Breast augmentation is performed to enhance the appearance, size, and contour of a woman's breasts. Women consider breast augmentation for many different reasons. Some women feel their breasts are too small. Some desire augmentation after their breasts change after pregnancy. Others desire to correct an asymmetry in breast size.
Breast augmentation is performed with implants (see below) that can be placed under a chest muscle or over a chest muscle. The incision can be placed in the axilla (armpit), areola (the area surrounding the nipple), or lower breast fold. In general, all breast augmentations are minimally invasive procedures. For augmentations in which the incision is made in the armpit, an endoscope (thin tube with a small camera and light) may be used during the procedure.
Breast implants are made up of a silicone shell filled with either saline (a salt water solution) or silicone gel. Women determine their desired size by fitting trial implants. Currently, saline filled implants are used on an unrestricted basis. Silicone gel filled implants, once banned by the FDA, are available only to women participating in approved studies.
Breast augmentation is a relatively straightforward procedure. As with any surgery, some uncertainty and risk are expected. Know your concerns and expectations. Review the benefits, risks, and alternatives. Seek consultation with a board certified plastic surgeon.
Breast augmentation poses various risks, including:
- Scar tissue that distorts the shape of the breast implant (capsular contracture)
- Breast pain
- Infection
- Changes in nipple and breast sensation
- Implant position changes
- Implant leakage or rupture
Before you decide to have surgery, consider the following:
•Breast implants won't prevent your breasts from sagging.Your plastic surgeon may recommend a breast lift in addition to breast augmentation to correct sagging breasts.
•Breast implants aren't guaranteed to last a lifetime.The average life span of an implant is about 10 years. Implant rupture is a possibility. Also, your breasts will continue to age, and factors such as weight gain or weight loss might change the way your breasts look. These issues will likely lead to more surgery.
•Mammograms might be more complicated. If you have breast implants, in addition to routine mammograms, you'll need additional, specialized views.
•Breast implants might hamper breast-feeding.Some women are able to successfully breast-feed after breast augmentation. For others, however, breast-feeding is a challenge.
•Insurance doesn't cover breast implants. Unless it's medically necessary — such as after a mastectomy for breast cancer — breast augmentation isn't covered by insurance. Be prepared to handle the expenses, including related surgeries or future imaging tests.
•You might need additional surgery after breast implant removal. If you decide to have your implants removed, you might need a breast lift or other corrective surgery to help restore your breasts' appearance.
• Screening for silicone implant rupture is recommended. The FDA recommends routine monitoring with a breast MRI five to six years after placement to screen for silicone breast implant rupture. Then, a breast MRI is recommended every two to three years. An ultrasound may be an alternative screening method — unless you have symptoms. Talk to your plastic surgeon about the specific type of imaging needed for routine monitoring of your implants.
You might need a baseline mammogram before your surgery. Your doctor might adjust certain medications before the surgery as well. For example, it's important to avoid aspirin or other medications that can increase bleeding.