Breast Augmentation & Implants

updated September 6, 2017

Breast augmentation is a surgical procedure in which the size and shape of a woman's breasts are enhanced, usually through the placement of an implant behind each breast. It is also possible to enlarge the breasts using fat harvested from another area of the patient's body, such as the abdomen or the buttocks.

Between 1997 and 2012, nearly 4.5 million breast augmentation procedures were performed in the United States, according to the annual statistical reports published by the American Society for Aesthetic Plastic Surgery (ASAPS). This makes breast augmentation the second-most popular plastic surgery procedure during that span, behind only liposuction.

Clinically known as augmentation mammoplasty, breast augmentation is generally performed for cosmetic purposes, whether to add volume to disproportionately small breasts, restore balance to asymmetrical breasts, or simply create a more voluptuous figure. Although the risks of breast implants have been the focus of much media attention, the rate of satisfaction among patients who have had their breasts enlarged is among the highest in cosmetic medicine.

Ultimately, the decision to undergo breast augmentation is a highly personal one that should be made only after becoming as educated about the procedure as possible. If you are considering breast augmentation, you will likely find answers to many of the questions you have on this page. The best source of information in your specific case, however, is an in-depth, one-on-one consultation with an experienced, board-certified plastic surgeon in your area.

One of the primary reasons for the popularity of breast augmentation is that the procedure can readily be customized to the specific goals of the individual patient. Women who undergo breast augmentation have a variety of options at their disposal, giving them tremendous control over their outcome. These options include:

• Breast Implant Type: Currently, women in the United States can choose between silicone gel-filled implants, saline-filled implants, and form-stable, ultra-cohesive silicone gel-filled (known informally as "gummy bear") implants.
• Breast Implant Placement: Breast implants can be placed in pockets made either beneath the pectoral muscle (the submuscular placement method) or in front of the pectoral muscle, immediately behind the breast tissue (the subglandular or submammary placement method).
• Location of the Incision: Breast implants may be placed through inframammary incisions (just below the crease at the base of the breast), periareolar incisions (along the border of the lower half of the areola), or transaxillary incisions (in the armpit). Some plastic surgeons also place implants through the navel (the transumbilical, or TUBA, incision); however, this method is less commonly used than the other three.

Other options include breast implant size, shape, profile, and texture.
Each decision a woman makes regarding her breast augmentation will influence her overall result. It is therefore important that patients understand their options fully before proceeding with surgery. A qualified, experienced plastic surgeon will take the time to explain every aspect of the procedure in clear, comprehensible terms, patiently answering any questions and addressing any concerns the patient may have.

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Candidacy for Breast Augmentation

Part of the process of determining your candidacy for breast augmentation involves asking yourself a question that only you can answer. The more honestly you answer this question, the more confident you will feel in your decision on whether or not to proceed with the procedure:

Why do I want to enlarge my breasts?

For some women, the answer to this question is simple; for others, it is anything but. There is a good chance that you are considering breast augmentation for a variety of reasons, some more personal than others. Common reasons for undergoing breast augmentation include the desire to:

• Bring the breasts into better proportion with the rest of the body
• Improve symmetry between differently sized or shaped breasts
• Feel more feminine and attractive
• Restore volume to the breasts after pregnancy, breastfeeding, or weight loss
• Correct congenital deformities in one or both breasts
• Boost confidence and improve body image
• Add volume to breasts that did not develop fully after puberty, a condition called micromastia

If you are just starting to explore the possibility of surgically enhancing your breasts, you may not have thought much about your reasons for wanting to do so at this point. You may simply know that you want larger breasts. In itself, that is as valid a reason for undergoing breast augmentation as any other.

As you learn more about the procedure and your options, especially through the consultation process, you will want to continue to examine your reasons for wanting to enlarge your breasts. Once you have become fully acquainted with the benefits, risks, and costs associated with the procedure, and you feel confident that you want to proceed for you and not due to any external pressures, your candidacy for breast augmentation will depend on your health, your goals, and the establishment of reasonable expectations.

Breast Augmentation Internet Forums

One of the best ways to find practical, real-world information about breast augmentation is to connect with women who have undergone the procedure themselves. Online forums for patients who have undergone or are considering breast augmentation allow people to share their experiences and help inform those who are considering it.
In a breast augmentation forum, patients respond to questions about their surgery and how they felt afterwards, recommend good surgeons, and create a community of support. By being able to get personal stories from people who have experienced the surgery on a first-hand basis, potential patients are able to truly discover if it is right for them.

Health Requirements

In order to undergo any surgical procedure, you should be in good overall health. Be sure to disclose to your surgeon whether you have an autoimmune disorder such as diabetes, heart disease, high blood pressure, or any other condition that could interfere with your ability to heal from surgery. Your surgeon will also advise you as to whether any medications you are currently on may make breast augmentation problematic.
Otherwise, suitable candidates for breast augmentation will be:

• A non-smoker, or at least willing to quit smoking in the weeks leading up to and following her breast augmentation
• Reasonably fit and near her ideal weight
• Free from bleeding tendencies and infections
• Willing to reduce or eliminate alcohol consumption during the healing period
• Not currently pregnant or breastfeeding
• Free from cancerous and pre-cancerous tissues

Age Requirements

When the FDA allowed silicone breast implants to be re-introduced onto the U.S. market, the agency restricted use of the implants in breast augmentation to women aged 22 and older. This restriction extends to ultra cohesive gel ("gummy bear") implants, as well. However, saline breast implants can be placed in women beginning at the age of 18.

The placement of breast implants in women younger than 18 is allowed only in the correction of injuries and congenital deformities.

Establishing Realistic Goals and Reasonable Expectations

Other than general health, the best candidates for breast augmentation are those who are well informed about the procedure, keeping realistic results in mind while being fully aware of potential risks and side-effects.

Breast implants are not a surefire solution to severe body-image issues, emotional trauma, or marital woes. When done properly and for the right reasons, they can help boost confidence and kick-start a path to better self-esteem, but only to a degree. To be truly pleased with the results, it's best for candidates to have realistic expectations about what breast augmentation can do for them.

Someone who is considering breast implants should also be confident in the reasons why, and not be pressured into it by someone else. Patients who undergo the procedure to try and save a failing relationship, please their partner, or are pressured into getting them, usually end up regretting the procedure. This can sometimes lead to negatively compounding personal issues and a drop in self-esteem, or even other multiple surgeries to reduce and correct the original procedure.

If you are an adult who is sure of your reasons, is well informed, and is in generally good health, then breast augmentation may be right for you.

The Cost of Breast Augmentation

Although it should not be the primary factor in selecting a surgeon to perform the procedure, the cost of breast augmentation is a natural starting point for many women who are thinking of enhancing their breasts. According to the 2012 ASAPS statistical report, the average plastic surgeon's fee for performing breast augmentation is:

• $3,535 with saline breast implants
• $3,918 with silicone breast implants

However, these averages account only for surgeon's fees and the cost of the implants, themselves. Other costs associated with breast augmentation include:

• Hospital or surgical facility fees
• The anesthesiologist's fees
• The cost of prescription pain medication
• Post-surgical garments
• Any necessary medical tests
• The plastic surgeon's consultation fee (if any)

Wherever you reside within the United States, you should be prepared to pay between $5,000 and $10,000 altogether for your breast augmentation. In larger cities and along the West and East Coasts, prices tend to be higher than in other regions in the country. However, prices are equally likely to vary from practice to practice, even within the same city.

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Again, while cost may be a factor in your choice of plastic surgeon, it should not be the factor. It is best to entrust your breast augmentation to a surgeon with whom you feel comfortable and whose credentials, philosophy of practice, and history of results make the best impression on you. You may find that, depending on the payment and financing options available at your practice of choice, quality breast augmentation is more affordable than you realized. 

Is there a relationship between cost and quality?

As a range for breast augmentation costs, $5,000 to $10,000 is a fairly precise estimate, but an estimate nevertheless. You may find perfectly qualified plastic surgeons in your region who charge less than $5,000 overall for breast augmentation with saline implants, while you will almost certainly find surgeons who charge more than $10,000, especially if you opt for silicone implants.

However, you should be immediately skeptical of any surgeon who charges significantly less than $5,000 for breast augmentation. If a deal seems too good to be true, especially compared to the cost of the surgery at other practices in your area, it is possible that quality is being compromised at one or more stages of the procedure.
There are three major costs associated with breast augmentation that, if reduced substantially, should raise red flags:

• Surgeon's fees - Many excellent surgeons raise or lower their fees depending on the economic climate. In general, however, board-certified plastic surgeons cannot cut their fees too drastically because of the high costs of maintaining their practices, investing in the latest technology, and meeting their continuing education requirements. Extremely low surgeon's fees could indicate that a surgeon is not board certified or that he or she is frantically trying to fill an empty operating room schedule.
• Anesthesiologist's fees - As with surgeon's fees, inordinately low anesthesiologist's fees could indicate that you are dealing with an undertrained individual who has not been board certified. It may also indicate that the quality of the anesthesia being used is substandard. In either event, your safety is being put at unnecessary risk.
• Facility costs - If your breast augmentation is performed in a freestanding surgical facility, you will want to be sure that it has been accredited by the American Association for Accreditation of Ambulatory Surgery Facilities, Inc. (AAAASF), the Accreditation Association for Ambulatory Health Care (AAAHC), the Joint Commission, or the Health Care Facilities Accrediting Program (HFAP). In order to earn and maintain accreditation from any of these organizations, a facility must meet stringent standards of safety, sterilization, and competence of staff. Meeting these standards can be expensive, which means the cost of a certified facility is generally going to be higher than that of a non-certified facility. If your breast augmentation is performed at a local hospital where your surgeon has unlimited plastic surgery privileges, the cost may be a bit higher, but you will also have the peace of mind of knowing that the hospital is comfortable having your surgeon operate on its staff. Either way, if costs are being spared by compromising the quality of the surgical facility, or if your surgeon does not have privileges at a local hospital, your safety is once again being put at unnecessary risk.

While you will want to be wary of plastic surgeons who seem to be charging too little for breast augmentation, you will want to approach surgeons who charge significantly more than $10,000 for the procedure with equal caution. Some surgeons charge exceptionally high fees to reflect and enhance their reputations as elite practitioners. Indeed, many of these surgeons do produce excellent results, but you should not automatically assume that they are more skilled than surgeons whose prices fall within the $5,000 to $10,000 range.

Many of the nation's most esteemed, talented, and highly trained plastic surgeons offer breast augmentation at competitive prices. Ultimately, excellence in plastic surgery does not have to be unreasonably expensive.

Is breast augmentation covered by insurance?

In general, insurance companies do not provide coverage for breast augmentation or any other procedure that is performed primarily or exclusively for cosmetic purposes. Such procedures fall under the umbrella of elective surgery, as opposed to surgery that is considered "medically necessary."

It is important to note that most insurance companies do not consider breast augmentation to be medically necessary in any context, even when it is performed to correct severe asymmetry between the breasts or congenital deformities. On the other hand, most insurance companies will provide coverage for breast implants when they are used in breast reconstruction after mastectomy or lumpectomy, in accordance with the Women's Health and Cancer Rights Act of 1998.

Before you undergo breast augmentation, it is important that you contact your insurance company to find out how your procedure could affect your future coverage. Many insurance companies will not cover procedures related to complications arising from the placement of breast implants, while some may refuse to cover any future breast surgery, even if it is deemed medically necessary.

Payment and Financing Options

Many practices offer in-house payment and financing options to help make breast augmentation affordable to a wider variety of patients. Some surgeons allow patients to make payments in installments while others give discounts to patients who pay for their breast augmentation in full, in cash, on the day of their surgery. Most plastic surgery practices accept major credit cards, as well.

During your initial consultation, you will have the opportunity to discuss your budget with your surgeon and find out whether he or she offers any payment or financing solutions that will work for you. Reputable plastic surgeons will not cut corners or compromise quality in order to bring down the cost of treatment; however, they are often willing to work with patients to find ways to make surgery more accessible given their financial situations.

Many practices also accept third-party financing options. Healthcare financing programs are designed to help patients pay for medical expenses that are not covered by insurance. They work by setting up a revolving line of credit which the patient can use to pay for any type of medical procedure - elective or medically necessary. A wide range of payment plans are available and designed to accommodate a patient's budget with the added benefit of allowing additional charges to be added, so long as the full line of credit has not been used.

You may also be able to secure a personal loan to cover the cost of your breast augmentation, or you can open a savings account to put money aside specifically for your surgery. It is far better to save toward being able to afford the services of a surgeon you trust than to make the rash decision to have your procedure performed by an inexperienced surgeon who is offering the "best deal."

How to Choose a Breast Augmentation Surgeon

When considering breast augmentation, it is very important that you chose your plastic surgeon with carefully. To ensure that you receive the highest quality care, you should select a board-certified plastic surgeon with extensive experience in performing breast augmentation surgery. A surgeon with the right credentials, training, and experience will help to minimize the chances of any serious complications occurring. Additionally, with the right surgeon, patients are more likely to be satisfied with their results.

Before deciding on a surgeon, you should speak with several in your area. If you find multiple surgeons with excellent credentials and qualifications, trust your instincts and choose the one you feel most comfortable with. Breast augmentation surgery can help women achieve the appearance they truly desire; however, it is important to remember that it is a major surgery. You will want to feel confident that your surgeon of choice will put your safety and health above all else.

Questions to Ask Plastic Surgeons

During your consultations with surgeons in your area, there are several questions you will want to be sure to ask. These include:

Are you board certified?

Make sure that your surgeon has been certified by the American Board of Plastic Surgery (ABPS), a distinguished board of the American Board for Medical Specialties (ABMS). In order for a surgeon to receive certification, he or she must meet the strict criteria established by the board. Surgeons must have obtained a degree from a well-respected medical school, fulfilled their five-year residency, received further specialized training in plastic surgery, and proven that they meet a high standard of ethics. Additionally, in order for any cosmetic or reconstructive surgeon to receive certification, their practice must be mainly centered on plastic surgery procedures.

Do you have any specialized training?

Many plastic or cosmetic surgeons are licensed to practice; however, they lack the necessary training to perform certain procedures. Make sure that your breast augmentation surgeon has received specialized training in all types of breast augmentation surgery. Only go to a practice that concentrates on primarily plastic surgery. Board-certified surgeons are required to complete a certain amount of training. Additionally, as advancements are continuously being made, make sure that your surgeon receives continued training and is up-to-date on the latest cosmetic and plastic surgery techniques.

Do you have full plastic surgery privileges at one or more local hospitals?

If a surgeon has hospital privileges, it means he or she can operate out of an accredited, state-licensed, or Medicare-certified surgical center or hospital. In order for a surgeon to receive such privileges, they must be approved by a committee, which determines eligibility based on several factors, including education, training, and overall aptitude. Make sure that your breast augmentation surgeon is approved to perform breast surgery within an accredited hospital.

What is the rate of satisfaction among your breast augmentation patients?

A qualified surgeon should be able to present you with testimonials, as well as photos showing actual results that he or she has produced. Request to see patient testimonials and photos so that you can get an idea of overall patient satisfaction. You will be able to learn a lot about not only the quality of work, but also the level of professionalism and personalized attention that patients experience.

In addition to seeing what other patients think of the surgeon, find out if any third party groups have referred him or her, such as the American Board of Plastic Surgery.

Finally, your own intuition is probably one of the best indicators if a surgeon is qualified to meet your needs. Make sure that when you meet with the breast augmentation surgeon, you feel comfortable with him or her. Discuss your goals, ask questions, and make sure you have a strong understanding of what the procedure will entail. You should feel confident in your decision to move forward with breast surgery.

Breast Augmentation Patient Satisfaction Rates

Despite the procedure's sometimes controversial history, satisfaction rates of patients who have undergone breast augmentation have consistently been high. According to the results of a study presented at the 2008 annual meeting of the American Society of Plastic Surgeons (ASPS):

• 99 percent of the 325 patients surveyed would undergo breast augmentation again.
• 91 percent reported improved self-esteem.
• Overall, 96 percent were satisfied with their results, with an average satisfaction rating of 9.2 out of 10.

The results of a more recent five-year study were published in the May 2013 issue of Plastic and Reconstructive Surgery®. Of the 225 women who participated in this study:

• 98 percent reported that their results met or exceeded their expectations.
• 85 percent felt that their new breast size was "just right."
• Only 1 percent expressed dissatisfied with their post-surgical scarring.
• 92 percent reported improved self-esteem.
• 64 percent reported an improved quality of life.

While patient satisfaction cannot be guaranteed with any plastic surgery procedure, breast augmentation has among the highest satisfaction rates in all of medicine.

Your Initial Consultation

Before undergoing breast augmentation, you will have an in-depth, personal consultation with your plastic surgeon of choice. The consultation will allow you and the surgeon to discuss your expectations and go over important considerations such as size, shape, type of implant, and the location of your incision.

Your surgeon will also provide you with pre-surgical instructions. It is important that you take these instructions seriously and follow them faithfully. Failing to do so will increase your risk of complications during or after surgery.

Breast Implant Options

In planning your breast augmentation surgery, you will need to decide on which type of implants you want, where they should be placed, and where your incisions will be located. Your surgeon will advise you during this process, but these decisions will ultimately be yours. It is important to be well-informed about and truly understand each of your options.

Breast Implant Materials

There are two basic materials used to fill breast implant shells: silicone and saline. Each type of material offers its own unique benefits and carries its own risks. Your plastic surgeon can help you to decide which type of implant material is right for you based on your individual needs and goals.

Silicone Gel Breast Implants

Silicone gel breast implants were approved by the Food and Drug Administration (FDA) to be reintroduced onto the U.S. market in 2006 after extensive testing showed that they were safe for use. Silicone implants offer more natural looking and feeling results than their saline counterparts because silicone gel is more similar in consistency to organic breast tissue than the saline solution.

Silicone breast implants are designed with a shell of silicone surrounding a gel, which is also silicone based. Silicone breast implants used to be common; however, they were pulled from general use in 1992 because of various health concerns (in particular, concerns about implant rupture and leakage). Due to that, saline breast implants became the go-to choice for breast augmentation.

The FDA rescinded the ban on silicone breast implants in November 2006, after medical studies that had been utilized to say that silicone was unsafe were themselves discredited, and other concerns about shell ruptures were answered with a more durable shell. Now women have both saline and silicone types of breast implants available for breast augmentation.

Advantages of Silicone Implants

One of the primary advantages of silicone implants have is that they look and feel remarkably like natural breasts, much more so than saline implants. The silicone material is a close facsimile of actual breast tissue, which makes under-the-muscle placement feel very natural. The rippling effect that can occur with saline implants is also less common with silicone implants, since the filler gel helps push out against the inward pressure. This makes it a popular choice for thinner women or those who want reconstructive breast surgery.

Disadvantages of Silicone Implants

One of the disadvantages of silicone implants in comparison to saline implants is that a rupture will go undetected with silicone. When a saline implant ruptures, it is immediately evident. The saline solution quickly dissipates, and the implant collapses. On the other hand, when a silicone implant ruptures, the gel can escape the implant yet stay within the pocket of tissue keeping the implant in place, making detection of the rupture difficult.

Silicone breast implants have a higher rate of capsular contracture than saline implants. Capsular contracture is when scar tissue around the implants harden and squeeze them uncomfortably, making the breasts feel hard and sometimes look irregular. Your surgeon can give you more information about this and other breast augmentation risks and potential complications from breast implants.

In addition, because silicone breast implants come pre-filled, they require larger incisions for insertion. Silicone implants do cost more than saline filled implants, so make sure to take that into consideration when discussing augmentation cost.

Controversies over the Safety of Silicone Gel-Filled Implants

In the more than 50 years that breast implants have been available, breast augmentation has come under public scrutiny on many occasions, mostly due to safety concerns over implant ruptures. Concerns over silicone breast implants in particular led to their being removed from the U.S. market at the request of the FDA in 1992. After more than a decade of clinical studies demonstrating the safety and efficacy of silicone implants, the FDA allowed them to be reintroduced onto the U.S. market in 2006. Conversely, saline breast implants have remained available since their inception.

Since their reintroduction, silicone breast implants have eclipsed their saline counterparts in terms of popularity. In 2012, according to the ASAPS report, silicone breast implants were used in 71 percent of all breast augmentation procedures. Nevertheless, both silicone and saline implants offer distinct advantages and disadvantages, and the decision as to which type is preferable depends entirely on the individual patient's needs and goals.

Saline Breast Implants

Saline breast implants were used almost exclusively in the United States from 1992 until November 2006 because of a U.S. Food and Drug Administration (FDA) ban on silicone implants. Now that the FDA ban has been lifted and both types of breast implants are available, women have additional choices for breast augmentation surgery. While some people believe that silicone breast implants are softer and feel more natural, the latest saline implants are soft and very durable. Saline implants can be as small as 120cc or as large as 850cc, and they are available in round and teardrop shapes so that a procedure can be tailored to a patient's specific body contour. Anyone considering getting implants larger than the recommended size of 850cc should discuss getting implants custom made with their surgeon. Most saline breast implants are filled during surgery. Pre-filled saline implants are currently under review by the FDA.

Advantages of Saline Breast Implants

One of the biggest advantages of saline breast implants over silicone is their safety. The FDA originally banned silicone implants in 1992 because of reports that silicone leakage was causing serious health issues in some patients. With saline implants, this is not a concern. Saline is a sterile solution of salt and water, so if any leaks do happen, the body can take in the solution without any harm done. Leaks with these implants are apparent almost right after the rupture, because the solution escapes the plastic lining quickly. When silicone implants rupture, the silicone can leak without a noticeable difference in the look of the breasts. This and other breast augmentation risks should be discussed at length with a qualified cosmetic surgeon.

The cost of saline implants is much lower than silicone as well, which sways some patients who are concerned with breast augmentation cost.

Disadvantages of Saline Breast Implants

A disadvantage of saline implants is that they reveal ripples in their lining more easily than their silicone counterparts, with the saltwater solution not providing nearly as much outward resistance as silicone. This can be exaggerated by thinner women who don't normally have a lot of breast tissue to be placed over the implants, reconstructive surgery patients, and women who have subglandular placement of the breast implants. Saline breast implants also present the risk of capsular contracture. Capsular contracture is a potential complication from breast implants in which scar tissue forms around and squeezes the implants, causing the breasts to harden.

Breast Implant Shape

The shape of your breast implant will have a profound effect on how your breasts look after your surgery. While you may have a preferred shape in mind at this point, it is important that you learn fully about your options and discuss the advantages and disadvantages of each before settling on a definitive shape.

The two primary shapes of breast implant are teardrop and round. Which type is best suited to your case will depend on several factors, including:

• Your body type
• The amount of breast tissue you currently have
• Where you decide to have the implant placed
• Where you decide to have the incisions made

Round Breast Implants

The most commonly used type of implant is the round implant, which resembles a compressed sphere. This type of implant can vary in terms of projection, as well, from low profile to high profile. Women who wish to have more fullness in the top part of the breasts will probably consider round, high-profile implants to be a good choice.

Patients who choose the round implants do so for the lift, cleavage, and fullness they give to the breasts. On the other hand, some patients feel round implants look too artificial, and choose the teardrop-shaped implants because for their more natural appearance.

One of the advantages of round implants is that they will not cause a change in the appearance of the breast if they rotate. The implants can be textured or smooth, and they generally cost less than teardrop implants.

Teardrop Breast Implants

Teardrop shaped implants have sloped contours that are fuller at the bottom than at the top, mimicking the shape of natural breasts. Even though the upper portion of teardrop implants is not quite as full as the round implants, they tend to give greater projection than their round counterparts with the same amount of volume. For women who are seeking breast enhancement results that appear more natural, teardrop implants are probably the best choice.
Teardrop implants tend to costs more than round implants. They also need to be textured in order to keep the implant from rotating and distorting the shape of the breast, which is not a concern with round implants.

Breast Implant Texture

Breast implants can be either smooth or textured. The textured surface is rough, giving traction to the surface like fine sandpaper. The smooth surface is sleek and unvarying, a smooth plastic cover all the way around. Each of these different surface types hold individual benefits and drawbacks, and should be carefully considered while deciding what implant is right for you.

Smooth Breast Implants

The majority of breast augmentation surgeries use smooth breast implants, which can move without friction once they are placed inside the breast pocket. These implants normally have a thinner, softer shell than their textured counterparts. Compared to textured implants, they also:

• Tend to have a longer lifespan
• Generally cost less
• Are less likely to ripple

Textured implants are thought by some to have a lower risk of capsular contracture; however, there is no definitive evidence to support this, and there is disagreement among surgeons on this point. Many surgeons believe that placing smooth implants under the muscle helps to reduce the risk of capsular contracture.

Textured Breast Implants

Textured breast implants were created to keep the implant from moving around within the breast pocket created by the surgeon. By giving the implant a slight roughness, the surface of the implant adheres to the tissue around it, keeping them in their initial positions. This becomes particularly important with implants that are teardrop shaped, keeping them aligned properly within the breast tissue. If a teardrop shaped implant were to move around, the breast would become distorted and irregularly shaped.

The original notion of textured implants was to help lower the chances of capsular contracture, which is mentioned above, but mainly is when the scar tissue around the implant hardens and squeezes the implant into irregular shapes. Since creation though, there has been no conclusive medical evidence that the claim is correct. A 2012 retrospective study found that capsular contracture was in fact more common in smooth implants compared to textured implants.

Textured breast implants are known to leak and ripple more often than smooth implants, but textured implants don't become displaced nearly as much. The textured implants also cost more than smooth implants do, so that might factor into your decision if you're deciding which implants to pursue.

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Surgical Options

Breast implant options are not limited to type and shape. Results are also influenced by how and where the implants are placed by the plastic surgeon. There are two breast implant placement techniques commonly used: the subglandular method and the submuscular method.

Subglandular Placement

The patient and the surgeon can determine prior to the surgery where the breast implants will be placed to achieve the desired effects. Using the subglandular method, the implants are placed beneath the mammary gland but above the pectoral muscle.

Advantages of Subglandular Placement

There are many advantages to using the subglandular placement method. For one, there is normally less pain and discomfort after breast enlargement surgery with the subglandular option, and the recovery time is shorter as well. This is because the musculature isn't disturbed by the surgeon or an implant, and the skin and fat tissue being shifted instead is much more pliable.

Secondly, the over-the-muscle implants are usually much easier for a surgeon to manipulate and place. This goes for post-surgery access as well, if operations are needed afterwards. With implants usually lasting ten years on average, this should definitely be something to consider when choosing which implant is right for you.

Another important visual difference is cleavage. Subglandular implants can create cleavage more easily than submuscular implants, especially if the breasts are naturally far apart to begin with.

Finally, many athletic and active women prefer subglandular implants because it won't affect their muscles. Implants placed under the muscles can shift and look unnatural when the chest is flexed, which can be very concerning for women who weight train, are body sculptors, or professional body builders.

Disadvantages of Subglandular Placement

Of course, there are some disadvantages to this type of implant that submuscular implants don't have. Make sure to think about these if you are choosing between the two types.

Most people believe that breast implants placed under the chest muscle display a more natural looking slope and appearance than subglandular implants, which can sometimes look rounder than natural breasts. Ripples formed within the shell of the implant, due to pressure placed on the bag from being inside the body and the bag's natural tendency to fold inward, can be felt and seen more easily when it isn't placed behind a muscle. Women who have little or almost no breast tissue can experience this even more, since there is less to conceal the implant.

The detection of breast cancer can also be disrupted by a subglandular implant, since the implant is within the breast tissue and gland itself.

Also, and perhaps most seriously, capsular contracture is more likely to occur with the over-the-muscle implant. This condition is when the scar tissue tightens around the implant, making the implant appear to be much harder than it actually is. It can become painful as time goes on, and makes the breast look and feel very unnatural.

Submuscular Placement

Using the submuscular, also known as subpectoral, method, the implant is placed beneath the pectoral muscle in the chest. The chest muscle can accommodate this because it's connected to the chest wall along the muscle's outer perimeter, creating a natural pocket where the implant is inserted. When this method is chosen, the muscle normally covers around two-thirds of the implant.

Advantages of Submuscular Placement

The submuscular placement method tends to produce more aesthetically appealing results for naturally small-breasted women. Since the implant is concealed underneath the pectoral muscle, flaws in the implant like ripples or the edges of the implant are hidden. Submuscular placement of silicone implants tend to look and feel extremely natural.

Submuscular implants don't interfere with mammography exams, like subglandular implants sometimes do. Because the implant is behind the muscle, the breast tissue can be clearly checked for cancerous tumors by the mammogram. With the implant placed on top of the muscle but underneath the implant, the results of the mammogram can sometimes be less clearly defined.

Capsular contracture is also far less likely to occur when the breast implant is placed behind the muscle. This tightening of the scar tissue that happens with some patients can painfully squeeze the implant, creating a distorted look and hard feel in the breasts. Implants under the chest muscle are not as prone to this condition as their above-the-muscle counterparts.

Finally, "bottoming out" has less of a chance of occurring with implants placed under the muscle. This condition occurs when the implants have been placed too low along the chest wall, making the nipples appear to be too high up on the breast.

Disadvantages of Submuscular Placement

The primary disadvantage of submuscular placement is that it involves longer and more uncomfortable surgery and recovery compared to the subglandular method. This is because the harder, less flexible muscle tissue is being manipulated instead of just the mammary gland and fatty tissue found within the breast itself. Further procedures with under-the-muscle breast implants are also more difficult when compared to future procedures with subglandular implants.

This type of placement also makes it harder to create cleavage with women whose breasts are already widely spaced, particularly with textured breast implants.

Women who are very active and athletic, especially weight lifters and body builders, may prefer subglandular implants instead. This is because the submuscular implants don't flex along with the pectoral muscles, creating an irregular look to the breasts while flexing. Also, extremely strenuous exercises to the chest muscles may displace the breast implant.

Finally, under-the-muscle breast implants tend to sit higher on the chest than usual, at least until the muscle relaxes.

The type and location of the incision through which the implants are placed can also make a difference in breast augmentation results.

Breast Augmentation Incision Sites

The type and location of the incision through which the implants are placed can also make a difference in breast augmentation results, particularly in terms of how visible the resulting scars are.

Areolar Incision

The areolar incision is a popular choice because the resulting scar blends in with the border of the areola (the darker tissue that surrounds the nipple). This incision method also gives surgeons more control over the placement of the implant.

This technique involves the careful creation of an incision along the bottom edge of the areola, where the lighter breast tissue meets the darker tissue, so that the scar will blend in. Protective "sleeves" are utilized when inserting the breast implants through the incisions in order to protect the breast ducts.

Inframammary Incision

Inframammary incisions involve the placement of incisions at the base, or fold, of the breast where they are easily hidden beneath swimsuits or undergarments. When incisions are made in this location, a pocket is created into which the cosmetic surgeon may place the breast implant. The implant is inserted through the incision site, and centered behind the nipple. This is one of the most common incision methods used by cosmetic surgeons when performing breast surgery, especially when inserting silicone gel implants.

Transaxillary Incision

Transaxillary incisions are made in the armpit. Once the incision has been made, a channel to the breast is created. Next a pocket for the implant is made behind the breast, and then the empty implant is inserted into place. Then through some tubing, the implant is filled with a saline solution until it reaches the desired pre-determined size.

Transumbilical Incision (TUBA)

TUBA, or trans-umbilical breast augmentation, involves an incision around the edge of the navel for implant placement. An endoscope is then inserted through the incision to create a pocket within the breast for the implant to be placed. Afterwards, the implants are positioned into the breast pockets through the navel incision, which are then filled with a saline solution through a small tube. Once the implants are filled, the tube and endoscope are removed, and the small navel incision is closed for healing.

Transabdominal Incision (TABA)

Patients who undergo breast augmentation surgery in combination with a tummy tuck may be good candidates for the TABA, or transabdominal breast augmentation, incision technique. This method involves placement of the implants through the same incision that was created for the tummy tuck procedure.

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Before the Procedure

Before the procedure, you will be asked to:

• Avoid taking aspirin or anti-inflammatory drugs for a period of ten days prior to your breast augmentation, because these medications thin the blood and make surgery more dangerous.
  
• If you smoke, stop smoking at least two months before the procedure, as smoking will delay the healing process.
  
• Have any prescriptions that you will need after the breast enlargement surgery filled beforehand.

On the day of surgery, you should wear loose-fitting clothes that can be removed and replaced easily. It is important that you arrange for a close friend or relative to drive you home after the surgery and stay with you for 24 to 72 hours while you begin your recovery.

Please remember that these are general guidelines only. Your breast augmentation surgeon will know your medical history and your individual needs best. Follow his or her specific pre-operative instructions to the letter, and your breast augmentation will go as smoothly as possible.

The Surgical Procedure

Breast augmentation usually takes between one and two hours to complete. To some degree, the amount of time needed will depend on how and where the implant is being placed.

Anesthesia

In most cases, breast enlargement surgery is performed with the patient under general anesthesia. The anesthesiologist will use either intravenous (IV) or inhaled sedatives to put the patient to sleep and keep them sedated until the surgery is complete. The patient will not be able to hear, see, or feel anything that is going on during the operation. Once the breast implant placement surgery is complete, the patient will be brought out of the anesthesia, but will probably be groggy and tired for some time afterward. It is a good idea to have someone who you trust to take care of you during this period.

Some people experience side effects from anesthesia, such as sore throat, headache, dizziness, nausea, vomiting, shivering, or muscle pain. These effects are temporary and will wear off as the anesthesia leaves your system. If you have had any reaction to anesthesia in the past, you should communicate this to your doctor during consultations.
Some surgeons will use a combination of local anesthesia and a conscious sedative to keep the patient awake but relaxed during breast enlargement surgery. This is much less common, but may be an option for patients who would rather not be under general anesthesia.

Creating the Incision

Breast augmentation begins with an incision made in either the crease of the breast (inframammary), the armpit (transaxillary), the navel (TUBA), or the perimeter of the areola (periareolar). For both patient and surgeon, discreet incision placement is one of the top priorities in breast implant placement surgery. Although scars can fade significantly over time, they never completely disappear, so making the incision in an inconspicuous location helps to enhance the patient's overall results. The location of the incision is decided on a case-by-case basis; each patient's wishes and unique anatomy are taken into consideration.

Placing the Implants

The two main methods of implant placement used in breast enlargement surgery are subglandular breast implant placement (positioning of the implant in front of the pectoral muscle and directly behind the breast tissue) and submuscular breast implant placement (positioning of the implant under the pectoral muscle). Some surgeons recommend placing the breast implant in front of the chest muscle during surgery because this method tends to reduce postoperative pain and soreness. Other specialists advocate placing the breast implant under the pectoral muscle in order to prevent interference with future mammograms. You should discuss these options with your surgeon and come to a decision based on your preference and body type.

Sutures

After the implant has been placed, the incision is carefully sutured. Some surgeons use traditional stitches, while others use absorbable ones. If your stitches are the traditional variety, they will be removed between one and two weeks after your breast implant placement surgery, when the surgeon determines that the incision has been closed adequately and no longer needs to be sutured. Absorbable, or dissolvable, sutures will be broken down by the body and disappear on their own.

It is extremely important to keep the area around the stitches clean. Avoid submerging your incision site in water and do not let dirt or products come in contact with the area. You should also avoid any strenuous activity, lifting, or stretching that could pull the sutures. This will prolong healing time and make your scar more noticeable.

Drains and Bandages

Once the surgical incisions have been closed and taped, the breast implant placement surgery is complete. The breasts are wrapped and supported with a gauze bandage. The patient is then fitted with a special surgical bra that provides support for the first several weeks. Or the surgeon may suggest the use of a compression bandage or sports bra instead. In any case, it is important to follow the doctor's instructions on when and how to wear supportive garments. This will help expedite the healing process and minimize any discomfort.

In some cases, the surgeon will place drainage tubes to minimize swelling and bruising. This practice is more common for breast enlargement surgery using a submuscular placement, as the technique causes greater disturbance of tissues in the area and will trigger more swelling than a subglandular placement. If drainage tubes are used, they are removed within a few days.

Recovery from Surgery

If you choose to undergo breast augmentation, you must budget time for recovery. You can maximize your comfort and minimize the duration of your recovery by avoiding strenuous activities and following your surgeon's instructions as closely as possible.

Surgeons typically advise that their patients limit their movement and get plenty of rest following breast enlargement surgery. You should avoid bending, lifting, or straining, as these can all delay healing and increase pain. Patients whose jobs do not require strenuous activity such as lifting can normally return to work after a week. However, if your job is physically demanding, you may need longer time to recover before returning to work. Your surgeon can help you to determine when it is safe to resume working.

The total amount of time needed for recovery depends greatly upon the method of implant placement used. Subglandular breast implant placement (the placement of implants above the pectoral muscle) involves a shorter recovery time than patients who undergo submuscular breast implant placement, or the placement of the implant underneath the pectoral muscle.

Your surgeon will provide specific instructions for making your breast augmentation recovery time as short and painless as possible. By carefully following those instructions, the results of your breast augmentation surgery can give you years of satisfaction.

The First Two Weeks

Recovery can be uncomfortable for the first 24 to 48 hours after breast augmentation surgery, and it is common to experience breast pain and fatigue. Medications can help patients manage their pain in most cases, but a lack of energy, in addition to discomfort and soreness, may persist. If possible, you should have a friend, spouse or family member stay with you to help care for you during your recovery.

The gauze dressings applied to the breasts immediately following surgery will be removed after a few days and replaced with a special surgical bra. Stitches may be removed after seven to 10 days if they need to be removed.

The First Several Months

The breast will be very sensitive for the first several weeks after breast enlargement surgery, and may be swollen for up to five weeks. Until the sensitivity subsides, patients should avoid physical contact with their breasts to reduce the risk of injury and delayed recovery. Patients should wait about a month after surgery before resuming any strenuous activity or exercise.

You must be careful not to become impatient about resuming your normal regiment of physical activity. If you do not allow yourself the needed recovery time, you can injure the breasts and ultimately require even more recovery time. This can also result in diminished quality of the results. Anyone considering breast augmentation should discuss the recovery process at length with their surgeon to gain an accurate understanding of the time commitment required.

Breast Surgery Scars

The incision scars will be pink and firm for about six weeks following breast augmentation surgery. They will begin to fade significantly over the next several months, but will never completely disappear.

The incision site and implant placement technique chosen by you and your surgeon will determine the locations of these scars. A successful breast augmentation surgery results in scars that will be inconspicuous except under close observation. Reduce the likelihood of noticeable scars by following your surgeon's advice as closely as possible.

Breast Augmentation and Your Long-Term Health

Women over 40 should receive mammograms every year. Women who have undergone breast augmentation should visit a special radiology center that can perform mammograms on patients with breast implants. When you schedule a mammogram appointment, always be sure to mention that you have breast implants so the technician will know to avoid placing excessive pressure on your breasts. Your mammogram will require x-rays taken from multiple angles to ensure an accurate reading. An ultrasound may also be necessary to examine breast tissue.

Breast Augmentation Results

If you're considering breast augmentation surgery, it is important to seek improvement in the appearance of your breasts rather than perfection. There are things that breast augmentation can accomplish and things it cannot. Your satisfaction with your breast enhancement results depends on your understanding of the capabilities and limitations of the procedure.

Breast augmentation can increase breast size. Other breast implant results include the correction of asymmetry to some degree (although no pair of breasts is perfectly symmetrical), and a restoration of fullness and "perkiness" to breasts that have lost volume due to pregnancy or age. Women who choose to have breast implants may fill out their clothes better and sometimes experience an increase in their confidence and self-esteem. However, breast implants should never be considered as a way to change a life, improve a career, or make more friends; they solely make the breasts larger and fuller.

The best breast augmentation results are the product of good communication. Be sure to discuss your desires and expectations with a plastic surgeon you can trust and with whom you feel comfortable. By listening to your surgeon's feedback you can ensure that your expectations are realistic, which will make for a better outcome.

Tips for Maximizing Your Results

The first and most important step to ensuring positive breast implant results is to select your cosmetic surgeon carefully. He or she should be board certified and experienced in breast augmentation surgery. Do not be shy about asking for references, before-and-after photos, or educational information. It is your right to know your surgeon's qualifications. He or she should also be someone with whom you can easily communicate. It is important for you to be able to express your opinions and desires about your own body and to have your questions answered clearly and completely. This will facilitate the process of reaching great breast augmentation results.

Once you have chosen a surgeon, take the time to select implant size (small, or large) shape, and texture carefully. This can be the most difficult step because there are so many options to choose from, and all of them have benefits and drawbacks. If you have chosen your surgeon well, he or she can be a good resource for advice and information. Be sure you are well-informed about all of your options, and choose the implant that will help you best achieve the breast implant results you want.

You should also thoroughly consider the various surgical techniques available to you. Whether you want your implant placed above or below the chest muscle, and where you would like your incision scar to be concealed (beneath the breast, under the arm, around the areola, or within the navel) are choices you should make based on a thorough understanding of the options and your own desired outcome.

Finally, carefully follow all pre- and post-operative instructions. They are designed to improve your breast augmentation results and your chances of healing properly without complication. By failing to follow them, you risk putting unnecessary strain on your body, extending your healing time, and possibly triggering complications.

Benefits of Breast Augmentation

An attractive, proportional figure is the most apparent benefit of breast enlargement. However, the benefits of this procedure extend to several other facets of a breast enlargement patient's well-being. The enhancements to the figure, the new options in clothing, and the boosted self-confidence that accompany the results of a successful breast enlargement surgery can have a profound positive impact on the patient's life.

The size of a woman's breasts is important to her overall appearance. If a woman is unhappy with the size of her breasts, she may experience doubts about her physical appeal. Surgical breast enhancement can help women achieve a shapelier figure, and potentially boost a woman's self-esteem, giving her greater confidence in her social and professional life.

Aesthetic Improvement

Breast augmentation with breast implants enhances a woman's figure by increasing breast size, reshaping the bust line, and providing shapelier body contour. Small breasts can cause some women to feel that their bust line is disproportionate, creating an overall figure that lacks balance. Breast enlargement can add curves and definition to the body's profile for an appearance that is more conventionally attractive. Women can potentially eliminate a pear-shaped profile by undergoing breast enhancement surgery because larger breasts complement womanly hips.

If a woman's breasts have lost size and firmness because of pregnancy or aging, breast enhancement can help her reclaim a more youthful bust line. Breast enhancement surgery with breast implants can be used to restore breast size and shape following a mastectomy. If a woman's breasts are of noticeably different sizes, a single breast implant can make the breasts more similar in size, creating an attractive symmetry.

Breast implants are available in a variety of shapes and sizes, allowing plastic surgeons to select precisely the implants to help the patient achieve their desired breast size. If you are interested in finding out how beast enhancement with implants can benefit you, a qualified surgeon can explain your options and assist you in choosing implants that will best meet your needs.

Increased Confidence

Reduced confidence and feelings of inadequacy are common when a woman feels that the size of her breasts is detrimental to her outward appearance. These feelings can be alleviated after a successful breast enhancement surgery adds size and youthful contour to the breasts. Women who have undergone a breast enlargement surgery consistently report experiencing increased self-esteem and confidence.

After giving birth, many women lose breast size and volume, which can make them feel less attractive. A specially designed "mommy makeover" procedure addresses several post-childbirth issues such as stretch marks and loose abdominal skin, in addition to sagging breasts. This procedure can restore a youthful vibrancy to a mother's body, helping her to feel confident and beautiful.

More about Mommy Makeovers: The mommy makeover procedure addresses several post-childbirth issues

A mastectomy, or the removal of one or both breasts as treatment for cancer, can be traumatic for many women. To regain the bust line they had before their mastectomy, many women will choose to undergo reconstructive breast enhancement surgery, often with breast implants to achieve the most natural look possible.

More about Breast Lifts and Stretch Marks: Breast lift surgery helps to lift aging and sagging breasts and stretch mark removal treatments will help to minimize and remove scars

More Clothing Options

Many women are excited by the prospect of broadened clothing options as a result of a breast enhancement surgery. The way clothing hangs from a woman's frame is a key consideration by clothing designers, and a firm, perky bust line allows clothes to be even more striking and expressive. From dresses to swimwear, a whole new world of flattering clothing suddenly becomes an option. Low-cut tops and dresses can be worn with confidence. During their initial consultation with their surgeon, it is not uncommon for women to bring clothing they would like to eventually fit. By fully expressing your desires and goals for breast enhancement surgery, your plastic surgeon can determine how to best create the bust line you desire.

Breast augmentation is considered to be a safe and effective method of giving women the appearance they want. Larger breasts or more lifted, symmetrical, or proportional breasts can make a positive difference in the way a woman not only looks, but feels. While there are a number of excellent benefits of breast augmentation surgery, there are also several complications that could occur of which you should be aware. Before undergoing any cosmetic surgery it is important to have an in-depth understanding of any potential health-related problems that may result from the procedure. We urge you to continue reading, so you are equipped with all of the pertinent information before choosing to move forward with the procedure.

Risks of Breast Augmentation

In order to minimize your chances of complications from breast augmentation surgery, it is important that you choose a plastic surgeon with the right credentials and experience. During your consultation, your doctor will inquire about your medical history and any existing conditions you have to determine whether you are a good candidate for the surgery, or if you are at high risk. Additionally, make sure that your physician addresses any questions you have, and that you feel completely comfortable with the procedure before you decide whether it is right for you.

Post-Operative Complications

The various complications that could occur after surgery range in severity. Many patients will have to undergo an additional surgery at some point in their lives due to complications, which could include:

Capsular Contracture

As the body heals itself during breast augmentation recovery, scar tissue, called the capsule, naturally develops around the implant. The capsule could contract, placing too much pressure on the implant, resulting in pain, discomfort, hardening of the breast, or a distorted-looking breast. Your doctor may recommend that the implant be placed beneath the chest muscle to avoid this complication.

The "Baker Grading System" determines the level of severity of the capsular contracture, from grades one through four - four being the worst. If the breast is hard, looks unnatural, and is very painful, you are likely at a stage three or four, in which case surgery is required. Your surgeon will either perform an open capsulotomy to loosen the scar tissue, or a capsulectomy to remove the scar tissue completely.

Rippling

Rippling occurs when the breast implant is wrinkled or folded, causing the breast to look distorted on the surface. In order to avoid rippling, your surgeon may suggest a silicone-gel implant so the substance doesn't move around as easily, or a smooth-surfaced implant. If patients notice a bump, valley, or ridge, usually at the outer portion along the bottom of the breast, she may be experiencing rippling, and should go see the surgeon right away.

Infection

Infection can occur after any type of surgery, and breast augmentation surgery is no exception. If patients experience a fever or notice the breasts are red, tender, or inflamed, an infection may be the cause. In order to avoid infection, refrain from submerging in water as the incisions are still healing. And, do not use lotions, deodorants, or any other irritants near the incision location. If infection is going to occur, it usually will from one to six weeks following the procedure. If you have an infection, you should see your doctor, who may prescribe antibiotics or recommend removing the implant until the infection is gone. An infection may also cause the onset of capsular contracture.

Hematoma

Hematoma, an accumulation of blood also known as bruising, can lead to breast implant complications, including infection or capsular contracture. Patients generally experience some bruising and other side effects after the breast augmentation surgery, however excessive bruising may need to be surgically drained in order to properly heal. Your surgeon will have to be extremely careful not to rupture the implant when inserting the tubes required for draining.

Numbness or Sensitive Nipples

Very minor numbness or nipple sensitivity can occur immediately following the breast augmentation procedure, which subsides after several days to a few months. However, some patients claim that they experience either intense nipple sensation or a loss in nipple sensation as long as five years after the surgery. This is due to nerve pathways being disrupted during the breast surgery. Patients may experience intensified or weakened sensation, or no feeling at all.

Displacement

Though displacement is extremely rare, patients may experience shifting of the implant from its correct location, usually just several days following the procedure. Women with larger implants are at a greater risk of displacement, which can be corrected with surgery.

Implant Rupture

Patients with saline or silicone breast implants are at risk of experiencing a rupture. With silicone, there are no noticeable symptoms that a rupture occurred, and therefore regular MRI checkups may be necessary. However, with saline implants, the rupture results in rapid leakage and therefore quick deflation of the breast that patients notice right away. The saline solution is harmless and is easily absorbed into the body. If a leakage does occur, patients should see the surgeon right away to replace the implant.

Interference with Mammograms

Breast implants may cause an obstruction during a mammogram, as the x-ray machine cannot photograph anything underneath. Your surgeon may recommend the implants be placed below the chest muscle. Make sure the mammogram technician is aware that you have implants so he or she can best accommodate your needs.

Temporary Side Effects

Breast enlargement surgery can benefit you in several ways. You can expect to look better, and feel more confident and attractive. Although the surgery itself generally takes only an hour, a great deal of patience is required on your part before the results become fully apparent. Immediately following breast enlargement surgery, you can expect to feel very sore, tired and groggy. When the effects of the anesthesia subside, you can expect some other common side effects that can cause pain or discomfort, but are temporary and can be more easily endured with the help of medication and other treatments.

Patients should not confuse side effects with complications. Complications are unexpected problems that occur during or because of surgery. On the other hand, side effects are a common part of healing. They will subside over time, and should be expected. Your doctor will provide medication to help you manage pain after the procedure.

Settling

When breast implants are placed beneath the pectoral muscle (submuscular placement), they may take weeks or even months to settle into their permanent position. Your muscle and skin will have to stretch to make room for the implants. During this time, your breasts might appear too tight, too high, or unnaturally round. But as the tissues begin to relax and accept the new implant, they will begin to take on a much more natural appearance. This process generally occurs over the course of a few weeks. If you are worried about the results of your surgery, speak with your surgeon, but give your body ample time to heal before coming to any conclusions about the results.

Swelling

Swelling occurs after every type of surgery, including breast augmentation surgery. Your breasts may temporarily feel large, tight and heavy as a result of post-surgery swelling. The supportive garments your surgeon provides will help. Swelling may also extend into the abdominal region of your body. This is common, and you should not let this alarm you. Swelling may subside more quickly if you try sleeping in a reclining position.

Bruising

Bruising is possible following breast augmentation surgery. Breast implant size, as well as the placement method employed, can affect the amount of bruising that occurs. Bruising can extend to the abdominal area in rare instances. This is uncommon, but not a complication. Contact your doctor if you experience large, firm, painful bruises. This could be a hematoma, a serious kind of bruise that requires special treatment. After one or two weeks, normal bruising will subside.

Nipple Sensation

Patients' nipples often become either numb or very sensitive immediately following breast enlargement surgery. The surgery usually results in some disturbance of the nerve pathways and is almost always temporary. This loss of sensation can persist for several days or months. It is permanent in a small percentage of patients.

Pain Control

The pain that follows breast enlargement surgery is usually moderate. Pain medication should be taken as directed by their doctor. Pain will decrease quickly over the first few days following surgery and continue improving as the implants settle.

Itching

The skin stretches considerably after breast surgery. As this occurs, the patient may experience itching. Lotion can help relieve this effect, but you must take care not to allow the lotion to contact the incision site. Consult your surgeon to find out which kind of anti-itching medications you can safely use.

Scars

Breast enlargement always leaves scars. It cannot be prevented. The scar can be made minimally visible if it is placed in an inconspicuous location, such as the crease of the breast or around the areola. It generally takes up to a year for a scar to finish fading. Some topical treatments are available to help patients minimize their scars. Talk to your surgeon to find the best method of scar treatment for you.

Infection

When bacteria is introduced into the body through the incision, infection can occur. Tenderness, localized swelling, redness and warmth can all indicate that an infection has taken place. Fever can accompany these symptoms in some instances. Antibiotics can clear most infections. In more serious cases, the surgeon may have to remove the breast implants while the body fights the infection.

Constipation

Pain medication taken after surgery can cause constipation in some instances. This is a rare side-effect, but it should be discussed with your surgeon before you undergo breast augmentation surgery so you can determine which kinds of remedies you should have on-hand following treatment.

Breast Augmentation and Pregnancy

Breast augmentation will not interfere with a woman's ability to become pregnant or maintain a healthy pregnancy. Conversely, women that have already had children may be unhappy with the affect that pregnancy and breastfeeding had on the breasts. The breast augmentation procedure can safely restore shape and volume to the breasts, improving each patient's post-pregnancy figure.

Breast Implants Do Not Affect Pregnancy

For many parents, the decision to try and conceive is an emotional time when hopeful couples will likely have a multitude of concerns about how their health and lifestyles will affect their ability to successfully become pregnant. The good news is that the breast augmentation procedure does not affect a woman's reproductive system. It will neither decrease nor increase a woman's chances of becoming pregnant. Millions of women have undergone breast implant surgery prior to getting pregnant and having children.

Breast Implants and Breastfeeding

One of the most common questions young women have for plastic surgeons is whether the breast augmentation procedure will affect their ability to breastfeed in the future. In the vast majority of cases, the placement of breast implants will not impede the breastfeeding process. The incisions made during breast augmentation surgery do not disrupt the milk ducts.

The most common problem implants pose to a woman's ability to breastfeed her child is inadequate breast milk production. Though the milk ducts remain intact and a mother remains capable of producing a full supply of milk, if any permanent nerve damage has taken place as a result of breast enlargement surgery, hormonal signals to the brain that trigger milk production may not be received. A woman's body depends on the nerves in her breast to sense her baby suckling, which signal to the brain that more milk is needed.

Another very rare complication that can occur is the leaking of breast implants into the breast milk. Most implants are filled saline instead of silicone; saline is not considered dangerous if ingested by a feeding baby. Mothers can test their milk for traces of silicone. Any mother concerned about how her silicone breast implants may affect her milk is encouraged to test regularly both for the health of her child and her own peace of mind.

As always, the best way to ensure that your breast implants will give you satisfying results without interfering with your ability to breastfeed is to select a plastic surgeon you trust. Never hesitate to fully explore your prospective surgeon's qualifications, credentials, and track record before committing to breast enlargement surgery, or to voice your concerns in great detail during your initial consultation.

Restoring Volume to the Breasts after Pregnancy

Many women find that their breasts have lost their youthful shape after having children. Breast augmentation can increase the size of the breasts, while breast lift surgery can be performed to change the position of the nipple, restoring a perky, youthful look to a woman's bust line.

Many women, after deciding they do not want to have any more children, decide to mark the occasion by treating themselves to a breast enlargement surgery. This can often be incorporated into the popular mommy makeover procedure, which often combines breast procedures with liposuction, abdominoplasty (tummy tuck), and other body lift procedures to counteract the loose skin and sagging that can occur after pregnancy. The popularity of post-pregnancy plastic surgery treatment continues to gain popularity as mothers choose to reclaim their youthful figures after giving birth.

Of course, the experience of pregnancy can cause a woman's breasts to change size and shape. If a woman had breast implants before pregnancy, they may no longer complement her breasts in a way she finds flattering or satisfactory. In this case, many women choose to have their breast implants removed, or have different implants placed to once again achieve bust lines they feel complements their figures.

Revision Surgery

Breast implant revision surgery may involve the replacement of an implant or the removal of an implant altogether.

Breast augmentation revision is similar to breast augmentation. General anesthesia is used during secondary breast augmentation. Implant revision or removal may require less time than implant replacement because there are fewer steps involved, but most secondary breast augmentations take less than an hour to complete.

Most patients will be kept under observation for three to 24 hours after breast implant revision surgery. Patients will be on bed rest for two to three days after surgery, and may return to work in one to two weeks. Strenuous exercise and heavy lifting should be avoided for four to six weeks.

Breast implant removal surgery is an option for women who are not satisfied with the results of their breast augmentation, or when complications with breast implants arise. Breast revision surgery may become necessary if the original breast implant placement was performed incorrectly. Breast implants may become displaced or contracted because of improper placement or due to pressure from scar tissue. The procedure may also be necessary if the implants rupture or deflate as a result of injury or a defect in the implant itself. Additionally, breast implants may need to be removed if infection occurs.

Safety Data

While no surgical procedure is entirely risk free, breast augmentation is generally safe, and no serious health hazards have been proven.  In 1992, the FDA banned the use of silicone gel implants in breast augmentation surgery, not because of definitive evidence that they were unsafe, but because the agency required additional information supporting their safety. In 2006, after many years of clinical tests, the FDA was satisfied that silicone implants were reasonably safe for their intended use and allowed them to be reintroduced to the U.S. market.

Statistics

Breast augmentation has been the single most popular cosmetic surgery performed in the United States since 2006, according to the American Society of Plastic Surgeons (ASPS). Though the procedure is widely performed and considered safe when performed by an experienced, qualified surgeon, it is important for anyone considering breast enlargement surgery to learn as much about it as possible before committing to this treatment. Often, by analyzing the statistics associated with a plastic surgery procedure, anyone considering the treatment can gain insights into their own reasons for wishing to surgically enhance their appearance.

As the waning American economy began to gain prominence and publicity in 2008, the numbers provided by the ASPS indicate that many potential patients either passed up or postponed plans for breast augmentation as the total number of procedures dropped from 347,524 to 307,230. Total breast augmentation surgeries continued to drop in 2009 as numbers fell from 307,230 to 289,328. However, in 2010, those numbers began to rise once again, reaching 296,203. It is important to note that meanwhile, the number of breast augmentation surgeries performed in 2000 (187,755) has increased by more than 50 percent in 2010 (283,721). These findings suggest that no matter how much the economy suffers, the surgical pursuit of the perfect bust line is only getting hotter among American women.

There were more than 13 million plastic surgery procedures performed in the United States in 2010, a five percent increase from 2009. Of those, 1.6 million were cosmetic surgical procedures, a two percent increase from the previous year. Almost 18 percent of those surgeries were breast augmentations.  The statistics provided by the ASPS allows us to analyze the frequency of breast augmentation surgery over the last decade, which age groups received the most breast augmentation surgeries, and where the majority of those surgeries took place within the United States.

Breast Surgery in the 2000s

The number of plastic surgeries performed in the United States increased by nearly 100,000 between 2000 and 2007. Perhaps as a result of the waning economy, that total decreased in 2008 and 2009. But in 2010, the ASPS reported an increase in Americans choosing to undergo surgical cosmetic enhancement. Of the 1,555,614 total plastic surgeries performed in 2010, most (296,203, or about 20 percent) were breast surgeries. This equaled a 2 percent increase in the frequency of breast augmentation surgery from 2009. The other most popular plastic surgeries in 2010 were rhinoplasty, liposuction, eyelid surgery and tummy tucks.

Breast Augmentation Popularity

# of Procedures	Year
296,203	2010
289,328	2009
307,230	2008
347,524	2007
329,396	2006
291,350	2005
264,041	2004
254,140	2003
236,888	2002
219,883	2001
212,500	2000

Breast Augmentation and Age

The ASPS includes statistics on the number of people that underwent breast augmentation surgery in 2010 by age group. Just as in 2009, women in the 30 to 39-year-old age range underwent the most breast augmentation procedures in 2010, with a total of 107,638. The next most popular age group was women in their 20s (90,273), followed by women between the ages of 40 and 54 (82,666).

• 13-19: 8,525

• 20-29: 90,273

• 30-39: 107,638

• 40-54: 82,666

• 55+: 7,101

Also of note, most breast reconstruction surgeries, such as those that follow mastectomy surgery, were administered to women between the ages of 40 and 54 (47,155, or roughly half of 93,083 total breast reconstruction surgeries performed in the US in 2010).

Breast Augmentation by Region

Breast augmentation was most popular in what the ASPS classifies as Region 5, which includes most of the west coast (California, Arizona, Idaho, Montana, Nevada, New Mexico, Utah, Wyoming, Alaska, Hawaii, Oregon and Washingon.)

Region 1: (Connecticut, Maine, Maryland, New Hampshire, Rhode Island, Vermont, New Jersey, New York, Pennsylvania)  42, 663 (14%)

Region 2 : (Illinois, Indiana, Michigan, Ohio, Wisconsin, Iowa, Kansas, Minnesota, Missouri, Nebraska, North Dakota, South Dakota) 47,925 (16%)

Region 3 : (Delaware, Washington DC, Florida, Georgia, Maryland, North Carolina, South Carolina, Virginia, West Virginia, Puerto Rico) 45,620 (15%)

Region 4 : (Alabama, Kentucky, Mississippi, Tennessee, Arkansas, Louisiana, Oklahoma, Texas) 48,666 (16%)

Region 5 : 111,329 (38%)

Frequently Asked Questions

The following questions include some of those most commonly asked by patients who are considering breast augmentation. The answers are general and should not be considered definitive advice. For answers to your specific questions, schedule a consultation with a plastic surgeon in your area.

What is "natural" breast augmentation?

The "natural" breast augmentation procedure, also known as stem cell breast augmentation and lipoaugmentation, involves the removal of fat from other areas of the body and its transfer to the breasts. The fat is removed from the buttocks, thighs, or another area of the body. It is then prepared so it can be injected into the breasts to create more volume and lift.

How can I participate in clinical trials of new breast augmentation techniques?

If you are interested in undergoing breast augmentation using new breast augmentation techniques or technologies, check the government's clinical trials website to see if you can participate in a study.

How long do breast implants last?

It is important that you understand before you undergo breast augmentation that implants are not permanent devices. Eventually, they will require replacement or removal. Yes, there are cases in which implants have lasted for twenty years or longer and are still in excellent condition, but these are the exceptions.  The average lifespan of a breast implant is approximately ten years.

Will breast augmentation improve the appearance of drooping breasts?

In and of themselves, breast implants will not correct breasts that have begun to lose their natural elasticity.  However, many women who wish to change the size and shape of their breasts combine breast lift surgery, in which the breasts and nipples are raised to more youthful positions, with breast augmentation, in which breast implants are placed to increase the size of the breasts.  The result is larger, but perkier, breasts.

What can I do if I am dissatisfied with the appearance of my breasts after augmenation surgery?

Breast implants, of course, can be removed. However, there are also plastic surgeons who perform secondary breast augmentation, correcting the unnatural or otherwise unsatisfactory results of a previous surgery.