Typical reasons women choose to have breast augmentation include fulfilling a desire for fuller breasts and restoring breast volume lost after pregnancy or weight loss. Breast implants may also be used to reconstruct breasts after mastectomy or injury.

Breast augmentation can:

• Increase the fullness and projection of your breasts
  
• Improve the overall balance of your figure
  
• Enhance your self-confidence and self-image
  

What breast augmentation will not do:

Though breast implants cannot correct severely drooping breasts, there are other surgical options. Women with sagging breasts may consider a breast lift instead of, or in addition to, breast augmentation.

Is breast augmentation right for you?

The decision to have breast augmentation surgery should be a personal one made in consultation with your doctor. It is an individualized procedure that should be done for you, not to fit an ideal image or to fulfill someone else’s desires.

Breast augmentation may be a good option for you if:

• You are physically healthy
  
• Your expectations are realistic
  
• Your breasts are fully developed
  
• You are bothered by the feeling that your breasts are too small
  
• You are dissatisfied with your breasts losing shape and volume after pregnancy or weight loss, or due to aging
  
• Your breasts are asymmetrical
  
• One or both breasts developed abnormally
  

Facts to consider before deciding to undergo breast augmentation:

• Breast implants don't last forever. If you decide to get breast implants, you may need additional surgeries throughout your lifetime, generally from as little as 3 to as many as 15 years after the initial surgery
  
• Many changes made to your breasts by implantation cannot be undone. If you ever decide to have your implants removed, your breasts will not revert to their pre-surgery appearance.  You’ll likely see permanent wrinkling, dimpling or puckering after the removal
  
• There are reportedly more risks associated with having breast implants revised or replaced than with the initial surgery itself
  
• Routine mammograms are more difficult to perform on a woman with breast implants.
• Breast implants can reduce and even eliminate milk production altogether, making the ability to breast feed quite difficult
  

Facts to consider regarding silicone gel-filled breast implants:

• Ruptures often don’t cause immediately detectable symptoms and can be difficult to detect
• Patients generally have an MRI screening at least three years after the implant and every two years thereafter in order to detect ruptures in the implant, specifically silicone breast implants
  
• MRI screenings may not be covered by medical insurance. As you continue to have the recommended MRI screenings, the cost of such procedures may exceed that of the original surgery
  

The FDA has approved saline-filled Mentor and Allergan breast implants for women 18 and older, whereas silicone gel-filled implants have been approved for women 22 and older.

The difference is due to the fact that risks associated with each type of augmentation are different. Silicone implants require frequent MRI monitoring to detect ruptures, while there is no risk of such in saline implants.

Women of any age, however, are eligible for saline-filled implants used in breast reconstruction to replace lost breast tissue or to repair tissue that has failed to develop properly.

Anesthesia:
Your breast augmentation procedure will most likely be performed under general anesthesia. It is important to ask your doctor about what methods will be used to keep you comfortable during surgery.

Location of operation:
Your procedure may be performed in your plastic surgeon's private operating room, at a nearby hospital or in a surgery center. If performed in your plastic surgeon's office, find out whether the office is certified and by whom.

Length of breast augmentation surgery:
The actual procedure takes between one and one-and-a-half hours. The length of time you will be in the actual operating room will be longer, as surgery preparation is time-consuming. You will have monitors placed, you will be sedated and then "prepped," meaning your skin will be carefully cleansed to get rid of bacteria. Drapes will be placed around your body and the surgical "field" will be set up. The breast augmentation surgery will then begin.

After the procedure is over, your skin be cleaned again and a dressing will be applied. Once you've awakened and are stable, you will be taken to the recovery room. For these reasons, your procedure could be scheduled to take up to three hours.

Length of stay:
You will usually be allowed to go home the day of surgery.

Discomfort:
On average, discomfort is mild to moderate after implant placement over the muscle and moderate to severe after placement under the muscle, but it varies for each patient. Discuss ways to reduce your pain and discomfort with your surgeon.

Swelling:
Less swelling occurs if the breast implants are placed over the muscle, and more swelling occurs if placed under the muscle. In either case, swelling is usually at its peak three to five days after surgery and improves thereafter -- generally decreasing by 75 percent in less than a month.

Bruising:
Most women don’t bruise after breast augmentation, but bruising is not unusual and does not affect the final results. If any bruising exists, it improves within a week or so.

Shower:
Most plastic surgeons will let you remove your bandages and shower within a few days of your surgery.

Stitches:
Though most surgeons use stitches that are absorbed by the body and do not require removal, it’s not uncommon to have stitches which do require removal within five to seven days.

Returning to work:
You may return to work in four to 7 days if the implants were placed over your muscle, and 7 to 10 days if placed under your muscle. If your job requires lifting, the timeframe is the same but you will probably have lifting restrictions set by your doctor.

Resuming exercise:
For breast implants placed over the muscle, most plastic surgeons will ask you to stop all exercising for 1 to 4 weeks after surgery. For implants placed under the muscle, two to eight weeks is the normal wait time.

Final results:
These will manifest themselves after the swelling has gone completely down.

Some of the risks associated with breast implants are:

• Revision surgery, with or without removal of the device
  
• Capsular contracture (hardening of the area around the implant)
  
• Breast pain
  
• Changes in nipple and breast sensation
  
• Rupture with deflation for saline-filled implants
  
• Rupture with or without symptoms for silicone gel-filled implants
  
• Migration of silicone gel for silicone gel-filled breast implants

The FDA has approved four breast implants in the U.S.:

• In May 2000, Mentor and Allergan (formerly Inamed) received FDA approval for saline breast implants in women 18 years or older and for breast reconstruction in women of any age
  
• In November 2006, Mentor and Allergan received FDA approval for their silicone gel implants in women 22 years or older and for breast reconstruction in women of any age
  
• All breast implants other than these four are considered investigational devices, including the more-cohesive (“gummy bear”) implants. For a woman to receive an investigational breast implant in the U.S., she must enroll in a clinical study

Now that these products have been determined safe and effective by the FDA, they will continue to be monitored according to a requirement that each company conduct a study of approximately 40,000 implant recipients through 10 years. The FDA anticipates that data from these long-term studies will provide important information for patients and physicians and may lead to improvements in device labeling.

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