher BMI values correlate with increased complication rates and compromised aesthetic outcomes.
| BMI Range | Risk Assessment | Common Surgical Approach |
|---|---|---|
| Below 18.5 | May have insufficient tissue coverage | Careful implant selection; may recommend weight gain |
| 18.5-24.9 | Optimal range for surgery | Standard surgical approach |
| 25-29.9 | Slightly elevated complication risk | May proceed with additional precautions |
| 30-34.9 | Significantly higher complication rates | Many surgeons recommend weight loss first |
| 35+ | High risk for complications | Most surgeons decline or require weight loss |
According to research published in the Aesthetic Surgery Journal, patients with BMI over 30 experience approximately:
The concerns regarding elevated BMI extend beyond surgical risks to aesthetic outcomes. Higher BMI can result in:
Most board-certified plastic surgeons recommend patients with BMI over 30 lose weight before undergoing breast augmentation. This not only improves safety margins but also enhances aesthetic outcomes and may reduce long-term complications like implant displacement.
Beyond medical and psychological factors, certain lifestyle and future planning considerations may make breast implants a suboptimal choice. These factors relate to long-term satisfaction, financial planning, and life priorities.
While breast implants don't prevent pregnancy or breastfeeding, timing considerations include:
Certain occupations and lifestyle factors warrant careful consideration:
Implants may interfere with chest muscle function and competitive requirements. Some sports featuring high-impact chest contact may increase risk of complications.
Individuals with medical conditions requiring frequent MRIs face additional surveillance burden, as silicone implants require periodic MRI monitoring (FDA recommends MRIs at 3 years and every 2 years thereafter).
Implants require lifetime maintenance with potential replacements every 10-20 years. Those unable to afford future revisions or replacements may face complications later.
Individuals living in remote areas or planning to relocate where specialized medical care is limited may have difficulty accessing proper follow-up care or emergency implant-related services.
Breast implants are not lifetime devices. According to FDA guidelines and manufacturer data, patients should be prepared for:
Patients who are unwilling or unable to commit to this long-term maintenance schedule should reconsider breast implant surgery. A 2023 JAMA Surgery study found that 24% of patients were unprepared for the long-term financial commitment of implant maintenance when surveyed 7 years post-procedure.
According to medical guidelines, breast implants are contraindicated for individuals with active infections, untreated or unstable breast cancer, certain autoimmune disorders, pregnancy/breastfeeding, severe health conditions, and those under 18 (saline) or 22 (silicone). Psychological contraindications include body dysmorphia, unrealistic expectations, external pressure to have surgery, or untreated mental health conditions.
Many surgeons recommend against breast implants if you have diagnosed autoimmune conditions like rheumatoid arthritis, lupus, scleroderma, or multiple sclerosis. While a direct causal link hasn't been definitively established, studies suggest foreign bodies like implants may trigger or worsen autoimmune symptoms in predisposed individuals. Anyone with autoimmune conditions should have a thorough consultation with both their rheumatologist and plastic surgeon before considering implants.
Yes. The FDA has set minimum age requirements: 18 years for saline implants and 22 years for silicone implants. There's no official upper age limit, but most surgeons evaluate candidacy based on health status rather than chronological age. Older patients (typically 65+) face increased surgical risks and may experience compromised results due to tissue changes. The ideal age range for breast augmentation is generally considered to be between 25-45 years when tissue elasticity is optimal and body development is complete.
The relationship between breast implants and autoimmune disease is complex and still being studied. While research hasn't conclusively proven that implants directly cause autoimmune disorders, there is evidence suggesting a potential association known as Breast Implant Illness (BII). Some patients with genetic predispositions to autoimmune conditions may experience symptom activation following implant surgery. The FDA now requires manufacturers to include warnings about these potential risks, and patients with family history of autoimmune disorders should undergo additional screening before considering implants.
Most plastic surgeons consider a BMI over 30-32 as potentially problematic for breast implant surgery. While there's no absolute BMI cutoff, studies show significantly higher complication rates in patients with BMI over 30, including increased risks of infection, delayed healing, anesthesia complications, and suboptimal aesthetic results. Many surgeons recommend weight loss before surgery for patients with BMI >30, as the procedure can be performed more safely and achieve better cosmetic outcomes at a healthier weight range.
Proceeding with breast implants when you're not an ideal candidate increases risks of complications including poor cosmetic outcomes, implant malposition, infection, capsular contracture, and wound healing problems. It may also exacerbate existing health conditions, lead to psychological dissatisfaction, and potentially require early revision or removal surgery. Ethical plastic surgeons decline patients who don't meet safety criteria, as the risks outweigh the benefits for non-candidates.
Textured implants have been associated with higher rates of breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), a rare type of non-Hodgkin's lymphoma. In response, several manufacturers have withdrawn certain textured implants from markets worldwide. Many surgeons now prefer smooth implants due to the reduced risk of complications. Patients with existing textured implants without symptoms are not universally recommended for removal, but should maintain regular screening and follow-up with their surgeons.
According to recent research, approximately 10-15% of women express some form of regret after breast implant surgery. This varies significantly based on proper patient selection, with higher regret rates among those with preexisting contraindications. The most common reasons for regret include complications, dissatisfaction with size (either too large or too small), ongoing maintenance requirements, and changes in aesthetic preferences over time. Thorough preoperative screening and education can significantly reduce regret rates.
Our interactive calculator provides personalized information about breast implant sizing and potential outcomes based on your measurements.
Try Breast Implant Calculator →Medical Disclaimer: This tool provides general educational estimates. Always consult your prescribing physician or healthcare provider before making medication changes or interpreting results from population-based models.