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General Breast Augmentation Frequently Asked Questions
This section covers frequently asked questions (FAQ) about breast augmentation in general. This section should cover the most common questions. If you have a suggestion for any additional question, please let us know.
- What are the risks of breast augmentation?
- Can a woman breastfeed after breast augmentation?
- Can breast implants give some lift to sagging breasts?
- Are breasts with implants more likely to sag over time?
- Will my breast implants feel natural?
- Someone told me that I have to take antibiotics before having any dental work after I have had a breast augmentation. Why is this?
- Will I have stretch marks after my breast augmentation? How can I keep this from happening?
- Is there much pain associated with breast augmentation? How bad will it hurt?
- Should I wait to get my breast implants until after I lose weight?
- Should I wait to get my breast implants until after having children?
- How big should I go when choosing the size of my breast implants?
- What age do I have to be to have breast augmentation? Am I too old/too young?
- My spouse or boyfriend is acting like a jerk, he says he will leave me if I get breast implants! What can I do?
- How can I tell my family about my breast augmentation?
- Should I tell people at work? Will I get fired for taking this time off to recover from my breast augmentation surgery?
- What type of anesthesia should I choose? Which is safest during breast implant surgery?
- Will my areolae stretch after breast augmentation?
- I went on several consultations for my breast augmentation and every doctor had a different opinion of what would be best for me. Now I am confused! What should I do?
- Why can’t they perform breast augmentation surgery with my own fat? Isn't this a better idea?
- I have fibromyalgia (or multiple sclerosis, etc.), is it safe for me to get breast implants?
- I have Poland's Syndrome (pectus excavatum, pectus carinatum, etc.) and have been told breast implants will help me look "normal" - is this true?
- Should I try pills or other methods before choosing to undergo breast augmentation with breast implants?
- How much does breast augmentation cost? What about the cost if I need a revision?
1. What are the risks of breast augmentation?
Breast augmentation is surgery, and all surgery has some risks to your health and life. Bad outcomes are very rare, but they can happen. In addition to health problems, there is the risk that you will not like the results of your breast augmentation.
Among the physical risks of breast augmentation, although extremely rare, it is possible to bleed postoperatively to the point where you need another surgery to control bleeding and drain the collected blood. You could develop a postoperative infection and need further surgery to remove the implant and deal with the infection. You would then have to wait several months before additional surgery can be performed to put new implants in. Loss of sensitivity in the breasts is common, although usually temporary. However, permanent sensation loss in the nipples or breasts can happen. You can develop a seroma, a mass caused by the accumulation of serum fluid, or a hematoma, which is a mass of blood caused by a broken blood vessel.
You could develop capsular contracture, which is hardened scar tissue that encapsulates and squeezes the implant. This rarely ever goes away on its own.
There is a chance of rippling (wrinkling or indentations) in the breast implant being visible. It is possible that the implant can shift and push through layers of tissue, and show through the skin.
The breast implant can deflate or rupture from an injury or from wear and tear. A breast implant can rupture during a mammogram. A saline breast implant usually deflates over the course of a few minutes or hours. You may never know if a silicone implant is leaking unless you have an MRI done. Any ruptured implant must be replaced.
There is also the risk that having breast implants may block the early detection of breast cancer. You still must undergo regular mammograms and mammography technicians will take more views of your breasts in more positions to help reduce the chance of missing something.
You may be disappointed about the size of your breasts after augmentation. Many women who have had implants wish they had gone bigger.
Please be sure to read the Risks and Complications page. You can also find out more about breast implants and their risks at the U.S. Food and Drug Administration’s implant information.
2. Can a woman breastfeed after breast augmentation?
Most women who have had breast augmentation find breastfeeding with implants to be no more difficult than breastfeeding without implants. Some women who have breastfed with and without implants say that breastfeeding with implants is easier!
In the early 1990s, when the first reports or problems with silicone implants were released, there was fear that breastfeeding with silicone implants could endanger the child. Studies were done and they have found no evidence that this is the case. Silicone molecules are too large to pass into the milk ducts and therefore cannot reach the child.
Usually, the milk ducts that bring milk from the lobes and lobules of the breast to the nipple are not disturbed or cut during breast implant surgery. The implant is placed in a pocket under all of the breast tissue. This is especially true of the transumbilical breast augmentation (TUBA), where the breast implants are inserted through incisions at the navel.
Please read our Breastfeeding Section for the continuation of this article.
3. Can breast implants give some lift to sagging breasts?
Although breast implants do not lift up a sagging breast, they can make breasts that are mildly sagging appear less saggy. They can take up some of the slack in loose skin by increasing the volume of the breast and they can also, to some extent, rotate the lower portion of the breast upward, making the breasts appear less saggy. But for moderate or severe sag, you really need a breast lift (mastopexy) instead of or in addition to breast augmentation.
4. Are breasts with implants more likely to sag over time?
All breasts relax with age, because the weight stretches the skin, elasticity is lost with age, and the amount of breast tissue usually decreases. This means that all breasts can be expected to sag whether or not there are implants in them. Breast implants do add some weight to the breast, which may increase the rate of sagging, but implants and surrounding scar tissue also can provide some internal support for the breasts. The end result is that usually implanted breasts sag less.
The best way to avoid breast sagging is to wear a properly fitting bra regularly. You cannot expect to go without a bra once you get implants, especially with larger cup sizes. If you regularly go braless, you will be returning to your plastic surgeon for a breast lift to correct the sagging.
5. Will my breast implants feel natural?
How your implanted breasts feel depends on several factors. The more natural tissue you have preoperatively, the more likely you will feel natural postoperatively. However if you have firmer silicone implants or overfilled saline implants, your breasts will feel firmer than natural breasts.
The amount that a saline breast implant is filled makes a difference. Too little volume will give you ripples, but too much volume can cause firmness and rippling.
Many people say that saline implants feel less natural than other types of breast implants.
The surface of the implant makes a difference. Smooth-surfaced implants are thinner than textured-surfaced implants. Although very slight, patients having had both often report that they can feel a difference.
You may hear that under muscle breast implant placement looks more natural than over muscle placement, but in fact, all cases are different. Overs actually move more naturally than unders but can add more fullness on the upper side of the breast. Unders tend to twitch a bit when you use the pectoral muscles during everyday movements or while working out.
The thicker and springier your skin is, the less the implant edges can be felt, which can make them feel less natural.
When anyone has dental work, even a routine cleaning, plaque and bacteria that are normally in the gums around the teeth are released and introduced into the blood stream. Most healthy people have no problem with this, but some people with heart conditions or poor immune systems are asked to take an antibiotic the day they have dental work done as a protection against an infection.
Any foreign presence within our bodies (such as breast implants, artificial joints, hernia repair mesh, etc.) can be a target for infection. There has been some debate on whether dental work can lead to scar tissue around breast implants and capsular contracture, but there is no proof. But since anyone with a pacemaker or artificial joint is urged to take antibiotics when going to the dentist, anyone with breast implants should be no different.
7. Will I have stretch marks after my breast augmentation? How can I keep this from happening?
No two people are alike when it comes to whether they develop stretch marks. Some patients develop stretch marks from growth spurts during puberty, from muscle gained from weight lifting, or from pregnancy. Other people never develop them. There is still no successful treatment for the removal of stretch marks. Some swear by shea nut butter and others by olive oil or vitamin E.
Stretch marks are caused by any abrupt expansion of the skin. When the expansion is very gradual stretch marks are practically nonexistent. I can only suggest massaging shea nut butter (if you are not allergic to nut oils) and lotions into the tissue beforehand and after until your skin is no longer tight feeling. But still ask your surgeon before doing anything other than what he or she instructs. There is no guarantee that stretch marks will not develop.
Mature stretch marks, those that have turned white and a bit shiny, are very difficult to remove. Stretch marks that have deep purple fissures can’t be removed by anything short of excision. The white marks can be darkened using a type of tattooing called micropigmentation.
8. Is there much pain associated with breast augmentation? How bad will it hurt?
No two people experience pain the same way. In addition to individual variation in pain thresholds, breast augmentation pain depends on the implant placement and incision placement. You can cause yourself more pain by not obeying your surgeon's instructions to not overexert yourself. You will also feel more pain if you don’t take your pain medications regularly. Don’t wait for pain to be severe to take the pills, since you will end up needing more pain medication than if you took it earlier.
Many patients report their discomfort to be like pressure or muscle soreness. I’ve heard many times "It feels like an elephant is on my chest! If you should experience any pain after your surgery that seems out of the ordinary, contact your surgeon.
9. Should I wait to get my breast implants until after I lose weight?
Although you can have breast augmentation surgery at any time, if you are considering losing any significant amount of weight (15 lb or more) you may lose breast tissue and end up with some sagging. This may not be as true if you have very small breasts and get implants, since your breast envelopes were not large to begin with.
10. Should I wait to get my breast implants until after having children?
Although you can get breast implants at any time, if you are planning on having children within the next year or two, you might want to wait. Weight gain and breast tissue gain and loss will affect the appearance of your breasts.
11. How big should I go when choosing the size of my breast implants?
This is totally up to you! If you are asking what the average size for breast implants is, Cs and Ds are pretty common. If you are asking what size would help balance your figure, you have to look at the ratio of your hips to your bust. Say for instance, if your hips are 36 inches, your bust measurement can be 34 to 36 inches and up and you will look more like an hourglass as opposed to a pear. Your surgeon will be able to give you some advice about what would look good. But it is entirely up to you. You will have to "wear" them. Just remember that most women who have breast implants say, "I wish I had gone bigger."
12. What age do I have to be to have breast augmentation? Am I too old/too young?
How young is too young for breast augmentation? The FDA recommends that no one under age 18 have saline breast implants and no one under age 22 have silicone-filled breast implants. The age cut-off is because a woman’s breasts may be still developing even into her early 20s and because a younger woman may not be mature enough to make a completely informed decision about getting breast implants. There are different minimum ages for the two types of implants because they have slightly different risk factors. However, younger women who have pronounced asymmetry or require breast reconstruction can have implants, but these are very specific and relatively rare cases.
On the other side of the spectrum, I have known women in their late 60s who have gotten breast implants. The only thing that would stop an older woman from having breast augmentation surgery is her general health.
The men in our lives can become threatened and intimidated by our desire for larger breasts. Your man may become jealous over the idea that other men may look at you after you get them. He may start to suspect that you want other men to look at you or that you will leave him for someone new. Things like this are a common cause of arguments before a breast augmentation surgery. You may even receive threats of "I will leave you if you get breast implants,” "I will not take care of you if you get breast implants," "You are going to look like a freak (or look fake) if you get breast implants," etc.
Rest assured, the majority (and I mean 99%) of the men absolutely adore their significant other's new breasts and cannot wait to see them and touch them. Just be aware that if you show them to your man right after breast implant surgery when they look their most unpleasant that he may slip up with a negative comment or two. Don't take it to heart. Have your man read The Male Perspective on Breast Augmentation.
14. How can I tell my family about my breast augmentation?
How you tell (or if you tell at all) is up to you. All families react differently, so there is no one-size-fits-all way to tell them. You can begin by telling them about how you feel about your appearance and about how you would like larger breasts. Make a list of the reasons you want breast augmentation surgery and go over these reasons in your head. Let your family know how you feel; they may not be as supportive as you would like at first, but they may come around.
If you choose to have breast implants, it is your business and you do not have to tell anyone. You can take personal time off or use vacation time for your surgery and recovery and tell your employers and colleagues absolutely nothing when you return.
If you are worried about them being able to tell that you have had breast augmentation, work up to it by wearing padded bras or falsies for a while before your surgery. Or have the surgery during winter when big, bulky sweaters can hide the change for a while. However, if you were flat-chested, hiding size C or D breast implants is going to be difficult.
However, if you choose to make up a story to tell your boss (or coworkers), such as that you are having female surgery, you will have to stick with that story. If later you are found to be lying, you can be held accountable.
16. What type of anesthesia should I choose? Which is safest during breast implant surgery?
Unfortunately, the type of anesthesia is usually not your choice. Most often, the type of anesthesia used is the surgeon's preference or is dictated by other considerations such as the length of the procedure or if you have any health problems. Please see our Anesthesia Section for more on this.
17. Will my areolae stretch after breast augmentation?
Stretching of the areolae (the discs of darker skin around the nipple) is common and sometimes unavoidable. In women with periareolar breast lifts and areolar breast reductions, some surgeons use permanent sutures (the kind that do not dissolve) around the areolae to keep them from stretching again.
If you talk to a lot of doctors, you may get a lot of opinions. Many great surgeons will have the same ideas, but many will have completely different ideas. Face it, one reason you consult with different doctors is to get a diversity of opinion. If they were all going to say exactly the same thing, then you would only need to consult with one, right?
This is why you need to do your own research. Don't expect every surgeon to agree, but do get them to tell you what techniques and options they think can get you what you want. Listen, ask questions, take notes at your consultations, and then think about each surgeon's recommendations.
19. Why can’t they perform breast augmentation surgery with my own fat? Isn't this a better idea?
It does sound like a good idea, taking fat from where you don’t want it and putting it where you do, but the technology is just not there yet. Fat grafting, especially in the amount needed for a breast augmentation usually does not last. It isn't as simple as liposuctioning fat out from somewhere else and then injecting it into the breasts. They are doing this for lip augmentation and in Brazilian Butt Lifts, but not all the fat that is transferred that way survives the procedure, which can result in asymmetry, lumpiness, and fat and tissue necrosis. Fat grafting into the breasts can develop into calcifications and scar tissue masses, which show up on mammograms as irregularities.
However, fat can be transplanted to the cleavage areas to help cover a bony sternum and soften the transition from implant/breast mound to breastbone, but larger amounts of transplanted fat can cause problems in the breasts.
Breast reconstruction after mastectomy is often done by transferring fat from the abdomen up to the breast, but this is done by excising a pad of fat with its blood vessels attached or by connecting the blood vessels using microsurgery. It is involved surgery and does a wonderful job for replacing breasts lost to breast cancer. However, it can leave scarring on the abdomen. The breasts created this way may look fine under clothes, but not when you are naked.
20. I have fibromyalgia (or multiple sclerosis, etc.). Is it safe for me to get breast implants?
You should give the matter extra thought, but it is up to you and your primary care physician. Breast augmentation with saline or silicone implants is safe for the vast majority of women. However, for many years, there have been reports of breast implants causing or worsening conditions such as fibromyalgia or an autoimmune condition like multiple sclerosis. The Institute of Medicine looked at the matter long and hard and concluded that implants neither cause nor contribute to disorders such as these.
But, it must be said that people who have fibromyalgia, multiple sclerosis, and lupus erythematosus can have flare-ups or exacerbations after periods of high levels of stress, trauma, surgery, foreign bodies, infections, high blood pressure, accidents, etc.
Some people with these conditions have told me that they have experienced worsened symptoms because of foreign bodies, whether they were breast implants or bovine collagen injections. The foreign body may place extra stress on the immune system. On the other hand, other people have told me they experienced no change at all.
Many patients with pectus excavatum and carinatum, which are deformities of the chest, have gotten breast implants to give the illusion of a normal chest. Patients with Poland's syndrome have also gotten just one implant or implants of two different sizes when there is considerable asymmetry involved because of their disorder. This is a situation where you need to find a surgeon who is not just well versed in breast augmentation, but who has dealt specifically with cases such as yours.
As far as breast enlargement supplements, the entire supplement industry is not regulated by the U.S. Food and Drug Administration. Anyone can concoct an herbal or dietary supplement and say what they want about it. Some breast enlargement pills contain herbs that are contraindicated with other medications and some can even cause side effects such as heart palpitations or nervousness. Use your best judgment when taking something like this and go over the ingredients list. Remember: If it sounds too good to be true, it probably is. Buyer Beware!
Please see our Alternative Breast Augmentation Options section for more information on both of these topics.
23. How much does breast augmentation cost? What about the cost if I need a revision?
The cost of any cosmetic plastic surgery depends on several factors, but the fee for the surgeon for breast augmentation can range from $2,500 to $10,000 and up. The price can vary due to the region, the newness of practice, marketing, the occasional "special," how popular the surgeon is, etc.
The fee that the surgeon’s office gives you may or may not include expenses such as operating room costs, anesthesia, lab work, medications, and more. You must be sure to ask what the fee includes beforehand and you must get it in writing. You should also ask what is not included in the fee, as well. Most cosmetic surgeons will give you a print out of what the fee covers and what is not, but if you do not get such a list, ask for it and get it in writing. This way there is no confusion after the fact when you are suddenly charged for things you thought were covered already.
Not all cosmetic surgery goes perfectly even with the best surgeon and with you doing everything right. As they say, stuff happens. Find out what your surgeon’s policy on fees for revisions is in advance, and again, get it in writing. Problems as capsular contraction and infection are usually not covered (although some surgeons will cover it). Surgical error should be covered at the surgeon's expense, so please review your surgeon’s revision protocol before booking your surgery. You may choose to go with a surgeon who charges a lower upfront fee, and does not cover any needed revisions, as long as you completely understand that in advance and don’t act shocked if you get charged for later revisions. It is better to prepare for the worst and hope for the best. Breast augmentation surgery also can be financed.
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