Also known as augmentation mammaplasty, breast enlargement or breast implants
Breast augmentation surgery increases or restores breast size using silicone gel implants, saline implants or in some cases, fat transfer. One of the most popular and frequently performed aesthetic surgery procedures, breast augmentation has a long and successful track record in satisfying women who wish to enhance, regain or restore balance to their figures.
These are the three top pros and cons to weigh when considering breast augmentation. If you wish to focus on what is unique to you, please consult with your aesthetic plastic surgeon.
The following are some common reasons why you may want to consider breast augmentation:
If you are in good health, have a positive attitude and realistic expectations, you are most likely a good candidate for this procedure.
In breast augmentation using implants, your surgeon makes an incision, lifts the breast tissue, creates a pocket in the chest/breast area and places an implant in the pocket.
An additional option for breast augmentation is autologous fat transfer, a process in which your surgeon removes your own fat, using liposuction, from a fat-yielding body part (such as your abdomen, thighs, or flanks) processes it and then injects it into your breasts. This procedure is currently considered experimental, due to a limited history of data, but the process has shown promise.
Multiple factors, including your anatomy and your surgeon's recommendations, will determine how your breast implant is inserted and positioned. The implant is placed in a pocket either:
Breast implants are placed either above or below the pectoral muscle.
Placement of the implant underneath the pectoral muscle may interfere less with mammograms and breast-feeding. Your plastic surgeon will discuss this with you.
There have never been more choices for breast augmentation. The following options are available, depending on your medical history, body shape and aesthetic goals.
Saline-filled breast implants are filled with sterile salt water. They may be prefilled at a predetermined size or filled at the time of surgery to allow for minor modifications in implant size.
Structured saline-filled breast implants are filled with sterile salt water, but contain a structure inside so they behave as if filled with soft, elastic silicone gel. This structure enables them to hold their shape better than traditional saline implants. Approved by the FDA and Health Canada in 2014, these implants have been available since 2015.
Silicone gel-filled breast implants are filled with soft, elastic gel and are available in a variety of shapes. All silicone gel breast implants are pre-filled and may require a longer incision for implant placement.
Cohesive gel silicone gel-filled breast implants, also known as “gummy bear” or “form stable” implants, are filled with a cohesive gel, made of crosslinked molecules of silicone, which makes them a bit thicker and firmer than traditional silicone gel implants. This enables them to hold their shape better. Approved by the FDA for use in the United States in 2012, these implants have been available in much of the world since 1992.
Autologous fat transfer removes fat through liposuction from an area of your body in which there are abundant fat cells, such as your thighs, abdomen and hips. After a process of preparation and refinement, the fat cells are injected into your breast. This is a less common method than breast implant augmentation and is still undergoing clinical studies and research for safety and effectiveness.
Your plastic surgeon might combine any of these breast augmentation options with a breast lift if there is any sagging or drooping of your breasts.
Your anatomy and health profile as well as your personal preferences will help you and your surgeon determine:
Factors that influence the size and type of breast augmentation recommended for you include:
The goal of your aesthetic plastic surgeon and staff is to help you achieve the best results and to make your surgical experience as easy, safe and comfortable as possible.
An incision can be made in one of four places:
It is important for women with breast implants to keep in mind that while breast implants are intended to last your lifetime, replacement may become necessary. After breast implant surgery, you should have periodic examination by a board-certified plastic surgeon to monitor your implants.
Silicone gel-filled breast implants have been under scrutiny for years, but after gathering detailed and meticulous research and data, the FDA has approved them for use in cosmetic breast enhancement surgery, finding no link between silicone gel breast implants and connective tissue disease, breast cancer or reproductive problems. In addition, the FDA has approved three companies to develop and market breast implants and continue to collect data on their long-term safety and efficacy. For more information, please see the FDA breast implant information provided on their site.
Surgical techniques for breast augmentation and all breast implants are continually being refined, increasing the safety and reliability of the procedure. Ask your plastic surgeon to provide you with the information you need to make an informed decision.
It’s important to choose your surgeon based on:
Members of the American Society for Aesthetic Plastic Surgery are experienced and qualified to perform your aesthetic procedure. Learn how to select a surgeon.
After finding a board-certified plastic surgeon in your area who is experienced in performing breast augmentation, you will need to make an appointment for your consultation. Generally, because of the in-depth nature of the consultation, there is a cost associated with the initial visit.
During your initial consultation, you will have the opportunity to discuss your cosmetic goals. Your surgeon will evaluate you as a candidate for breast augmentation and clarify what a breast augmentation can do for you. Understanding your goals and medical condition, both alternative and additional treatments may be considered (see related procedures).
You should come to the consultation prepared to discuss your complete medical history. This will include information about:
Your plastic surgeon will examine, measure and photograph your breasts for your medical record. Your surgeon will consider:
If your breasts are sagging, a breast lift may be recommended in conjunction with breast augmentation.
If you are planning to lose a significant amount of weight, be sure to tell your plastic surgeon. The surgeon may recommend that you stabilize your weight before undergoing surgery.
If you think that you may want to become pregnant in the future, discuss this with your surgeon. Pregnancy can alter breast size in an unpredictable way and could affect the long-term results of your breast augmentation. There is no evidence that breast implants will affect pregnancy or your ability to breast-feed, but if you have questions about these matters, you should ask your plastic surgeon.
Based on your goals, physical characteristics, and the surgeon’s training and experience, your surgeon will share recommendations and information with you, including:
For a general list of questions to ask your surgeon about his or her background, to find out about plastic surgery safety and to plan your procedure, visit the Planning Toolkit.
We developed these questions to help you:
It is important for you to take an active role in your surgery, so please use this list of questions as a starting point for your initial consultation:
Your surgeon will provide thorough preoperative instructions, answer any questions you may have, take a detailed medical history and perform a physical exam to determine your fitness for surgery.
To help detect and track any changes in your breast tissue, your plastic surgeon may recommend:
In advance of your procedure, your surgeon will ask you to:
For breast augmentation using autologous fat transfer, you may be instructed to wear a special bra to expand the skin and tissue around the breasts to prepare them for fat injection.
Breast augmentation is usually performed on an outpatient basis. Be sure to arrange for someone to drive you home after surgery and to stay with you at least the first night following surgery.
What can I expect on the day of breast augmentation surgery?
Your breast augmentation surgery may be performed in an accredited hospital, free-standing ambulatory facility or office-based surgical suite. Most breast augmentation procedures take at least one to three hours.
Following insertion and placement of breast implants, your surgeon will use sutures to close the surgical incisions. Many plastic surgeons will wrap your chest area with a gauze bandage or a surgical compression bra to provide support and assist with healing. Occasionally, drainage tubes may be used for a short time following surgery.
Breast augmentation with autologous fat transfer requires two procedures: liposuction and fat injection. Using liposuction techniques, your plastic surgeon will remove your fat cells from a predetermined location with a cannula, process the fat and then inject the fat into your breasts. Your liposuction incisions will be closed with sutures, and you will wear compression garments over the liposuction areas and your breasts.
You may be permitted to go home after a short observation period unless you and your plastic surgeon have arranged other plans for your immediate postoperative recovery.
Your surgeon will discuss how long it will be before you can return to your normal level of activity and work. After surgery, you and your caregiver will receive detailed instructions about your postsurgical care, including information about:
See options for short-term recovery locations in Aftercare and Recovery (Planning Toolkit).
Immediately after breast augmentation surgery
After your breast augmentation procedure, you may be placed in a surgical dressing that can include a support bra or garment.
Breast augmentation surgery stretches the breast tissue and can be painful—especially when implants have been placed under the chest muscle. Typically, the most pain is experienced within the first 48 hours after breast augmentation surgery. Your level of pain will typically decrease each day and may be effectively treated with various pain medications.
Your breasts may feel tight and sensitive to the touch and your skin may feel warm or itchy. You may experience difficulty raising your arms.
Some discoloration and swelling will occur initially, but this will disappear quickly. Most residual swelling will resolve within a month.
When the anesthesia wears off, you may have some pain. If the pain is extreme or long-lasting, contact your physician. You will also have some redness and swelling after the surgery. Contact your surgeon to find out if your pain, redness and swelling is normal or a sign of a problem.
Recovery time frame after breast augmentation
You should be able to walk without assistance immediately after breast augmentation surgery. It is very important that you walk a few minutes every few hours to reduce the risk of blood clot formation in your legs.
It is vitally important that you follow all patient care instructions provided by your surgeon. This will include information about wearing compression garments, care of your drains, taking an antibiotic if prescribed and the level and type of activity that is safe. Your surgeon will also provide detailed instructions about the normal symptoms you will experience and any potential signs of complications. It is important to realize that the amount of time it takes for recovery varies greatly among individuals.
The first week
Two to six weeks
You should minimize excessive physical activity for at least the first couple of weeks after surgery. After that, take care to be extremely gentle with your breasts for at least the next month. Intimate contact will be guided by your comfort.
Your surgeon will encourage you to schedule routine mammograms at the frequency recommended for your age group. Following breast augmentation, you should continue to perform breast self-examination.
Under normal circumstances, the results of your breast augmentation surgery will be long-lasting; however, it’s important to know that breast implants need to be replaced if they leak. Routine follow-up with your surgeon is important.
Fat transfer surgery has different expectations, including losing some volume over time.
Your breasts can change due to:
After a number of years, if you become less satisfied with the appearance of your breasts, you may choose to undergo a breast revision to exchange your implants, or a breast lift to restore a more youthful shape and contour.
Maintain a relationship with your aesthetic plastic surgeon
For safety, as well as the most beautiful and healthy outcome, it’s important to return to your plastic surgeon's office for follow-up evaluation at prescribed times and whenever you notice any changes in your breasts. Do not hesitate to contact your surgeon when you have any questions or concerns.
The cost of breast augmentation varies from doctor to doctor, from one geographic area to another, and based on the specific augmentation procedure.
These numbers only reflect the physician/surgeon fees last year and do not include fees for the surgical facility, anesthesia, medical tests, prescriptions, surgical garments or other miscellaneous costs related to breast revision.
Because breast augmentation is elective surgery, insurance does not cover these costs. Many surgeons offer financing plans to make the procedure more affordable.
Choose your surgeon based on quality, training and experience — not cost.
See why ASAPS members are widely recognized for upholding the highest standards in the area of aesthetic plastic surgery by viewing their basic credentials, training and certifications.
Fortunately, significant complications from breast augmentation are infrequent. Your specific risks for breast augmentation will be discussed during your consultation.
All surgical procedures have some degree of risk. Some of the potential complications of all surgeries are:
All surgical procedures have some degree of risk. With breast augmentation, minor complications occur occasionally, but do not affect the outcome. Major breast augmentation complications are very unusual.
Other risks specific to breast augmentation are outlined below:
Breast Cancer Detection
If you are of an age in which you get regular mammographic examinations, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts are often required.
Your aesthetic plastic surgeon, in some instances, may recommend other types of examinations, such as ultrasound or magnetic resonance imaging (MRI). It is possible that the presence of breast implants could delay or hinder the early detection of breast cancer.
You can help minimize certain risks by following the advice and instructions of your board-certified plastic surgeon, both before and after your breast augmentation surgery.