Important things to know about breast augmentation

Cosmetic plastic surgery has been consistently on the rise, but breast enhancement is by far the most popular procedure. In 2017 alone, there were 300,378 breast augmentations and 105,219 breast lifts performed.

Many women have lots of important questions about breast augmentation, including the following frequently asked questions.

What is breast augmentation?

Breast enhancements are performed to enhance the size and shape of a woman's breasts. This is done primarily and traditionally with implants.

There are lots of reasons why women opt for this treatment, including when they have significant asymmetry or have experienced loss of breast volume due to weight loss or pregnancy, or generally to enhance their breast shape and volume and create more balance with the rest of their body.

What types of breast implants are available?

Breast implants are composed of a silicone shell that is either filled with a cohesive silicone gel or saline (salt water). Ultimately the decision on which implant to use will come down to aesthetic goals and personal preference.

Aside from the material, implants also come in different shapes and sizes. Round implants are quite popular and are generally chosen by women who want substantial lift, cleavage and fullness, and teardrop-shaped implants can in some cases give a more natural projection and fullness to the breasts.

How do the types of implants differ?

Saline implants are silicone shells filled with sterile salt water or saline. If saline implants leak the saline will be absorbed by the body. This leak can occur but is an uncommon event.

Silicone implants are filled with a special, medical-grade gel that is intended to create a more natural feel and look to the breast as compared to saline implants, in particular in thinner women.

Who is an ideal candidate?

For saline implants, any healthy patient 18 or older is eligible for this surgery. To receive silicone implants, the FDA deems that only patients 22 or older are eligible.

Ideal candidates are:

• Nonsmokers
• Not pregnant or breastfeeding
• Fully informed with realistic expectations
• Living at a healthy and stable weight

What to expect during the procedure

The surgery is usually performed with either general anesthesia or conscious sedation, which means the patient is either asleep or sedated for the procedure. This varies by surgeon and patient, so be sure to discuss beforehand.

During surgery, the surgeon uses small incisions to create a "pocket" to make room for the implant. Once the implant is positioned, the incisions will be closed and bandaged. A helpful 3D visual animation of the process can be found at the ASPS website. In general, the entire procedure usually lasts two hours or less, and patients can go home soon afterward.

What are the risks of this procedure?

As with any surgery, there are potential risks to be aware of, including:

• Infection
• Implant leaks
• Pain and tenderness
• Excessive scar tissue
• Cosmetic dissatisfaction
• Asymmetry

Speaking to your surgeon about these and preparing in advance can greatly help allay any concerns and minimize risks.

How to prepare for the surgery

Your doctor and their staff will give you a specific list of instructions, but in general:

• No smoking for a prescribed amount of time before the surgery
• Limit food and alcohol intake the night before
• Dress comfortably and warmly
• Ask someone to accompany you and drive you home post-surgery

How to choose a plastic surgeon

When choosing a plastic surgeon, patients should consider the following questions:

• Is this person board certified by the American Board of Plastic Surgery?
• How much experience does this person have with this procedure?
• Does this surgeon's cosmetic style match my goals?
• Does the staff make me feel comfortable?
• Is the surgeon up-front about risks and expectations?
• Does the staff promptly and professionally respond to my questions?
• Does the surgeon have hospital privileges?
• Is the practice transparent about cost and fees?
• Who will assist during the procedure?
• Will the surgeon use sedation?
• What measures are taken to ensure a safe surgery?
• Is the facility certified?

What questions should be asked about this surgery?

After choosing a plastic surgeon, patients should be sure to ask questions such as:

• What realistic results can I expect?
• Why are you recommending this size and style of breast implant for me?
• Are there risks for future breastfeeding or mammograms?
• What should I expect my implants to look like over time?
• How long will the procedure last?
• What can I expect during each step of the procedure?
• Will there be scarring?
• Are revisions possible?
• What is the cost of revision surgery?
• Will I need post-surgical assistance at home?
• What is my estimated recovery time?

How long will recovery take?

Recovery varies from one patient to the next, so each person's total recovery time may be different. On average, full recovery ranges from four to six weeks. Most patients will feel substantially improved within one week of surgery, but doctors generally recommend sticking to light activity and no strenuous exercise until a patient is fully healed.

Will there be scarring?

All skin incisions are permanent and will leave some type of scar, but in most cases they heal very well and become harder to see with time. Most surgeons can leave minimal scarring in an inconspicuous place, such as underneath the breast, but patients should always ask about size and placement of scars before surgery.

What kind of results can be expected?

It's important to go into this surgery with realistic expectations. This type of breast enhancement procedure can:

• Improve breast fullness
• Improve asymmetry or volume loss
• Increase the projection, size and shape of the breasts
• Create a more balanced hip-to-breast ratio

Augmentation does have some limitations, and in the case of severe drooping or sagging, many women will need a supplementary breast lift as well. This is normal and can easily be performed alongside augmentation.

How much does this surgery typically cost?

Exact cost should always be discussed in detail with your doctor because it can differ greatly depending on your location and needs.

Life after breast augmentation

The results of a breast implant procedure are typically long-lasting. Breast implants often "last" as long as 10 years (this number is variable and can be larger or smaller) but can vary depending on the patient, type, size and shape, among other factors. Patients often elect to undergo second or even third breast augmentation procedure as they naturally age to maintain their aesthetic profile.

Patients cite this procedure as a great confidence booster, especially when patients are good candidates and maintain reasonable expectations for what breast augmentations can achieve. Asking the right questions and performing your due diligence before your procedure can go a long way to help provide a wonderful experience and ultimately reach your aesthetic goals.