Breast Augmentation

The concept of female beauty never stops changing. At one point in history, plumper and heavier bodies may be more desired than thinner ones and at another slender bodies come into vogue. The perception of beauty and attractiveness of women also varies from culture to culture depending on their traditions, religion, and geography. 

While there isn’t a consensus among all societies about the ideal female body, when it comes to the size and shape of the breasts most people almost have the same opinion: bigger, perkier breasts look more attractive. This is because larger and firmer breasts are considered a sign of physical health and fertility in women and are more sexually appealing to men, and as several studies have shown, the desire to be sexually beautiful is a reproductive instinct and doesn’t have anything to do with culture.

At any rate, a curvaceous female body that includes rounded breasts and buttocks and a slim waist is highly desirable these days. But unfortunately, not all women are naturally endowed with such physical characteristics. And what’s more, the effect of aging on the plumpness and firmness of the breasts is unavoidable. 

The good news, however, is that there are real solutions to this common concern. Plastic surgery has come to the rescue of women who have issues with the size or shape of their breasts, helping them achieve their ideal bodies and improve their self-confidence in a matter of days. We’re talking about breast augmentation, a procedure that is in high demand these days.

Breast augmentation, otherwise known as augmentation mammoplasty and also referred to by many other names such as breast enlargement, breast enhancement, breast implants, and boob job, is a widely performed procedure to add volume and firmness to the breasts. The procedure is often performed with breast implants but there are other techniques as well, which are as follows.

There are 3 main approaches to breast augmentation: breast implants, fat injection (fat transfer), and injectable filler injection. Of these techniques, the placement of implants is the most common method to increase the size of the breasts, and for that reason in many cases when we say ‘breast augmentation’ we mean breast implant surgery. 

Fat transfer is also a popular breast enhancement procedure but the results are not as great as those of implants. Fat transfer is not just used for enhancing the breasts but it’s used in many other parts of the body for the same purpose.

Injectable filler injection is the least popular breast augmentation technique, which is less safe than the other approaches and is not recommended by many surgeons.

Breast implants 

Breast implants are prosthetic devices used to add volume and firmness to the breasts. They are either completely made of silicone (outer silicone shell with silicone gel inside), which are the most common type of implants and are known as silicone implants, or have a silicone shell filled with saline (salt water), known as saline implants.

Breast implants surgery is often performed under general anesthesia, during which the patient remains unconscious under the effect of anesthetic medicines. The implants are inserted into the breast through incisions that are made in different locations, including under the breasts (inframammary), around the areola (periareolar), in the armpit (transaxillary), and above the navel (transumbilical). 

As for the placement of the implants too, there are two main approaches: placing the implant under the breast tissue and over the chest muscle (subglandular placement) and placing the implant under the chest muscle (submuscular or subpectoral placement).

Learn more about breast implants surgery

Fat transfer 

A fat transfer breast augmentation is a less invasive solution. It is one of the most common uses of the fat transfer (fat grafting) procedure, more technically known as autologous fat grafting, which involves extracting fat from one part of the patient’s own body with excess fat deposits and injecting it into another part to add volume to it and enhance its shape.

Breast enlargement with fat grafting involves a liposuction procedure to harvest fat from other parts of the patient’s body followed by purification and injection steps. The procedure is usually done under local anesthesia on an outpatient basis. 

Fat grafting breast augmentation has a double benefit. The liposuction removes the unwanted fat deposits from areas such as the abdomen, flanks, and thighs, making them slimmer and fitter, and the injection of the fat into the breasts makes them look fuller and shapelier. The result of this technique is, however, not as good as that achieved with breast implants, but it is best for those who want to get the benefits of a fine body sculpting procedure all over their body while avoiding the risks of getting artificial objects into their body. Furthermore, up to 50 percent of the injected fat is reabsorbed by the body over time, causing the breasts to lose some of the volume obtained.

Learn more about fat transfer

Dermal fillers

Dermal fillers for breast augmentation is the least invasive technique. Dermal fillers, also called injectable fillers, are gel-like substances made from different materials that are injected under the skin for cosmetic purposes, including enhancing the volume and smoothing out wrinkles. 

Injectable fillers are an option for women who do not want to have a surgical operation but also do not have enough fat deposits for fat transfer. However, dermal fillers for breast enlargement also carries a higher risk of complications than the other two methods, so it is not a very common procedure. While the FDA has approved dermal fillers to be used for the augmentation of lips, cheek, and jawline, it doesn’t recommend them for body contouring purposes, including breast augmentation. 

Learn more about dermal fillers

Good candidates for breast augmentation in general are those who are in good physical health and have realistic expectations. As different breast augmentation techniques are different in terms of how they’re performed and the results they provide, women looking to get breast augmentation should clearly understand the benefits and risks of each of them. Also, candidates should have a clear understanding of what they want so that they can choose the right type of procedure. For instance, women who are looking for a significant increase in their breast size are not good candidates for fat grafting and dermal fillers and should go for breast implants, which are available in different sizes.

You are not considered a good candidate for breast augmentation if:

• You are under 18: The breasts of women who are under the age of 18 are still in the development stage, which may continue into the 20s. Any further development of the breasts after surgery may distort the results, so it is crucial to wait until you reach at least 18, preferably 20, before considering any type of breast augmentation. As for breast implants, doctors recommend having at least 18 years of age for saline and 22 for silicone implants.
• You are a smoker: Women who regularly smoke are not the ideal candidates for breast augmentation surgery — and other cosmetic procedures. This is because smoking has a negative effect on the healing process causing your body to not properly recover from the surgery. However, for those who smoke and want to get the procedure, stopping smoking from at least 2 weeks before until 2 weeks after the procedure is a vital preparation step.
• You are in a bad emotional state: Breast augmentation is a great way to improve your self-confidence and quality of life if the way your breasts look has tarnished your self-esteem. However, if you’re suffering from a deep sense of insecurity about your body as well as chronic depression and low self-confidence, chances are high that the procedure is not going to transform your life and improve all aspects of your life and relationships. You should first seek psychological assistance to have your psychological problems addressed. Also, if you want to have the procedure only because other people are telling you to and not for your own feelings, you are not considered an ideal candidate. 
• You are pregnant or breastfeeding: During pregnancy and the breastfeeding period, it is not a good idea to have breast augmentation. This is because at this time some changes are made in the breasts for lactation and breastfeeding, affecting the results of breast augmentation. However, if you already have breast implants you can get pregnant but it is recommended to wait for at least a year before doing that. Also, if you are currently pregnant or breastfeeding, it is advised to wait until 2-3 months after you have stopped breastfeeding your baby before having breast augmentation.
• You have sagging breasts: If you have droopy breasts with your nipples pointing downward, breast augmentation is not the right solution for you. Instead, you should have a breast lift procedure to get your breasts lifted. Of course, you can have a breast augmentation procedure after a breast lift to add to the volume of your breasts because a breast lift alone won't enhance the size of the breasts. The point is that breast augmentation on sagging breasts just makes them look awful.
• You have certain medical conditions: Some medical conditions increase the risks of surgical operations, such as heart disease, blood clotting disorders, high blood pressure, etc. Therefore, you should frankly discuss your medical history with your surgeon so that they could make the right decision about your eligibility for the surgery or make the right preparation plan for you. Active infections and breast cancer also make you unfit for breast augmentation.

Breast augmentation surgery, like all other surgery, entails some risks and potential complications. Although you can significantly reduce the risks by choosing a well-trained surgeon and adhering to the pre- and post-operative guidelines, it is still crucial to understand the possible risks of the surgery. 

Breast implants risks

• Capsular contracture (a condition in which the body reacts to the implants by forming hard scar tissue around the implants, contracting and deforming them.)
• Implant rupture
• Implant displacement 
• Infection
• Loss of sensitivity in the breasts
• Visible scars
• Asymmetry
• General anesthesia complications

Breast fat transfer risks

• Fat necrosis (fat cell death): It can bring about symptoms such as various types of lumps on the breasts, scar tissue, skin discoloration, bruising, uneven skin, and changes to the breast shape.
• Infection
• Fat reabsorption: a great deal of the fat may be reabsorbed by the body, diminishing the results of the procedure
• Anesthesia side effects: e.g. dizziness, headache, blurry vision, numbness, and muscle weakness
• Asymmetry

Breast filler risks

• Filler migration
• Infection
• Hematoma
• Skin irregularity and lumps
• Asymmetry
• Redness
• Itching
• Skin necrosis
• Blood flow blockage (when the filler is mistakenly injected into blood vessels)

After breast implant surgery, there will be some side effects for a few days. Pain, swelling, bruising, sore chest muscles, and slight bleeding at the incision sites are normal. It takes about a week for the side effects to start subsiding. Your surgeon may prescribe painkillers for you to relieve the pain and discomfort.

Most patients are able to resume their daily activities after 2 weeks, and if their work doesn’t involve intense activities, they can go back to work at this time. The swelling and bruising will gradually improve in a few weeks. During this time, you can do light activities such as walking but you still should avoid strenuous activities like running and heavy lifting for at least 6-7 weeks when your body has fully healed.

The overall time of recovery is different from patient to patient and it depends on many factors including the implant placement technique. In general, recovery after submuscular placement takes longer because the pectoral muscle is cut and stretched over the implant.

The recovery after a fat transfer breast augmentation takes around 5-6 weeks. During the first days, you may feel pain and soreness in the incision sites where fat has been removed. You may be asked to wear a compression garment for a few weeks for more comfortable and faster healing. 

Dermal filler injection has a much shorter recovery time and you will be able to resume your daily routine after 2-3 days. 

The cost of a breast augmentation procedure depends on various factors. The type of procedure, the country and location of the clinic or hospital where you undergo the procedure, the expertise of the surgeon, and many other factors contribute to the overall cost of the procedure. As a ballpark figure, the cost of a breast implant surgery ranges from $5000 to $10000. A fat transfer breast augmentation typically costs a little more than this because of the time and equipment it takes to perform the procedure. The cost of filler injection to breasts also depends on the amount of filler injected but it typically is lower than breast implants. 

Insurance generally doesn’t cover the cost of breast augmentation because it is considered a cosmetic procedure. However, it will pay for the procedure for breast cancer patients who have a mastectomy. Make sure to check the total cost with the provider before scheduling the procedure appointment including any additional fees and items you may need to purchase after the surgery, including a compression garment.