Breast Augmentation Guide: Frequently Asked Questions

Breast augmentation surgery is any procedure that enhances or restores the size and shape of the breasts. It is one of the most popular cosmetic procedures around the world.

Like many people considering breast augmentation, you probably have a lot of questions. We’ve drawn on the expertise of doctors on our site to bring you the following answers to the most frequently asked questions.

In this overview:

What is breast augmentation?
Is it right for me?
What are the options for breast augmentation?
How much does breast augmentation cost?
Will insurance cover breast augmentation?
How do I choose a surgeon?
How do I choose the right size for breast augmentation?
What happens on the day of the procedure?
What is the recovery time?
How long do the results last?
What are the possible side effects?
Is there an increased risk of lymphoma?
What else do I need to know?

What is breast augmentation?

Breast augmentation is an invasive surgery that increases or restores the size of the breasts or significantly alters their shape. It is typically done to enhance a naturally small bust, as part of reconstruction following mastectomy, or in combination with a lift on breasts that have sagged due to weight loss, pregnancy, or aging. “The intended result is a size and shape that you feel comfortably and naturally fits your body,” says Dr. Rady Rahban, a Beverly Hills plastic surgeon.

Augmentation can be performed using silicone or saline breast implants or through fat transfer

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Is it right for me?

You must be in good health to be considered for any kind of cosmetic surgery. If you have a heart condition, lung condition, or a neurological disorder, you may not be a good candidate.

Optimal candidates for breast augmentation are close to their ideal weight, preferably with a BMI of 30 or less. If you smoke, you’ll need to stop smoking for at least six weeks before and after surgery, as nicotine impairs healing. Depending on your body, health, and desired results, you may be a better candidate for one type of augmentation over another. Meet with a board-certified plastic surgeon, who can help you determine the right option. Back to top

What are the options for breast augmentation?

Breast augmentation can be done with implants or through fat transfer.

Breast implants come in saline and silicone varieties, as well as many sizes, shapes, and textures.

  • Saline implants are outer shells that are implanted into the chest, then filled with sterile saltwater. In the event that the implant leaks, the saline will be absorbed and naturally removed by the body. 
  • Silicone implants contain an elastic gel that may feel more like natural breast tissue. They might require a longer incision for placement, and you may need regular checkups to ensure that they’re properly functioning because silicone is not naturally absorbed in the event of a leak.
  • Cohesive Gel Silicone implants are also known as “gummy bear” or “form-stable” implants. Filled with a silicone gel that’s thicker than traditional silicone, they typically hold their shape better but require a longer incision.
Implants can be placed above or below the pectoral muscle, through a number of incision locations. Our glossary of common breast augmentation terms provides more information on these options.

Implant Incisions

Fat transfer, or fat grafting, involves harvesting fat cells from one area of the body commonly the stomach, hips, or thighs, and injecting them into another. Fat is removed from the body using liposuction, processed and purified through centrifugation, and injected into the breasts.

“We expect about 70% of the injected fat to stay in the area,” says Dr. Andrew Jimerson, an Atlanta plastic surgeon. “The fat that takes has a blood supply. Once that blood supply is established, the fat is going to stay there because it now has a new home.”

Breast Lift

A breast lift is frequently combined with implants to restore fullness in the upper part of the breasts, and is optional based on your individual needs. It is performed by “removing the excess skin and restructuring the breast tissue,” says Dr. David Reath, a Knoxville, Tenn., plastic surgeon. “In many women, a delicate incision around the nipple area is all that is needed. In others who have a large amount of excess skin, the incision will need to be extended.” Back to top

*Treatment results may vary

Dr. Brian Arslanian, an Atlanta plastic Surgeon, explains the difference between a breast lift and breast augmentation procedure, and how to determine which is right for you.

How much does breast augmentation cost?

The average cost of breast augmentation is listed around $6,500 on RealSelf, but the price can vary widely. Many factors affect cost, including the method used, the experience level of the surgeon, geographic location, and any additional costs associated with surgery, including the operating room, anesthesia, and post-op appointments.

As with any cosmetic procedure, price should not be the primary factor in choosing your method or doctor. “Find a plastic surgeon with elite credentials who performs hundreds of breast augmentations each year,” says Dr. Kenneth B. Hughes, a Los Angeles plastic surgeon, on a RealSelf breast augmentation Q&A. “Then look at the plastic surgeon's before-and-after photos to get a sense of who can deliver the results.” Back to top

Will insurance cover breast augmentation?

In most cases, breast augmentation is considered an elective cosmetic procedure and not a medically necessary treatment. For this reason, augmentation is typically not covered by insurance unless it’s performed as part of reconstruction after breast cancer.

Discuss your options with your plastic surgeon and insurance provider. If coverage is not available, and you don’t want to pay out of pocket, payment plans may be available through a financing company. Back to top

How do I choose a surgeon?

As with any elective procedure, the most important factor in choosing a plastic surgeon is experience. While any doctor—not just plastic surgeons—can legally offer breast augmentation, you want to look for a board-certified plastic surgeon who frequently performs the procedure and has proven safe results. We also recommended having multiple consultations before selecting your surgeon.

The following checklist from plastic surgeons Dr. Johnny Franco of Austin, Texas, and Dr. Michael Law of Raleigh, N.C., can help you determine if a doctor is right for you:

1. Check qualifications. “Be sure he or she is a plastic surgeon,” Dr. Franco says in a RealSelf Q&A. “There are a lot of doctors who are cosmetic surgeons or board-certified in fields other than plastic surgery. They do not have the same training as a plastic surgeon. Check the American Board of Plastic Surgery website [to verify certification].”

2. Ask about the operating facility. “It is critical to ask about the surgery center where your procedure will be performed,” Dr. Law says in a Q&A. “You need to know about accreditation, sterile processing procedures, and who will be with you in the surgery.” Check accreditation with the American Association for Accreditation of Ambulatory Surgery Facilities [AAAASF] or another nationally recognized body.

3. Look at before-and-after photos. “When considering breast augmentation surgery, I believe that the most important question for a prospective patient to ask themselves is, 'Am I seeking a natural-appearing result?' ” says Dr. Law in a Q&A. “If the answer is yes, then seek out a surgeon who has the same aesthetic sensibility that you have, as well as appropriate training and experience. Insist on seeing before-and-after photos. A lot of them. A plastic surgeon with experience and expertise should have dozens of images of breast augmentation from three different angles, all with the same lighting, distance from the camera, and cropping.” 

If you’re looking for a licensed and qualified plastic surgeon to perform your breast augmentation, use the Doctor Finder. Back to top

How do I choose the right size for breast augmentation?

Breast implants and the fat used for fat transfer are both measured in cubic centimeters (ccs). The same size of implant or amount of fat will look different on each individual. It’s important to discuss expectations and desired results with your surgeon so he or she can help you decide what’s right for you. Many doctors use digital imaging software as a way to see how you might look with different levels of ccs. Back to top

What happens on the day of the procedure?

Breast augmentation procedures typically take between one and three hours. After you arrive at the accredited hospital, facility, or office-based surgical site, your anesthesia will be administered. General anesthesia (putting you to sleep) is most commonly used during breast augmentation, but local anesthesia (numbing just the area of the body being treated) may be used in some cases.

Once you’re prepped for surgery, your doctor and the medical team will follow the predetermined surgical plan you agreed upon. After the procedure is over, you’ll be taken to a recovery area for a short period of observation. Unless your doctor thinks otherwise, you’ll be able to go home in your dressings and surgical bra that same day. Back to top

What is the recovery time?

“Breast augmentation recovery goes through some predictable stages,” Dr. Rahban says in a Q&A. “Initially, the breasts are tight, swollen, and may be painful. Over the next six weeks, there is a significant amount of settling. By three months, I would say 90% of the swelling has resolved, and the breasts are soft and look more natural. Of course, everything has to do with your anatomy, but this is a rough guideline. I tell patients they need one week off from work and six weeks off exercise.”

Dr. Otto Joseph Placik, a Chicago plastic surgeon, explains what you can expect in a Q&A and below: 

  • Days 1 to 4: “The inflammatory period. Swelling, pain, discomfort. This is the period that requires the vast majority of medication. Bruising may appear. Fluid retention is common, as is weight gain.”
  • Days 5 to 10: “Generally OK to shower and get wounds briefly wet if permitted by your surgeon. Possible constipation due to pain meds. Pain tends to occur at night from 3 to 6 a.m. and is worse with submuscular placement (having implants placed underneath the pectoral muscle). Begin breast massages if permitted by your surgeon. Between 7 and 10 days, be aware of signs of bleeding or infection.” This is also the time when external sutures will be removed. If your surgeon used tissue glue or tape, these will fall off after a week or two.
  • Days 11 to 21: “Lowered risk of infection and bleeding. Increased physical activity, such as low-impact exercises. Vast majority of swelling begins to subside. Occasional pain at night. Nerves begin to wake up and may cause ‘pins and needles’ sensations to the nipple area. Normal to have some areas of skin numbness.”
  • Days 22 to 42: “A plateau period in terms of wound-healing. Rare to require any pain meds. Generally OK to switch to ibuprofen or Tylenol, but consult with your physician first. May be able to transition to higher impact aerobic activities.”
  • Day 43 to 9 Months: “Progressive relaxation of scar tissue and softening of the initially firm result. Resolution of the remaining 5 to 10% of swelling.”

It is critical to follow all your surgeon's post-op instructions. These will include information on taking care of your drains, wearing compression garments, taking pain medication, and avoiding certain activities. Your surgeon will explain the symptoms you can expect. If you think you’re experiencing something abnormal, call your plastic surgeon right away. Back to top

How long do the results last?

In most cases, breast augmentation results last a long time. However, it’s important to monitor the status of your implants on a regular basis. Those with saline implants can check their status by simply looking in the mirror. Leakage will be obvious as a ruptured implant will deflate and the saline absorbed by the body. The FDA recommends that those with silicone implants have an MRI three years after initial placement, and then every two years after. 

If you chose to undergo breast augmentation using fat transfer, you might lose some volume over time. Your breasts may also change due to pregnancy, weight fluctuations, hormonal factors, or aging.

To get an idea of the kind of results you can expect, here are three of our most viewed breast augmentation before and after photos. Back to top

Breast Aug 1
Breast augmentation using implants
Photos courtesy of Dr. Rady Rahban, a Beverly Hills plastic surgeon

Breast Aug 2
Breast augmentation using fat transfer
Photos courtesy of Dr. Grant Stevens, a Los Angeles plastic surgeon

Breast Aug 3
Breast augmentation using breast lift and implants
Photos courtesy of Dr. James Boynton, a Houston plastic surgeon

What are the possible side effects?

When performed by an experienced plastic surgeon, breast augmentation has a high success rate. However, as with any surgery, it is not risk-free. Potential side effects include infection, bleeding, hematoma, scarring, capsular contracture, implant rupture, adverse reaction to anesthesia, and unsatisfactory results that may require additional surgery. Back to top

Is there an increased risk of lymphoma?

In March 2017, the FDA released a report highlighting the possible association between breast implants and the development of a rare type of non-Hodgkin's lymphoma called anaplastic large cell lymphoma.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare form of lymphoma that can develop following breast implants, according to the FDA's report. The FDA said the condition occurs more frequently with textured surface implants compared to smooth surface implants. 

"All of the information to date suggests that women with breast implants have a very low but increased risk of developing ALCL compared to women who do not have breast implants," read the FDA statement. "Most cases of breast implant-associated ALCL are treated by removal of the implant and the capsule surrounding the implant and some cases have been treated by chemotherapy and radiation."

If you have breast implants, the FDA says there is "no need to change your routine medical care and follow-up." The report says to continue to follow your doctor's instructions on how to monitor your breast implants, including routine mammography screening and periodic MRIs to detect ruptures in silicone gel implants. 

If you are considering breast implants, the FDA suggests you discuss the benefits and risks of textured implants compared to smooth implants with your doctor. 

Additional information about BIA-ALCL can be found on the FDA's breast implants website.

What else do I need to know?

Should I wait to have breast augmentation until after having kids?
“There is no real good answer,” Dr. Rahban says in a Q&A. “I tell patients it’s very personal, and only they can make the decision. If you are planning on having kids soon, then wait. If there are no kids in sight, then it’s your call. As for breastfeeding, if [you and your doctor] choose the crease approach (placing the implants through the fold under the breast), it will not be affected.” 

What will my scarring be like?
“The typical incisions used for breast augmentation are in the fold beneath the breast, at the border of the areola, and within the armpit crease,” says Dr. Lewis Albert Andres, a Scottsdale, Ariz., plastic surgeon in a Q&A. “Incision placement will have a lot to do with your preference, the surgeon’s comfort level with that approach, and the type of implant. These incisions heal very well and are often inconspicuous.”

“It’s common for scars to mature for up to a year,” Andres adds. “In the meantime, there are a few things that may help. Applying pressure and massaging the well-healed scar has been shown to improve the appearance, as it breaks up the scar tissue. Avoid direct sunlight on the incision, as they tend to discolor with UV light during the healing process. If unsightly scars are still present after approximately a year’s time, other things your surgeon may consider are steroid injections, laser, or surgical revision of the scar itself.”

When can I have sex after breast augmentation?
“Most surgeons will tell you to wait two weeks,” says Dr. Luis Macias, a Beverly Hills plastic surgeon, in a Q&A. “We don’t want your blood pressure rising too much, as that can lead to a blood collection around the implant called a hematoma. After two weeks, you should approach it carefully and avoid movements that can cause you or your partner to dislodge the placement of the implant for about six weeks.”

More to explore:

"The RealSelf Guide to Breast Augmentation" has been medically reviewed for accuracy by Dr. Rady Rahban, a Beverly Hills plastic surgeon. Dr. Rabhan attended medical school at the University of California, San Diego, where he graduated in the top 10% of his class. Fluent in Spanish, he travels to Latin America with organizations such as Operation Smile and Mending Kids, performing much-needed surgeries on cleft lips and palates.

This content is for educational and informational purposes only. It is not a substitute for medical advice, diagnosis, or treatment provided by a qualified healthcare professional. Your reliance on any information or content provided in the guide is solely at your own risk. You should always seek the advice of your physician or healthcare professional for any questions you have about your own medical condition. RealSelf does not endorse or recommend any specific content, procedure, product, opinion, healthcare professional or any other material or information in this guide or anywhere on this website.

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