What You Need to Know About Breast Augmentation

Reviewed by Walter Erhardt, MD

Breast augmentation is one of the most commonly performed cosmetic plastic surgery procedures in America. Each year, hundreds of thousands of women opt to enhance the appearance of their bustlines with implants. If you are thinking of joining them, you have many decisions to make in conjunction with your breast surgeon. Size, incision pattern, implant placement, implant type and whether you also need a breast lift — these are just a few of the choices you will need to make as you begin your breast augmentation journey.

Basics of Breast Augmentation

Breast augmentation is performed by inserting a breast implant behind the breast or behind the breast and chest wall muscle. Currently, there are two types of breast implants available: saline breast implants and silicone breast implants. Both come in a variety of shapes and sizes, with varying designs. In the not-too-distant future, highly cohesive silicone gel, or “gummy bear” implants, may be available, too. Breast implants can be placed in different positions through a variety of incision patterns.

Another option, for women who are interested in a modest augmentation, is breast augmentation fat transfer. This procedure is also used to make cosmetic improvements after breast reconstruction or to fill in contour irregularities after breast augmentation with implants.

Please click here to view an animation about breast augmentation surgery with saline implants.

Breast Lift with Breast Augmentation

Your plastic surgeon may recommend that a breast lift and breast augmentation be performed at the same time. This helps treat the breast sagging (ptosis) that can result from changes after pregnancy, weight loss or advancing age. During this combined procedure, breast tissue is reshaped, your breast skin is tightened and lifted, and an implant is inserted. Both breast augmentation and/or breast lift may also be part of a mommy makeover.

Initial Consultation

Finding the right surgeon to perform your breast augmentation will help ensure your peace of mind throughout the process. One place to start is here.

During the initial consultation, your surgeon will discuss your goals and expectations, the size and shape you are looking for and your feelings about the procedure.

You and your surgeon should make decisions together about the type of implant, the incision location and the implant placement. The breast implant size (how large you want to go) will also come up during this initial discussion. Your anatomy plays a major role in these decisions. Tell your surgeon what you want, and then listen to his or her expert advice on what will work best given your frame.

How Is Breast Augmentation Performed?

Breast augmentation is typically performed as an outpatient procedure at a surgical suite or hospital. General anesthesia or conscious sedation with a local anesthetic are most often used during breast augmentation. The surgery takes one to three hours to perform based on the nature and extent of the surgery and whether or not it is being performed as a standalone procedure or in conjunction with another surgery.

To begin the procedure, an incision is made in one of four primary locations:

After the incision, a special surgical tool will be used to fashion a pocket so that the implant can be inserted. There are three primary positions where the implants can be placed:

In addition to working out the details of your breast augmentation, your surgeon should also provide you with a comprehensive list of what you can and can’t do before your breast augmentation surgery, information on what to expect during your breast augmentation recovery, a list of breast augmentation risks (including capsular contracture), and cost information.

[page updated February 17, 2011]