Breast Augmentation

Breast augmentation is usually done using a breast implant and less commonly with fat transfer, in which fat cells are harvested from the body (thighs, belly, hips or flanks) and injected into the breast tissues. The latter is less common for several reasons, including the predictability of results and limitations on the amount of fat that can be transferred during a single procedure. Fat transfer is also only able to provide a moderate increase in size.

There are several types and shapes of implants, including those filled with saline (sterile salt water) or silicone gel designed to feel like breast tissue; some are “structured,” meaning they contain internal supports meant to make the augmented breast feel more natural. Each has different qualities and risks, which should be discussed with your surgeon.

If your breast skin has a lot of laxity, a breast lifting procedure (known as a mastopexy) can be combined with breast augmentation. While there is an upside to limiting the number of surgeries you undergo, it’s important to note that when these two procedures are performed together, the risk of complications or needing a revision surgery is higher than when each is performed alone.

The quality and safety of breast implants have steadily improved, yet even today’s most sophisticated options will not last forever. As a general rule, implants may have to be exchanged for new ones around every 10 years. That said, if routine checkups show no issues, many patients end up safely keeping their breast implants for 20 years or more.

Patients seeking augmentation should have fully developed breasts and be at least 18 years old before using saline implants and 22 years old before using silicone gel. Regardless of age, you should hold off on this surgery if you’re pregnant or breastfeeding, given the changes that happen to the breasts before and after childbirth.

Breast augmentation surgery can be a crucial procedure for individuals who have issues with the size, shape or symmetry of their breasts. Studies have linked the procedure with an improved perception of body image and higher self-esteem, more confidence in social situations and improvements to overall psychological well-being.

Surgeries are typically performed by board-qualified plastic surgeons with extensive training.  When done artfully, the procedure requires only a small surgical incision. The thickness and color of the resulting scar will depend on your body’s wound-healing capacity, as well as the surgeon’s expertise and meticulousness.

Several factors will help determine how the surgeon accesses the breast, and where any resulting scar might be: These include the type of implant, your unique anatomy, your preferences, and your surgeon’s experience. The incision is typically made so it can be hidden in the crease under the breast (inframammary), around the nipple-areolar complex (periareolar), or in the armpit (transaxillary). The first two methods are most common among surgeons because they tend to minimize the risk of infection.

Breast implants have been well-studied and are generally considered safe. But like any medical device, they are prone to possible complications, including infection, leakage, or rupture. In addition, breast augmentation carries other risks, including changes in the sensation of the nipple and scarring at the incision site. It’s essential for you to understand these possible outcomes and discuss them with your surgeon before undergoing the procedure.

Before you go

During your consultation with your surgeon, you can expect to discuss your desired outcomes, your medical history, and any concerns you have about the procedure. Your surgeon will evaluate your anatomy to help determine which methods and implant types will work best for you. They should also review before and after photos with you, so you can discuss your aesthetic goals. If you prefer not to have an implant, you and your surgeon should discuss the option of using fat transfer as a means of enhancing the size and shape of your breasts.

During the procedure

Breast augmentation is typically performed under general anesthesia, so you will be comfortable during the procedure. The procedure typically takes one to two hours, and you can expect to go home the same day (though someone else will need to drive you).

In a typical procedure, the surgeon will make incisions, create space for the implants, insert the implants, and then close the incisions with sutures. Usually, these are self-dissolving sutures that will not need to be removed.

Before you leave, you’ll be given a supportive bra and may have swelling and mild bruising.

Breast Augmentation Aftercare

Recovery from breast augmentation typically involves a period of rest and limited physical activity, with patients advised to avoid strenuous exercise and heavy lifting. You may be asked to wear special supportive garments during this period. Most patients can return to work and normal activities within a week, but full recovery may take several.

The pain experienced during recovery is usually managed with over-the-counter pain medicines and prescription pain medication. The surgeon will monitor for any complications or issues during follow-up appointments. As mentioned above, implants can last 20 years or more. But patients will need to attend checkups every year or so to assess their status.