Breast Augmentation (Breast Implants) | American Board of Cosmetic Surgery (2024)

What Is Breast Augmentation Surgery?

Breast Augmentation (Breast Implants) | American Board of Cosmetic Surgery (1)

Breast augmentation is a cosmetic surgery procedure to increase breast size and enhance breast shape, typically through the placement of silicone or saline breast implants.From a cosmetic surgeon’s perspective, the ultimate goal of breast augmentation is to enhance a patient’s natural proportions andcreate a more symmetrical,aesthetically pleasing breast profile. Theexact procedure is tailored to meet a woman’s individual needs.

There is no “typical” breast augmentation patient, and women choose to have the procedure for many different reasons—the desire to have larger breasts is just one of them. Breast augmentation is one of the most effective procedures to correct noticeable breast asymmetry, and breast implants can be used to help correct tuberous breast deformities. Other common goals of breast augmentation inlcude:

  • Restoring breast fullness lost after pregnancy & breastfeeding
  • Feeling more confident in a swimsuit
  • Adding balance to better complement curvy hips
  • Enhancing self-image

How To Choose A Qualified Cosmetic Surgeon

If you’re considering breast augmentation surgery, the most important decision you’ll make is who will perform your procedure. When you visit a cosmetic surgeon, ask how many breast augmentations they have performed, and be sure to look at plenty of before and after photos during your consultation—this will help you get a feel for a cosmetic surgeon’s aesthetic style.

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Make sure your cosmetic surgeon is board certified; this ensures that they are specifically trained and experienced in cosmetic surgery, including breast augmentation, and that your procedure will take place in an accredited facility, which is essential for your safety. Finally, don’t choose a breast augmentation surgeon based on price. You cannot put a price on your safety & results. Most cosmetic surgeons offer multiple financing options to help a patient fit breast augmentation into their budget.

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Choices for Breast Implants

There’s never been a better time to have breast augmentation, as today you have more choices than everto help you customize your new look. Whether you’d like moredramatic curvesor a modestboost in cleavage, there’s an option for you.Hereare some choicesyou can expect to go over during your consultation process:

  • Filling type: Saline, Silicone Gel, or Highly Cohesive Silicone “Gummy Bear” Implants. Neither is “best,” but there are some differences in cost, feel, and incision requirements that you need to consider. Your cosmetic surgeon will help you find the right implant type for you.
  • Shape: Saline & Silicone Gel implants are typically round, while gummy bear implants come in shaped and round options. Round implants will typically achieve a fuller upper pole (the top portion of your breast), while shaped implants lend agently sloping look to your breast profile. Both can look very natural with a skilled cosmetic surgeon’s help.
  • Profile: Your cosmetic surgeon will help you choose this based on your existing proportions and your goals. Generally, patients with a more petite frame will require a higher profile implant to achieve the desired size increase while ensuring the implants are not too wide at the base.
  • Size: Breast implants range in size from about 150cc to 800cc or larger. Many patients require a different sized breast implant for each breast; this helps to achieve the best possible symmetry. The size you choose depends on your existing breast size, your personal goals, and your cosmetic surgeon’s recommendations.

Of course, all of these implant options make it even more important to choose a cosmetic surgeon who is well-qualified and has experience using a variety of breast implants.

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Breast Implant Safety

In October 2021, the FDA announcednew breast implant safety guidelines for both manufacturers and surgeons. These guidelines are intended to enhance patient safety, increase transparency around the potential risks and side effects of breast implants, and ensure patients provide informed consent before receiving implants. With concerns over breast implant illness and other possible implant-related risks on the rise, these guidelines have largely been met with support from both patients and surgeons, including surgeons from the American Board of Cosmetic Surgery.

As an organization dedicated to enhancing patient safety, we wrote this post to help you make sense of these guidelines and understand potential risks associated with breast implants: What You Need to Know About the New FDA Breast Implant Guidelines.

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  • Key Benefits
  • Glossary

Key Benefits

  • Enhances breast size: Breast augmentation can increase the size of the breasts, creating a more curvaceous and feminine silhouette.
  • Improves breast shape: Breast implants can also improve the shape of the breasts, adding fullness in the upper pole, for example, and correcting issues such as asymmetry.
  • Restores breast volume: Breast augmentation implants provide a noticeable boost in volume, restoring breasts post-pregnancy or after weight loss.

Glossary

  • Mammoplasty: Any surgical procedure involving the reshaping, reconstruction, or enhancement of the breasts.
  • Augmentation mastopexy: A combined procedure that involves both breast augmentation (implant insertion) and mastopexy (breast lift).
  • Breast implant revision: A surgical procedure performed to replace or adjust previously placed breast implants.
  • Silicone implants: Breast implants filled with cohesive silicone gel, commonly used in breast augmentation and reconstruction procedures.
  • Saline implants: Silicone breast implant shells filled with a sterile saline solution, often used in breast augmentation and reconstruction surgeries.
  • Transaxillary incision: An incision made in the armpit area for accessing and placing breast implants.
  • Periareolar incision: An incision made around the edge of the areola (pigmented area surrounding the nipple) for accessing and placing breast implants.
  • Inframammary fold: The natural crease or fold beneath the breast where it meets the chest wall.
  • Bottoming out: A complication in which breast implants descend to a lower position below the inframammary fold, resulting in an unnatural breast appearance.
  • Capsular contracture: A complication in which the scar tissue capsule hardens irregularly around a breast implant, causing it to feel tight or firm.
  • Capsulectomy: A surgical procedure to remove the scar tissue (capsule) surrounding a breast implant.
  • Drop and fluff: Refers to the process by which breast implants settle into their final position and the breast tissue and chest muscles adjust to the implant, resulting in a more natural appearance.
  • Hematoma: A collection of blood that forms outside of blood vessels, often resulting from injury or surgery.
  • Implant rippling: Visible or palpable wrinkling or rippling of the breast implant, which can occur due to thinning of the overlying tissues.
  • Nipple-areolar complex: The pigmented area surrounding the nipple, including the nipple itself.
  • Submuscular placement: Placement of breast implants beneath the chest muscle (pectoralis major).
  • Dual plane breast augmentation: Breast implant placement technique that involves placing only the upper portion of the implant beneath the chest muscle.
  • Subglandular placement: Placement of breast implants above the chest muscle and beneath the glandular breast tissue.
  • Symmastia: A condition where the breast implants migrate toward the center of the chest, creating a “uni-boob” appearance.
  • Upper pole fullness: The degree of fullness and projection in the upper portion of the breast.
  • Mammogram: An X-ray examination of the breast to screen for breast cancer or evaluate breast abnormalities.
  • BIA-ALCL: Breast Implant-Associated Anaplastic Large Cell Lymphoma, a rare cancer of the immune system that has been associated with textured breast implants.

Augmentation Without Implants: Fat Transfer Breast Augmentation

While breast implants are the gold standard for improved breast shape and size, they are not the only way to increase breast volume: a small increase can be achieved without any implants, using your own fat.

Fat transfer breast augmentation is a surgical procedure that involves removing fat vialiposuctionfrom an area of the body such as the hips, flanks, stomach, or thighs and re-injecting that fat strategically into the breast to add volume. This technique can be customized to improve asymmetry, add cleavage, and/or increase volume up to about 1 cup size.

You are a good candidate for the aesthetic benefits that this procedure can provide if you identify with the following:

  • You already are happy with your breast shape, but are looking for a small boost in volume; or, you want to add specific contour or symmetry to a small area.
  • You are planning to keep your weight stable.
  • You have some extra fat in the flanks, hips, or thighs.
  • You prefer natural fat transfer over implants.

Learn more about fat transfer breast augmentation

Incision Options for Breast Augmentation

One common question that patients have before breast augmentation is, “What will my scars look like?” You’ll be glad to learn that an experienced, qualified cosmetic surgeon will use a surgical technique that places breast augmentation incisions so the resulting scars are easily hidden and inconspicuous, even to the patient themself. Depending on your anatomy and your desired outcome, your cosmetic surgeon will use one of the following incision techniques to place your breast implants:

  • Inframammary.This involves a short incision made in the crease underneath the breast, called the inframammary fold. This leaves a thin, 1 to 2 inch scar that is easily concealed within the crease. Advantages of this incision type include a wider access point, allowing a cosmetic surgeon to place larger silicone implants or gummy bear implants with precision.
  • Peri-areolar. The incision is made around the outer edge of the areola, so the resulting scar is located within this natural transition in pigmentation. Cosmetic surgeons will often use this incision type if they are also performing a mild to moderate breast lift at the same time.
  • Trans-axillary. This involves a small incision made within the armpit, through which your cosmetic surgeon will place the breast implant using a specialized camera and instruments to ensure optimal placement.This leaves a small scar within the armpit but achieves a breast augmentation with no scar on the breast itself.
  • Transumbilical. This technique involves an incision just above the belly button. Each breast implant is inserted through this incision and then brought up to the breast. Advantages of the transumbilical technique include a single scar with no scarring on the breast itself.
Breast Augmentation (Breast Implants) | American Board of Cosmetic Surgery (12)

Results & Recovery: Life After Breast Augmentation

Breast augmentation is an outpatient procedure, typically performed using general anesthesia. You can expect to walk around on your own a few hoursafter surgery, and most patients feel up to leaving the house within the next day or two.

You may feel sore the first week or so, and you will need to limit strenuous exercise for about 2-4 weeks.Your cosmetic surgeon may also askyou to wear a supportive surgical bra or sports bra for a certain period of time after breast augmentation—it is crucial tofollowyour cosmetic surgeon’s instructions to ensure you heal optimally.

If your breast implants are placed partially beneath the pectoral muscle—the preferred method in most cases—your breasts may seem to sit high on the chest at first. This is normal, and your implants will settle into their optimal position over the next several weeks, with final results after a couple ofmonths.

Once you have your breast implants, you’ll want to keep the following in mind:

  • It’s safe to have mammograms with breast implants, so be sure to maintainregular screening as prescribed by your doctor.
  • For silicone implants, itis recommended that patients undergo periodic monitoring(via mammogram, ultrasound or MRI) to screen for ruptures, which are rare.
  • Future pregnancies or weight fluctuations may affect your results, and a secondary surgery may be needed to correct any changes you are unhappy with over time.
  • Nothing can stop the normal aging process; over time, breast tissue will change. You can help prevent unnecessary sagging by wearing a bra with adequatesupport for your activity level.
Breast Augmentation (Breast Implants) | American Board of Cosmetic Surgery (13)

Find Board Certified Breast Surgeons Near You

When performed by a qualified cosmetic surgeon, breast augmentation is a safe surgery with long-lasting results, and theoverwhelming number of patients are very glad they chose to have the procedure.The best way to decidewhether or not breast augmentation is right for you is to meet with a board certified cosmetic surgeon for a consultation. You can find cosmetic surgeons in your area by using our ABCS Find-a-Surgeon tool.

References »

Coroneos CJ, Selber JC, Offodile AC 2nd, Butler CE, Clemens MW. US FDA Breast Implant Postapproval Studies: Long-term Outcomes in 99,993 Patients. Annals of Surgery. 2019 Jan;269(1):30-36. doi: 10.1097/SLA.0000000000002990.

Swezey E, Shikhman R, Moufarrege R. Breast Implant Rupture. 2023 Jan 16. In: StatPearls [Internet]. Treasure Island (FL): StatPearls Publishing; 2023 Jan–.

Eisenberg T. The Underappreciated Saline Breast Implant. Aesthetic Plastic Surgery. 2023 Apr;47(2):897-900. doi: 10.1007/s00266-022-03106-z.

Hadad E, Sualhi I, Legarda C, Seligman Y, Sorkin A, Dor O, Menashe S, Heller L, Wiser I. Silicone breast implant rupture is more prevalent in the dominant limb side: A retrospective cohort study. Journal of Plastic, Reconstructive & Aesthetic Surgery. 2023 May;80:126-132. doi: 10.1016/j.bjps.2023.02.016.

Guimier E, Carson L, David B, Lambert JM, Heery E, Malcolm RK. Pharmacological Approaches for the Prevention of Breast Implant Capsular Contracture. Journal of Surgical Research. 2022 Dec;280:129-150. doi: 10.1016/j.jss.2022.06.073.

Christopher R. Costa, Kevin H. Small, William P. Adams, Bra Sizing and the Plastic Surgery Herd Effect: Are Breast Augmentation Patients Getting Accurate Information?, Aesthetic Surgery Journal, Volume 37, Issue 4, 1 April 2017, Pages 421–427, https://doi.org/10.1093/asj/sjw221

Breast Augmentation (Breast Implants) | American Board of Cosmetic Surgery (2024)
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