When any foreign body, such as an implant, is put into your body, your immune system responds by forming fibrous tissue around it. Over a few months this fibrous tissue will contract as part of the natural healing process. This is known as capsular contracture. If this contraction is severe, you may have tightening, hardening and changes in the shape of the reconstructed breasts, which may be uncomfortable.

About 10–20 out of every 100 women will develop this problem, although recent improvements in implant design have reduced the risk. Some capsular contractures form in the early years, but others may form many years after the surgery. In a few cases the implant and the capsule may need to be surgically removed; a replacement implant is then inserted at the same time.

Abdominal hernia is a complication that can occur after a pedicled or free TRAM flap. This is due to removal of the abdominal muscle, which weakens the abdominal wall. Even if your surgeon has inserted a protective mesh to replace the muscle and try to prevent this happening, a hernia can sometimes develop.

Using a flap from your back (latissimus dorsi) may reduce your shoulder movement, because of loss of muscle. This can sometimes make it difficult to do everyday activities like getting in and out of the bath, or can affect your ability to do some sporting activities, such as tennis, skiing, climbing etc.