Understanding the Risk and the Safety Measures at AVAN TOKYO

“Can breast augmentation cause a collapsed lung (pneumothorax)?”

This is an important question that patients occasionally ask during consultation.

The answer is yes—although uncommon, pneumothorax is a recognized potential complication of breast augmentation surgery.

Like any medical procedure, breast augmentation carries risks. While these risks cannot be completely eliminated, they can be minimized through meticulous surgical technique, sound anatomical knowledge, and immediate access to emergency management when necessary.

At AVAN TOKYO, we believe that patient safety begins with honest communication. Rather than minimizing potential complications, we explain them clearly and prepare thoroughly for even the rarest situations.

Every Cosmetic Procedure Has Risks

No cosmetic treatment is completely risk-free.

Even minimally invasive procedures have potential complications.

For example:

• Hyaluronic acid fillers may cause infection or vascular occlusion.
• Botulinum toxin injections may result in temporary asymmetry or muscle weakness.
• Liposuction carries risks such as bleeding, infection, or hematoma.
• Breast augmentation may involve infection, bleeding, capsular contracture, implant malposition, asymmetry, and, in rare cases, pneumothorax.

The most important question is not whether a complication is possible, but whether the surgical team has taken every reasonable precaution to reduce the risk and is fully prepared to manage it should it occur.

Why Can Pneumothorax Occur During Breast Surgery?

Understanding the anatomy helps explain why this complication is possible.

From the surface inward, the breast is generally composed of:

• Skin
• Subcutaneous fat
• Breast tissue
• Pectoralis major and minor muscles
• Rib cage
• Pleura (the thin membrane surrounding the lungs)
• Lung

A pneumothorax occurs when the pleura is accidentally breached, allowing air to enter the chest cavity and causing partial or complete collapse of the lung.

The pleura is an extremely thin and delicate membrane. Because of this, surgeons performing breast procedures must always maintain precise anatomical awareness and respect safe tissue planes.

Cases of pneumothorax have been reported worldwide not only after cosmetic breast augmentation but also following reconstructive breast surgery using fat grafting. Although uncommon, it is a well-recognized complication that experienced breast surgeons must understand and be prepared to manage.

How AVAN TOKYO Minimizes the Risk

Fat Grafting Breast Augmentation

During fat grafting, we avoid unnecessarily deep injections.

Fat is placed carefully within appropriate anatomical layers while respecting safe tissue planes.

Our goal is not simply to maximize the injected volume, but to achieve a natural result with the highest possible level of safety.

Silicone Implant Breast Augmentation

For most patients, we prefer subglandular implant placement because it often provides a more natural breast contour and attractive upper-pole fullness.

However, every patient is different.

Submuscular placement may be more appropriate in selected cases, such as:

• Male breast augmentation
• Breast reconstruction after mastectomy
• Patients with extremely thin breast tissue

The surgical plan is individualized based on each patient’s anatomy, tissue thickness, and aesthetic goals.

Preparing for the Unexpected

No surgeon can honestly guarantee that a complication will never occur.

For this reason, our responsibility extends beyond prevention.

We also maintain protocols for rapid diagnosis and emergency treatment should a pneumothorax occur.

Our emergency response includes:

• Immediate physical examination
• Point-of-care ultrasound evaluation
• Needle decompression when indicated
• Chest tube placement when necessary
• Prompt coordination with affiliated hospitals for advanced care

Because AVAN TOKYO also performs Rib Remodeling procedures, our surgical team has extensive experience with chest wall anatomy.

We regularly maintain our emergency procedural skills through ongoing anatomical training and hands-on education so that, in the unlikely event of a pneumothorax, immediate treatment can be initiated without delay.

Pneumothorax Can Occur Even Without Surgery

Interestingly, pneumothorax is not exclusive to surgery.

Tall, slender individuals may develop spontaneous pneumothorax after vigorous coughing, exercise, or even without an obvious trigger.

This highlights how delicate the pleura can be.

For breast surgery, respecting anatomy and maintaining meticulous surgical technique are essential for minimizing risk.

Our Philosophy at AVAN TOKYO

We do not believe in saying that surgery is “100% safe.”

Medicine does not offer absolute guarantees.

Instead, we believe patients deserve:

• Honest discussion of potential risks
• Surgery based on sound anatomical principles
• Continuous efforts to minimize complications
• Immediate and appropriate management if complications occur

At AVAN TOKYO, our commitment is not only to achieving beautiful, natural-looking breast augmentation but also to maintaining the highest standards of patient safety before, during, and after surgery.

Beautiful results and patient safety should always go hand in hand.

This article is intended for patient education.

All surgical procedures carry potential risks. The most appropriate surgical technique is determined individually after careful evaluation of each patient’s anatomy, tissue characteristics, and medical history.