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Breast Augmentation Surgery – A Complete Consumer Guide

Medically Reviewed by: Dr. John Kim

breast augmentation preparation marking the breasts for incision

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 the insertion of breast implants into the breast mounds to add volume and enhanced shapeliness.

Women opt for breast surgery for a variety of reasons. For example, some wish to increase the size of naturally small breasts, while others seek to correct disproportionate breasts or repair breasts following mastectomy or trauma to the chest.

Breast Augmentation Education and Consultation

If you are thinking about breast enhancement surgery, be sure to do some research and learn more about breast augmentation. Our Breast Implants Consumer Guide can provide you with valuable information as you consider your options.

Next, consult with a board-certified plastic surgeon and ask “Am I a candidate for breast implants?” During this consultation, the surgeon will perform an exam and listen carefully to your goals for surgery. It is important to be as clear as possible about what you want to achieve with the surgery and the exact look you desire.

The surgeon will then tell you what you need to know about breast augmentation, including information about breast augmentation cost and risks.

Types of Breast Implants

If you decide to go ahead with surgery, one of the first questions you will have to ask yourself is, Which breast implant is right for me? However, you will not make this decision on your own. Your surgeon will help you decide the best implant type for you based on your body type and goals.

Breast implants come in two basic types: saline and silicone. Both types are composed of a rubbery silicone shell containing a filler material. Saline implants are filled with a saltwater solution, whereas silicone implants are filled with silicone gel. There are two types of silicone gel: cohesive gel and highly cohesive, form-stable gel. The latter is found in “gummy bear” implants, so named because they have the consistency of gummy bear candies.

One of the differences between the two types of implants is cost; saline breast implants are slightly cheaper than silicone implants. The implants also differ in the way they feel to the touch. Most people agree that silicone breast implants feel more natural than saline implants.

Both types of implants are approved by the Food and Drug Administration (FDA). For information about the approval history of implants, please visit our page on breast implants and the FDA.

Breast Implant Sizes and Shapes

In addition to the type of implants you wish to receive, you will need to make decisions about the size and shape of your implants. Your surgeon may ask you to “try on” different sizes and test them out using special devices and bras. One of the most common reasons women undergo revision breast augmentation is to receive larger implants, so take your time and be sure you are making the right choice the first time through.

Implants also come in different shapes. Some implants are teardrop-shaped for a more natural appearance, while others are rounded for a fuller look at the top of the breasts. Again, your surgeon will help you choose the shape that will help you attain the look you want.

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:

  • Under the breast (inframammary incision)
  • Around the nipple (periareolar incision)
  • In the arm pit (transaxillary incision), or
  • In the navel area (transumbilical or TUBA incision).

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:

  • Subglandular or above the pectoral muscles
  • Partial submuscular or partially behind the muscles
  • Complete submuscular or completely behind the muscles

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 recovery, a list of augmentation risks (including capsular contracture), and cost information.

Other Types of Breast Surgery

In addition to breast augmentation, women often seek other types of breast enhancement surgery, including breast lift, breast reduction and nipple surgery.

Breast lift is performed to correct drooping, sagging breasts. In performing this procedure, the surgeon removes excess skin to raise the breasts higher on the chest. Breast lift is often part of a mommy makeover, a combination procedure to help mothers regain a more youthful appearance following the rigors of pregnancy and childbirth.

Breast reduction is a procedure in which excessively large breasts are reduced in volume by means of the surgical removal of breast tissue and skin.

Nipple surgery is performed to correct nipples that are too large, too small or mismatched.

Regardless of the type of surgery you might be considering, be sure to consult with a board-certified plastic surgeon who is certified by the American Board of Plastic Surgery. Visit our directory to find a surgeon near you.

About the Reviewer

John Kim, MD, is a board-certified plastic surgeon who is Clinical Director of Plastic Surgery at the Northwestern University Feinberg School of Medicine. Dr. Kim has published more than 50 articles and chapters regarding plastic surgery; has had his work featured by ABC News and the Chicago Sun Times, among other; holds several medical device patents; and sits on the editorial board of the Annals of Plastic Surgery, as well as many American Society of Plastic Surgeons committees.