Breast Implants Guide: Top Questions & Answers
Breast implants add volume to existing breast tissue to create a fuller chest. Typically one of two types of implants is used, silicone or saline, with many options for placement, incision location, size, shape, and texture.
If you’re considering breast implants, you probably have a lot of questions. We’ve drawn on the expertise of our doctors and the RealSelf community to give you answers to those most commonly asked.
In This Overview:
What Is Breast Implant Surgery?
Are Breast Implants Right for Me?
What Are the Different Options?
Are Breast Implants Safe?
How Much Does It Cost?
How Do I Choose a Surgeon?
How Do I Choose the Right Size?
What Happens During the Procedure?
What Can I Expect During Recovery?
What Results Can I Expect?
What Else Do I Need to Know?
What Is Breast Implant Surgery?
Are Breast Implants Right for Me?
Typically, women who want a larger chest have two surgical options: breast implants or breast fat transfer. The latter uses liposuction to move a woman’s fat from areas such as the thighs and stomach to increase the volume of the breasts. While fat transfer will increase the size of the breasts, do not expect the same results as those realized by implants.
“Women who seek the look of a breast implant with fat transfer will not achieve it,” says Texas plastic surgeon Dr. Mario Diana. “Breast implants and fat transfer do not give the same outcome, as these are two very different treatments for patients who have different desires.”
Women who seek breast fat transfer rather than implants tend to “prefer a smaller size and shape adjustment,” adds Dr. Diana. With fat transfer, size increases are typically one cup or less compared to the one cup or more results of implants. Back to top
What Are the Different Options for Breast Implants?
Breast implants come in a number of shapes and sizes but they fall into two main groups based on the implant’s filling.
- Saline implants are filled with sterile salt water. In the event of a leak, the body absorbs and naturally removes the saline and the implant deflates. There are two types of saline implants: single lumen (traditional) and the newer double lumen. The double lumen have internal shells that are designed to make the implant feel more like silicone and maintain their shape better with less chance of capsular contracture.
Silicone implants are filled with an elastic gel prior to surgery. They may require a longer incision. In the event of a leak, the body does not absorb the silicone and so you may need regular check-ups and MRIs every few years to monitor the status of the implants.
- You may also hear about cohesive gel breast implants. These implants use a silicone gel that is thicker than traditional silicone filling and has more of a tendency to maintain its shape. These are also known as “form-stable” or “gummy bear” implants.
Implants also come in different shapes and textures: round and shaped, smooth and textured. Santa Rosa, Calif., plastic surgeon Dr. Heather Furnas recommends that patients discuss their goals with their plastic surgeon. For the patient who wants more fullness, round implants may serve her best, while shaped implants are the best implant option for breast reconstruction after a mastectomy.
Implants can be placed above or below the pectoral muscle, through a number of incision locations. The RealSelf Glossary of Breast Augmentation Terminology provides more information on these options. Back to top
Are Breast Implants Safe?
Worried that breast implants cause cancer? Don’t be.
In fact, Dr. Walden adds, women with breast implants may actually detect cancers earlier than women without them, as “they are more in tune with their breast anatomy after having undergone a breast augmentation.”
As for silicone breast implants, don’t be overly concerned about them leaking, say RealSelf doctors. “The newest silicone gels are highly cohesive,” says Dr. Furnas, “so leakage into the [breast] pocket is uncommon.”
Unfortunately, not much research has been done on the health impact in the unlikely event a silicone breast implant leaks. Some refer to the range of reported symptoms as “silicone toxicity,” though the term is controversial. Back to top
How Much Do Breast Implants Cost?
While you can expect to pay upward of $6,000 for a set of breast implants, the price varies depending on a number of factors, including the type of implants (silicone tend to be more expensive than saline), experience of the surgeon, where the surgery takes place (office, surgical center), the length of the procedure, and geographic location, among others.
As with any cosmetic procedure, price should not be the primary factor. “Find a plastic surgeon with elite credentials who performs hundreds of breast augmentations each year,” says Los Angeles plastic surgeon Dr. Kenneth B. Hughes. “Then look at the plastic surgeon's before and after photos to get a sense of who can deliver the results.” Back to top
How Do I Choose a Surgeon for Breast Implant Surgery?
As with any elective procedure, the most important factor in choosing a doctor is experience. While any doctor — and not just plastic surgeons — can legally offer breast implant surgery, you want to look for a board-certified plastic surgeon who performs the procedure frequently and has proven safe results. One marker to look for is certification from the American Board of Plastic Surgery.
“Anyone certified by the American Board of Plastic Surgery has undergone six to eight years of the most rigorous training, with an emphasis on all types of breast implant surgery,” explains Dr. Furnas. “They will have performed everything from routine breast augmentations to complicated breast reconstructions. Then they will have passed a comprehensive written examination, as well as oral examinations based on a year’s worth of cases.”
Beyond board certification, review the doctor’s before and after photos and read online reviews. Also consider having multiple consultations before selecting a surgeon to make sure your wishes are clearly communicated and understood. Back to top
How Do I Choose the Right Size of Breast Implants?
“There are two major factors that drive your choice,” says Seattle plastic surgeon Dr. Mary Lee Peters. “The first is the look you want to achieve. The second is what your anatomy will allow.” The size that’s right for one woman may not be right for another, so RealSelf doctors advise keeping an open mind during a breast implant consultation.
Like many doctors, Dr. Lowen often uses gel implant sizers to give women a sense of their post-op options. Some women make sizers at home in what you may hear called the Rice Test.
“After measuring dried rice and putting it loosely into nylon stockings and inserting the knotted stockings into a bra of the desired size, the patient puts on a tight shirt,” explains Dr. Furnas. “The best way to get an objective view is to have a friend or partner take photos. That way the patient can look at herself as if she’s looking at someone else, instead of looking in the mirror.”
Watch our video below to learn more about how to make rice implant sizers:
Doctors may also use 3-D imaging devices to help a woman visualize the potential changes, however this technology may not always be accurate. Bringing in “wish pics” and using sizers are the most helpful in determining and achieving your goals.
It’s important to remember to stay realistic when discussing your desired outcome with your surgeon. “Most important is the communication between patient and plastic surgeon,” says Dr. Furnas. “Not all desired sizes and goals are achievable. The more the patient understands the limits and the better the surgeon understands her goals, the more likely she’ll be happy with the result.” Back to top
What Happens During a Breast Implant Procedure?
Breast implant surgery typically takes between one to three hours to complete, depending on the implant used and the doctor’s particular technique. Most breast implant procedures are performed under general anesthesia (you go to sleep), but some surgeons may choose to use local anesthesia (only the treated area is numbed).
Once you’re prepared 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 should be able to go home in your dressings and surgical bra that same day. Back to top
What Can I Expect During Breast Implant Recovery?
“Breast implant recovery goes through some predictable stages,” says Beverly Hills plastic surgeon Dr. Rady Rahban. “Initially, the breasts are tight, swollen, and possibly very 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.”
Most surgeons recommend a week off from work with no strenuous exercise (lifting above 10 pounds) for four to six weeks. “The biggest concern is a bleed in the implant pocket, so really take it easy the first couple of weeks. That means no vacuuming, laundry, picking up gallons of milk or juice (buy quarts and pints instead), and don’t change the sheets on your bed!” says Dr. Furnas. “Prepare as much as you can ahead of time. If you have a baby, enlist help.” (Read more about how to prepare your home for recovery in our guide.)
Why the caution? “Your risks, problems, and potential complications will be lowest if you follow the instructions provided by your medical team,” says Dr. Furnas. “Don’t ask for shortcuts, like increasing your activity sooner than recommended. You could compromise your result.”
- 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.” Back to top
What Kind of Results Can I Expect From Breast Implants?
Once swelling has subsided and the implants have “dropped” into position, expect a fuller chest with lasting results. You may have heard you have to replace breast implants every 10 to 15 years, but Dr. Frank Lista, a Toronto plastic surgeon, says this isn’t necessary true. “If you have no problems with your implants, then nothing needs to be done with them.”
That said, it’s important to monitor the state of your implants on a regular basis. Those with saline implants can check their status on their own by simply looking in the mirror. Leakage will be obvious as a ruptured implant will deflate and the saline absorbed by the body. Women with silicone implants are recommended to have an MRI three years after initial placement, and then every two years thereafter to ensure they’re functioning correctly.
To get an idea of the kind of results you can expect, here are three of our most viewed breast implant before and after photos. Back to top
Photo courtesy of Dr. Heather J. Furnas
Breast Implant Surgery
Photo courtesy of Dr. Mary Lee Peters
Breast Implant Surgery
Photo courtesy of Dr. Gregory A. Buford
What Else Do I Need to Know?
What If I Get Pregnant After My Breast Implants?
Your breasts will definitely change with pregnancy, but it won’t “ruin” the results. “Pregnancy will not damage the implants themselves, but you might develop additional loose skin, which creates a saggy look,” says Seattle plastic surgeon Dr. Marshall T. Partington. “The best thing to do is to wear a supportive bra during pregnancy and breastfeeding and consider a mastopexy, or breast lift, after delivery and breastfeeding.”
Can I Get a Breast Lift If I Already Have Implants?
Yes, this is possible, say RealSelf doctors. The implants just need to be in good shape.
Can I Breastfeed With Breast Implants?
Yes, but be sure to tell your doctor this is important to you before you have surgery. “To lower the risks of interfering with breastfeeding, the general recommendation is to avoid the periareolar incision because of the risk for interfering with nipple sensation and to place the implant under the muscle,” says Denver plastic surgeon Dr. Gregory A. Buford.
Why Do I Have to Massage My Breasts?
It might feel awkward at first, but massaging your breast implants can be very important. The body naturally forms a thin inner membrane or “capsule” around the implant, which your body sees as a foreign object. Massage helps create room in the “pocket” so that your implant doesn’t sit too tight. Depending on the recommendations of your surgeon, massage may not be needed for textured implants.
“Although there is very little science behind this, anecdotal experience shows that my patients who do not massage their implants tend to have a higher risk for high-riding implants and capsular contracture,” says Dr. Buford.
He recommends that his patients massage at least several times a day until their implants have completely settled, which could take anywhere from a week to several months. Your doctor will advise you on what routine is best for you and when you should begin implant massage. (This may range from 24 hours to a week or two after surgery or, in the case of some doctors, never.)
What Is Capsular Contracture?
That thin inner skin or “capsule” we mentioned in the previous question? Sometimes it constricts or thickens. This is known as capsular contracture. The result can be a deformed, hardened implant that may cause pain. Various treatment options are available, but the most effective is to have the implant removed and (if desired) replaced.
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This guide has been medically reviewed for accuracy by Dr. Heather J. Furnas. Inspired by watching her plastic surgeon father operate in African bush hospitals, Dr. Furnas followed in his footsteps, training at Stanford and serving on the Harvard clinical faculty. Upon graduating with a bachelor’s and a master’s degree from Stanford University, she received her M.D. degree from UCLA School of Medicine. After her comprehensive training in plastic surgery, she became a board-certified plastic surgeon and member of the American Society of Plastic Surgeons (ASPS) and the American Society of Aesthetic Plastic Surgery. Learn more on her RealSelf profile.
Disclaimer: 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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