Women can get breast implants to make their breasts bigger and fuller. That can be done for reconstructive purposes, such as after mastectomy for breast cancer, or for cosmetic reasons.
This article covers cosmetic breast augmentation only. It discusses the types of breast implants available, the procedures used, and possible complications.
Saline and Silicone Breast Implants
There are two basic types of breast implants: saline and silicone gel.
Saline-filled implants are silicone shells filled with sterile salt water (saline). Some are pre-filled and others are filled during the implant operation.
Silicone gel-filled implants are silicone shells filled with a plastic gel (silicone). Although many women say that silicone gel implants feel more like real breasts than saline, they pose more of a risk if they leak.
Both saline and silicone come in different sizes and have either smooth or textured shells. Each has its own pros and cons, so it is a matter of preference.
How much breast implants cost depends on the location, doctor, and type of implant used.
Typically, the surgery ranges from $5,000 to $10,000. Because it is a cosmetic procedure, health insurance usually doesn't cover breast augmentation.
Finding the Right Surgeon
Before any cosmetic surgery, it’s most important to find a trained, experienced plastic surgeon. Many doctors advertise themselves as plastic surgeons -- and any doctor who graduated medical school can make that claim.
Start your breast implant research by getting a list of surgeons' names. Talk to friends who have had breast implant surgery. Talk to your general physician or gynecologist. Once you have a list of potential surgeons, schedule a free consultation with each doctor.
Questions to Ask About Breast Implant Surgery
Asking questions will help you get the best results -- with no surprises.
Take two copies of this list when you meet with each cosmetic surgeon: one for you and one for the surgeon. Don't be afraid to ask tough questions. Getting everything out in the open will raise your comfort level, and you'll go into the surgery relaxed and confident that you have made the best choice.
Qualifications and experience
1. Are you certified by the American Board of Plastic Surgery? If not, why not?
2. How long have you been performing breast implant surgery?
3. How many breast implant surgeries do you perform a month?
4. How many revisions of your own work, on average, do you perform?
5.Have you been involved in any medical malpractice suits?
6. Do you have hospital privileges at an accredited surgical facility? Which hospitals?
The surgeon’s past work
7. Can I see some before-and-after photos?
8. Can I speak with some of your past breast implant patients?
9. Is there someone on your staff who has been a patient, and can I speak to them?
10. If I don't like the results of my surgery, what can I do?
11. Are silicone breast implants or saline implants better for me, and why?
12. What breast size do you suggest for my body frame?
13. Will I lose any sensation in my nipples or breasts?
14. Will I be able to breastfeed after having implants?
15. Will the implants make mammograms less accurate in detecting breast cancer?
16. Do you have a video I can watch about breast implant surgery?
17. What is the warranty for this breast implant, and what fees do I have to pay if it ruptures?
Breast implant complications and risks
18. What are the possible risks of breast implant surgery?
19. Is it possible to prevent breast implants from rupturing, rippling, or wrinkling?
20. Are there possible breast implant complications that I should be aware of?
21. If I have any breast implant complications, what is your policy? Do you cover expenses? Do you recommend a cosmetic surgery complication insurance policy?
Breast implant surgery preparation
22. What diet and lifestyle changes will I need to make before breast implant surgery?
23. What do you recommend to treat swelling, bruising, and pain?
24. Will my regular pills -- birth control pills, antidepressants, diet pills -- affect the anesthesia?
25. How long should I take off from work?
The breast implant procedure
26. Where will my breast implant surgery be performed, and is the surgery center accredited?
27. Is the center set up to handle a life-threatening emergency?
28. What hospital would I be taken to if there were a problem?
29. Will I have general anesthesia, and will a certified anesthesiologist administer it?
Recovery from breast implant surgery
30. If I have an emergency after going home, how can I reach you?
31. How long will healing take?
32. How soon can I get back to my regular exercise routine?
Breast implant financial issues
33. What is included in the surgical fee? What is not covered?
34. If I am not satisfied and need a revision surgery, is that included in the initial fee?
35. Is implant removal included in the initial fee?
36. If there are breast implant complications after surgery, is that included in the initial fee?
37. How much is the deposit required, and when is it due?
38. Do you offer financing, or do you expect full payment up front?
39. Do you take credit cards?
40. Will my deposit be refunded if I change my mind?
How the Breast Implant Procedure Is Done
Because breasts can continue to develop until women reach their late teens or early 20s, the FDA requires that women be at least 18 years old to get breast augmentation with saline-filled implants and at least 22 years old to receive silicone implants.
Before your breast implant procedure, you will meet with your surgeon for a medical evaluation. You can talk about what you want and get feedback from the doctor. Your surgeon may ask you to stop taking certain medications a few days or weeks before your surgery.
You can get breast augmentation done as an outpatient procedure, or you may stay overnight in the hospital.
The procedure takes 1 to 2 hours. You will likely be given general anesthesia, during which you will be "asleep" and pain-free.
The surgeon will make a cut under your breasts, under your arms, or around your nipples, depending on your body, the type of implant, and how much enlargement is being done.
The surgeon will put the breast implant into a pocket above or below your chest muscle. After the implant is in place, the surgeon will close the cuts with sutures or surgical tape.
Recovery After Breast Implantation
Your breasts will be covered with gauze after the surgery. You may have drainage tubes, which will be removed in a few days. You may need to wear a surgical bra as you heal.
You'll need to take it easy for a few days after your breast augmentation surgery. For instance, you shouldn't do any heavy lifting for up to 6 weeks after getting your implants.
Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you.
You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease and the scars will fade.
Although it is a cosmetic procedure, breast implant surgery can have risks, such as:
- Breast pain
- Changes in sensation in the nipple and breast
- Scar tissue forming and hardening in the area around the implant
- Problems with the size or shape of the implants (for example, the breasts may not be symmetrical)
- Associated Anaplastic Large-Cell Lymphoma or AALCL (rare, but may be linked to textured implants)
- Breast implant illness ( fatigues, m,emory loss, rash, “brain fog”)
It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture.
Breast implants are not designed to last a lifetime. You may need to have the implants replaced if you have complications or if the size and shape of your breasts change over time.
Women who have silicone gel-filled implants need to get regular mammogram screenings yearly plus an MRI or ultrasound scan five to six years after the initial implant surgery and every two to three years after that to check for silent rupture. If you have symptoms at any time or uncertain ultrasound results for breast implant rupture, an MRI is recommended If your implants rupture, you will need to have them removed or replaced.
Breast implants also may make it harder for you to breastfeed.