Breast Enlargement Research Library

Wound drainage after plastic and reconstructive surgery of the breast

Cochrane Review · Published 21 October 2015

Whether surgical wound drains should be placed after breast augmentation, reduction or reconstruction. Three randomised trials (306 women, 505 breasts) were found out of 190 screened studies — all of them in breast reduction — comparing drains with no drains after surgery.

• Across the three trials, drains produced no statistically significant improvement in infection, other wound complications, pain, bruising, seroma, haematoma or reoperation.
• Women who were not drained left hospital a mean 0.77 days sooner (95% CI 0.40 to 1.14 days sooner; low-certainty evidence) — the only significant result.
• No trials of drains after breast augmentation or breast reconstruction were identified, so the findings apply to breast reduction only.
• Cochrane concludes that the limited evidence shows no significant benefit of routine post-operative drains, and that augmentation and reconstruction still require investigation.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD007258.pub3 · PMID 26487173

Breast implant insertion funnels for preventing capsular contracture

Cochrane Protocol · Review in progress · Published 30 March 2026

Registered protocol for a review that will assess the effects of breast implant insertion funnels — devices used to guide the implant into place while minimising contact with skin — on capsular contracture rates in women having breast reconstruction or breast augmentation.

• This is a protocol, not a completed review: no results are available yet.
• The primary outcome planned is capsular contracture, alongside other complications, with both randomised and non-randomised studies eligible.
• The protocol anticipates few, if any, randomised trials of funnels, because capsular contracture often appears years after surgery and has many causes.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD016344 · PMID 41909996

Different types of implants for reconstructive breast surgery

Cochrane Review · Published 16 May 2016

Whether different breast implant types — textured or smooth, silicone or saline, anatomical or round, variable or fixed volume — change capsular contracture, complications, satisfaction and quality of life after reconstructive breast surgery. Five randomised trials with 202 participants were found.

• Every comparison was rated very low quality evidence: the trials were small, at unclear or high risk of bias, and too different from each other to pool.
• In one trial of 60 women, saline implants had less severe capsular contracture and higher satisfaction than silicone implants, but reinterventions were significantly more frequent with saline.
• No comparison reached statistical significance for textured versus smooth silicone implants (1 study, 20 women) or anatomical versus round implants (1 study, 36 women).
• No trials compared fifth-generation silicone implants or different manufacturers; the review concludes that surgeons still cannot counsel women on implant choice on the basis of randomised evidence.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD010895.pub2 · PMID 27182693

Implants versus autologous tissue flaps for breast reconstruction following mastectomy

Cochrane Review · Published 31 October 2024

Implant-based versus own-tissue (flap) reconstruction after mastectomy — quality of life, satisfaction and short- and long-term complications. Thirty-five non-randomised studies with 57,555 participants met the criteria; no randomised trials were found.

• Implants may reduce psychosocial well-being (mean difference -4.26 on a 0–100 scale; low-certainty evidence) and sexual well-being (-6.63; low-certainty) versus autologous flaps on BREAST-Q measures.
• Women may be less satisfied with the reconstruction with implants (-5.96; low-certainty) and with the breast itself (-8.17; very low-certainty).
• Long-term complications may be more frequent with implants (risk ratio 1.56, 95% CI 1.09 to 2.22; very low-certainty), while implant surgery was about 125 minutes shorter (very low-certainty).
• All evidence came from non-randomised studies (26 at serious overall risk of bias); the review found no superior technique for every woman and called for randomised trials.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD013821.pub2 · PMID 39479986

Mesh for immediate implant-based prepectoral breast reconstruction following mastectomy

Cochrane Protocol · Review in progress · Published 17 June 2025

Registered protocol for a review of biological or synthetic mesh used to support a prepectoral implant (placed above the muscle) in immediate breast reconstruction after mastectomy.

• This is a protocol, not a completed review: no results have been published.
• It plans to compare mesh versus no mesh, and biological versus synthetic mesh, for complications, patient-reported outcomes and reoperation after prepectoral reconstruction.
• Prepectoral placement is one of the placement options also discussed in breast augmentation, so the review will be relevant to implant positioning debate generally.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD015961 · PMID 40525534

Acellular dermal matrices for breast reconstruction surgery

Cochrane Protocol · Review in progress · Published 2015

Registered protocol for a review of acellular dermal matrices (biological meshes derived from human or animal skin) used around implants in immediate prosthetic breast reconstruction after cancer or risk-reducing surgery.

• This protocol was registered in 2015; no completed review has been published under this title.
• It plans to compare reconstruction with versus without acellular dermal matrix for seroma, infection, skin flap necrosis, haematoma, reconstruction failure and implant removal.
• The protocol notes that some studies suggest dermal matrix may raise complication rates, which the review is intended to test.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD011966

Autologous fat grafting for breast reconstruction

Cochrane Protocol · Withdrawn · Published 29 June 2021

Protocol for a review of autologous fat grafting — transferring the patient's own fat into the breast — for breast reconstruction after cancer surgery. Cochrane withdrew the protocol because the authors were no longer able to complete the review.

• Cochrane withdrew this protocol: "the authors are no longer able to complete this review", so no Cochrane systematic review of fat grafting exists under this title.
• The protocol itself was published on 29 June 2021 and remains readable as a record of the intended methods.
• No Cochrane review has examined fat transfer for cosmetic breast enlargement either.

Read the record on cochranelibrary.com → · DOI 10.1002/14651858.CD010793.pub2

Breast Implants

Regulatory hub · Content current as of 2023-12-15

The FDA's central breast implant resource. It explains that implants are medical devices placed under breast tissue or chest muscle to increase breast size (augmentation) or to replace tissue removed by cancer or trauma, and links to approvals, labeling, risks, safety communications and post-approval studies.

• Two implant types are approved for sale in the United States: saline-filled and silicone gel-filled. Both have a silicone outer shell.
• Implants vary in size, shell thickness, surface texture and shape.
• The FDA provides this information to support, not replace, the discussion between a patient and a physician.
• Patients are encouraged to report adverse events through MedWatch.

Read the original on fda.gov →

Types of Breast Implants

Regulatory page · Content current as of 2019-10-23

Describes saline-filled and silicone gel-filled implants, their approved age groups, and the role of breast tissue expanders in reconstruction.

• Saline-filled implants are approved for breast augmentation in women aged 18 or older and for reconstruction at any age.
• Silicone gel-filled implants are approved for breast augmentation in women aged 22 or older and for reconstruction at any age.
• Breast implants are not lifetime devices; the longer they are in place, the more likely removal or replacement becomes.
• The most frequent complications are capsular contracture, reoperation and implant removal, with or without replacement.
• MRI remains the most effective method for detecting silent rupture; ultrasound is an acceptable alternative for screening asymptomatic patients.

Read the original on fda.gov →

Breast Implants — Certain Labeling Recommendations to Improve Patient Communication

FDA guidance (2020) · Content current as of 2020-09-29

Final guidance recommending content and format for breast implant labeling, including a boxed warning, patient decision checklist, device description and rupture screening recommendations.

• Labeling should include a boxed warning and a patient decision checklist.
• Materials and device descriptions should list the types and quantities of chemicals and heavy metals found in or released by the implant.
• The guidance underpins the new labeling approved on 27 October 2021.
• The recommendations supplement the FDA's Saline, Silicone Gel, and Alternative Breast Implants guidance.

Read the original on fda.gov →

Saline, Silicone Gel, and Alternative Breast Implants

FDA guidance (2020) · Content current as of 2020-09-29

Guidance covering the information manufacturers should provide for saline, silicone gel and alternative breast implants, superseding the 2006 version.

• Applies to saline, silicone gel and alternative breast implants.
• Supersedes the previous version dated 17 November 2006.
• Should be read alongside the labeling recommendations guidance.

Read the original on fda.gov →

FDA Strengthens Safety Requirements and Updates Study Results for Breast Implants

Press announcement · Content current as of 2021-10-27

Announcement of orders restricting the sale and distribution of breast implants and approval of new labeling with a boxed warning, patient decision checklist, rupture screening recommendations and a patient device card.

• Sale and distribution are restricted to providers and facilities that give patients the approved risk information.
• The patient decision checklist must be reviewed, initialled and signed by the patient and signed by the implanting physician.
• New labeling includes a device description listing specific materials in the device.
• The FDA also released updated information on manufacturer post-approval studies.

Read the original on fda.gov →

Risks and Complications of Breast Implants

Regulatory page · Content current as of 2023-12-15

A detailed list of local complications and adverse outcomes reported in at least one percent of breast implant patients, plus sections on reoperation, removal, capsular contracture, rupture, BIA-ALCL, systemic symptoms, breastfeeding and effects on children.

• Listed complications include asymmetry, breast pain, capsular contracture, deflation, delayed wound healing, extrusion, hematoma, infection, malposition, necrosis, sensation changes, rupture, seroma, wrinkling and unsatisfactory size or style.
• Capsular contracture is graded I–IV using the Baker scale; grades III and IV are considered severe and may need reoperation.
• Silicone gel ruptures are often silent; MRI is the most effective detection method and ultrasound is an acceptable alternative for asymptomatic screening.
• The FDA has not detected an association between silicone gel-filled implants and connective tissue disease, breast cancer or reproductive problems, but notes that larger and longer studies would be needed to rule these out.
• Some patients report systemic symptoms grouped under the term breast implant illness (BII); causes are poorly understood.
• Some women can breastfeed after augmentation and some cannot; implant removal without replacement can leave dimpling, concavity, puckering or sagging.

Read the original on fda.gov →

Things to Consider Before Getting Breast Implants

Patient decision guide · Content current as of 2023-03-08

The FDA's pre-surgery checklist covering informed consent, reoperation, monitoring, BIA-ALCL, BII, surgical mesh and the information patients should discuss with their surgeon.

• Patients should assume additional surgery may be needed because implants are not lifetime devices and complications can occur.
• Implant removal or replacement may not be covered by insurance, even when a complication occurs.
• The most common local complications are capsular contracture, reoperation and implant removal; others include rupture or deflation, wrinkling, asymmetry, scarring, pain and infection.
• BIA-ALCL is a cancer of the immune system, not breast cancer; it is treatable but can be fatal, and treatment usually involves removing the implant and capsule.
• Surgical mesh used in breast implant surgery has not been approved by the FDA for that use.
• Silicone implants may require regular MRI or ultrasound screening for silent rupture, which may not be covered by insurance.

Read the original on fda.gov →

Breast Implant Surgery

Regulatory page · Content current as of 2023-08-03

Explains where breast implant surgery can be performed, the FDA position on surgical mesh, and questions patients should ask their surgeon.

• Breast implant surgery can be performed in a hospital or a surgery centre.
• The FDA has not cleared or approved any surgical mesh for use with breast implants or in breast reconstruction.
• Patients are advised to discuss the benefits and risks of mesh with their health care provider.

Read the original on fda.gov →

Breast Implant Postmarket Safety Information

Regulatory page · Content current as of 2025-06-02

Describes the FDA's ongoing postmarket review of breast implant safety, including medical device reports, BIA-ALCL, systemic symptoms and manufacturer post-approval studies.

• The FDA continually evaluates postmarket safety and manufacturer compliance with approval conditions.
• Review includes medical device reports for BIA-ALCL and systemic symptoms in women with breast implants.
• Ongoing post-approval studies are listed by manufacturer and application number.
• In July 2019 Allergan voluntarily recalled Natrelle BIOCELL textured breast implants and tissue expanders.

Read the original on fda.gov →

Questions and Answers about Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)

Patient and clinician Q&A · Content current as of 2019-10-23

FDA answers on BIA-ALCL: what it is, who is at risk, symptoms, diagnosis, treatment and what patients and clinicians should do.

• BIA-ALCL is a T-cell lymphoma of the immune system, not breast cancer.
• It is usually found in the fluid or scar tissue near the implant and may spread in some cases.
• Risk is higher with textured-surface implants than with smooth-surface implants.
• Main symptoms are persistent swelling, a mass or pain around the implant, often years after surgery.
• Most patients are treated successfully with surgery to remove the implant and surrounding capsule; some also need chemotherapy or radiation.
• The FDA does not recommend routine removal of implants in patients without symptoms.

Read the original on fda.gov →

UPDATE: Reports of Squamous Cell Carcinoma (SCC) in the Capsule Around Breast Implants

Safety communication · Content current as of 2023-03-08

Updated safety communication on reports of squamous cell carcinoma and various lymphomas in the scar capsule around breast implants.

• The communication updates a September 2022 safety communication.
• The lymphomas described are not the same as BIA-ALCL.
• The FDA believes cases of SCC and lymphomas in the capsule may be rare.
• Health care providers should discuss these risks with women who have or are considering breast implants.
• Patients and providers are asked to report cancers around breast implants to the FDA.

Read the original on fda.gov →

Dermal Fillers (Soft Tissue Fillers)

Regulatory page · Content current as of 2023-07-06

Describes approved facial and hand uses of dermal fillers, the risks, and the FDA's position on unapproved body uses including breast enlargement.

• Dermal fillers are approved for specific facial uses, lip and cheek augmentation, back-of-hand augmentation, HIV lipoatrophy and contour deficiencies.
• The FDA recommends against using dermal fillers or any injectable filler to increase breast size (breast augmentation) or for other body contouring.
• These uses are not approved by the FDA, and the risks of unapproved uses or unapproved products are not known.
• Injectable silicone is not approved for any aesthetic procedure and can cause long-term pain, infection, scarring, embolism, stroke and death.
• Needle-free devices are not approved for injecting dermal fillers, and no dermal filler is approved for over-the-counter use.
• Removal of filler may require injections, surgery or other interventions, and it may be difficult or impossible to remove permanent fillers.

Read the original on fda.gov →

FDA-Approved Dermal Fillers

Regulatory list

The FDA's list of approved dermal fillers and their approved indications, limited to facial tissue and the hands.

• The list covers approved facial and hand products.
• The FDA has not approved liquid silicone or silicone gel for injection.
• Approved indications vary by product; not every product is reviewed for every body site.

Read the original on fda.gov →

FDA Warns About Illegal Use of Injectable Silicone for Body Contouring and Associated Health Risks

Press announcement and safety communication · Content current as of 2017-11-13

Warning about injectable silicone and products falsely marketed as FDA-approved fillers to enlarge the buttocks, breasts and other body parts.

• Injectable silicone used for body contouring is not FDA-approved.
• Serious side effects include ongoing pain, scarring, tissue death, permanent disfigurement, embolism, stroke, infection and death.
• Complications may occur immediately or weeks, months or years later.
• Silicone injections for body contouring are often performed by unlicensed providers in non-clinical settings.
• Injectable silicone differs from the silicone contained inside approved breast implants, because the implant shell keeps the gel from migrating.

Read the original on fda.gov →

What to Know About Breast Implants

Consumer update · Content current as of 2025-01-31

Patient-facing overview of implant types, risks, labeling, long-term monitoring, BIA-ALCL and communication with a surgeon.

• The FDA has approved implants for augmentation, reconstruction after cancer or trauma, correction of developmental defects, and revision of previous surgery.
• Risks include additional surgery, BIA-ALCL, systemic symptoms (BII), capsular contracture, breast pain, rupture, deflation, silent rupture and infection.
• Breast implants are not lifetime devices and their lifespan cannot be predicted.
• Mandatory labeling includes a patient decision checklist, boxed warning and patient device card.
• Patients with silicone implants are advised to have regular screening for silent rupture and to tell mammography facilities that they have implants.
• Injectable silicone is not approved for breast augmentation, reconstruction or body contouring.

Read the original on fda.gov →

MedWatch: FDA Safety Information and Adverse Event Reporting Program

Reporting program

How patients and clinicians report injuries, adverse events or product problems related to breast implants, fillers and other FDA-regulated products.

• Voluntary reports can be filed online or by phone at 1-800-FDA-1088.
• Reports help the FDA monitor approved products after they are sold.
• Useful details include device name, manufacturer and a description of the event and any interventions.

Read the original on fda.gov →

Breast enlargement (implants)

Patient information page · Page last reviewed 2023-09-21

The NHS overview of breast enlargement (also called a boob job or breast augmentation). Implants are inserted to increase size, change shape or make breasts more even. The page covers funding, UK costs, choosing a surgeon and implants, how long implants last, the operation itself, recovery, complications, BIA-ALCL, breast implant illness, PIP implants, the implant registry, breast screening and how to report problems.

• Breast enlargement is major surgery; results are not guaranteed and there are risks to weigh up.
• It is usually paid for privately. The NHS may fund it in some circumstances, for example very uneven breasts or no breasts, depending on local rules.
• In the UK, breast implant surgery costs around £3,500 to £8,000, which does not usually include consultations or follow-up care.
• Two implant types are offered: silicone (most common in the UK) and saline. Placement is either behind the breast tissue or behind the chest muscle.
• Implants are not lifetime devices; some women need further surgery after about 10 years.
• The operation is done under general anaesthetic and takes between 60 and 90 minutes; most people go home the same day or stay overnight.
• Recovery takes a few weeks: one or two weeks off work, no driving for at least a week, and no heavy lifting or strenuous exercise for at least a month.
• Reported problems include capsular contracture, rupture, rippling, rotation, nipple sensation changes and reduced breast milk while breastfeeding.
• BIA-ALCL is an uncommon immune-system cell cancer associated with implants; breast implant illness is a term for symptoms some women report after surgery.
• PIP implants were banned in the UK in 2010; a ruptured implant should be removed as soon as possible.
• The Breast and Cosmetic Implant Registry (BCIR), set up in 2016, allows implants to be traced if a safety concern arises.
• Breast screening still matters after implants; mammograms are safe and can be performed differently so as much breast tissue as possible is seen.
• Check any hospital or clinic in England is registered with the CQC, and that the surgeon is on the GMC specialist register with a licence to practise; always meet the surgeon before the procedure.
• The MHRA publishes a Cosmetic Breast Augmentation Patient Risk Awareness Tool to help discuss implant risks and keep a record of treatment.

Read the original on nhs.uk →

Is a cosmetic procedure right for me?

Advice page · Page last reviewed 2023-05-09

NHS advice on working out whether a cosmetic procedure is a sound decision: questions to ask yourself, how to research, speaking to an expert, taking time, avoiding pressure and considering mental health.

• Ask what you want to change and why, how long you have thought about it, what triggered it now, and whether there are other ways to achieve the same change.
• Ask whether you are expecting the procedure to change your life as well as your appearance, and whether you want it for yourself or to please someone else.
• Consider all costs, including aftercare, correcting problems and future procedures needed to maintain the look.
• You should be given a cooling-off period after your consultation to decide.
• Avoid time-limited offers, extra treatments you had not considered, group treatment events involving alcohol, and mobile services operating in private homes or hotels.
• Tell the person treating you for a mental health condition, and your cosmetic practitioner, about any mental health problems past or present.
• Free NHS talking therapies are available for anxiety and depression if appearance concerns are affecting your wellbeing.

Read the original on nhs.uk →

Before you have a cosmetic procedure

Advice page · Page last reviewed 2023-05-22

NHS checklist for people considering a cosmetic procedure, surgical (such as breast implants) or non-surgical (such as dermal fillers or Botox): be clear about why, speak to an expert, research, understand costs, choose a qualified practitioner, ask questions, be cautious with social media and take time.

• All cosmetic procedures carry some risks, and complications can be serious if they are not done correctly.
• A GP or mental health professional can be a good first conversation, alongside a consultation with the practitioner.
• Understand the full costs including aftercare and any future procedures needed to maintain the result.
• Choose a practitioner who is trained, experienced and has the right insurance to correct anything that goes wrong.
• Social media influencers are usually paid to advertise services, so research anything found there with extra care.
• You should be offered a cooling-off period after any consultation, and you can walk away at any point.

Read the original on nhs.uk →

Choosing who will do your cosmetic procedure

Advice page · Page last reviewed 2023-06-23

NHS guidance on selecting a practitioner with the right training, skills and insurance: what to ask at a consultation, what the practitioner should explain, checks for cosmetic surgery in England (CQC clinic registration, GMC medical register, RCS certification, BAAPS/BAPRAS membership) and registers for non-surgical practitioners.

• Always book a consultation with the person who will do the procedure before deciding.
• Ask how many procedures they have done, their qualifications, common complications, aftercare, what to do if something goes wrong, and the full cost including any further treatment.
• The practitioner should explain how the procedure is done, how long it takes, whether anaesthetic is needed, expected pain, recovery time, risks, how long results last and what to expect afterwards.
• Do not pay for a procedure until you have had a consultation.
• In England, all independent hospitals and clinics providing cosmetic surgery must be registered with the Care Quality Commission (CQC), which publishes quality ratings.
• Only registered doctors can perform cosmetic surgery in England; check the GMC medical register, and note the Royal College of Surgeons certifies cosmetic surgeons against a national standard.
• For non-surgical procedures, look for practitioners on PSA-accredited voluntary registers such as JCCP or Save Face.
• Avoid group treatments, treatment vouchers from discount sites, mobile services in homes or hotels, and practitioners who only advertise on social media.
• Dermal filler complications can be serious, including infection, nerve damage and blindness, so avoid practitioners with only short training courses.

Read the original on nhs.uk →

Is cosmetic surgery available on the NHS?

Advice page · Page last reviewed 2023-04-17

Cosmetic surgery is not routinely provided on the NHS, though it may occasionally be funded for psychological or other health reasons. Breast enlargement may be funded for very uneven breasts or no breasts causing significant psychological distress. Reconstructive plastic surgery, such as breast rebuilding after mastectomy or cleft lip and palate repair, is different and often available.

• Most people who want cosmetic surgery pay for it privately.
• NHS breast enlargement funding depends on local commissioning rules; your GP can explain the rules in your area.
• Other examples where the NHS may pay include nose reshaping for breathing problems, ear correction, and breast reduction causing backache.
• Male breast reduction may be funded for long-standing gynaecomastia that has not responded to other treatments and causes considerable pain or distress.
• Reconstructive surgery aims to repair or reconstruct missing or damaged tissue after illness, accident or birth defect, and is often available on the NHS.

Read the original on nhs.uk →

Cosmetic surgery abroad

Advice page · Page last reviewed 2022-12-14

NHS advice on cosmetic surgery abroad: lower prices must be weighed against risks, follow-up care may be missing or of a different standard, holiday packages need caution, and aftercare, insurance and flying plans should be sorted out in advance.

• Overseas clinics may not provide follow-up treatment, or not to the same standard as the UK, and may have no UK professional you can see if problems arise.
• Be cautious of websites selling cosmetic surgery as part of a holiday: meet the surgeon, and do not pay for a hospital you have never seen or a surgeon you have not met.
• Recovering straight after a holiday is unrealistic; rest is required, with no alcohol, sunbathing, sightseeing or swimming.
• Find out what happens if there are complications, where follow-ups will be, how easily you could travel back for more surgery, and how much it would cost.
• Standards and qualifications abroad may differ, so find out how surgeons and clinics are regulated in the chosen country.
• You should have two consultations with the treating surgeon before surgery, giving a cooling-off period; they should explain the procedure, its limitations, alternatives and risks, and show before-and-after pictures.
• Travel insurance normally does not cover things going wrong with surgery; check clinic insurance, travel cover and how you would get home in an emergency.
• Do not fly for 5 to 7 days after procedures such as breast surgery, as air travel plus major surgery increases the risk of a life-threatening blood clot.

Read the original on nhs.uk →

What is breast augmentation?

Procedure page section · Reviewed November 2025

healthdirect defines breast augmentation as a form of cosmetic surgery that enlarges the breasts, also called breast enlargement or breast reconstruction. Implants sit either under the breast or under the chest muscle and consist of a silicone shell filled with saline (salty water) or silicone gel. Some surgeons also offer fat grafting, moving fat from another part of the body into the breast. The page notes that reconstruction after mastectomy is a separate topic, and that a Therapeutic Goods Administration (TGA) review led to some breast implants being withdrawn from the Australian market or given conditions on their use.

• Breast augmentation is cosmetic surgery to make the breasts larger; it is also referred to as breast enlargement.
• Implants are placed under the breast or beneath the chest muscle and are made of a silicone shell filled with saline or silicone gel.
• Some cosmetic surgeons offer fat grafting, transferring fat from areas such as the buttocks into the breasts.
• Reconstruction after a mastectomy uses implants or tissue for a different purpose; that is separate from cosmetic augmentation.
• After a TGA review, some breast implant products have been removed from the Australian market or had conditions placed on them.

Read the original on healthdirect.gov.au →

What are the benefits of breast augmentation?

Procedure page section · Reviewed November 2025

healthdirect states that people consider breast augmentation for many reasons, most commonly a desire to feel more physically attractive or more comfortable with themselves. The page frames the benefit in terms of how the person hopes to feel rather than promising any particular result.

• Reasons people give include wanting to feel more physically attractive or better about themselves.
• healthdirect does not guarantee an outcome; expectations should be discussed with a surgeon.

Read the original on healthdirect.gov.au →

What should I consider before choosing to have breast augmentation?

Procedure page section · Reviewed November 2025

healthdirect acknowledges social pressure around body shape and asks readers to weigh several points before deciding: implants are not lifelong and usually need replacing after 10 to 15 years; cancer has very rarely arisen in the fluid and scar tissue around an implant; some people are unhappy with how their breasts look afterwards; implants can make breast cancer harder to detect during screening; and breastfeeding may be affected.

• Implants do not last for life and usually need replacing after 10 to 15 years.
• There have been rare cases of cancer developing in the fluid and scar tissue around an implant.
• Some people find the result does not look the way they hoped.
• Implants can make it harder to detect breast cancer during screening checks.
• The ability to breastfeed may change after surgery.
• Body image and social pressure are worth examining before deciding, and counselling is an option.

Read the original on healthdirect.gov.au →

Current status of breast implant products in Australia

Regulator callout on the healthdirect page · Reviewed November 2025

The healthdirect page carries a callout about a Therapeutic Goods Administration (TGA) review after which some breast implants were removed from the Australian market or had conditions placed on them, and links to the TGA's current status page for the details.

• The TGA reviewed breast implant products and some were withdrawn from the Australian market or given conditions of use.
• The TGA website publishes the current status of breast implant products in Australia.
• The TGA also publishes information on breast implants and anaplastic large cell lymphoma (BIA-ALCL).

Read the original on healthdirect.gov.au →

What does a breast augmentation procedure involve?

Procedure page section · Reviewed November 2025

The procedure is normally done under general anaesthetic so the patient sleeps throughout. The surgeon cuts alongside the breast and positions the implant either between the breast tissue and the muscle, or behind the large chest muscle under the breast; the surgeon decides which method suits the patient. Different surgical techniques are available, and the method chosen can affect recovery time.

• General anaesthetic is usually required, so you are asleep during the operation.
• The surgeon makes a cut alongside the breast.
• The implant is placed either between the breast tissue and the muscle, or behind the chest muscle.
• The surgeon chooses the method, and the technique used can affect how long recovery takes.

Read the original on healthdirect.gov.au →

How can I prepare for a breast augmentation?

Procedure page section · Reviewed November 2025

healthdirect advises gathering as much information as possible and preparing by getting physically fit, reaching a healthy weight, trying to stop smoking, asking about medication changes, disclosing health conditions and allergies, and confirming whether you will stay overnight. On choosing a surgeon, it says to pick someone you feel comfortable with who will be honest about benefits and risks, notes that a GP must refer cosmetic surgery patients to their surgeon, and points to the AHPRA register where you can confirm the surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS) and check for serious disciplinary action. On cost, Medicare generally does not cover cosmetic surgery, private health insurance should be checked, and fees typically include the surgeon, anaesthetist, clinic or hospital, the implants, and medication, dressings and support garments. The page lists questions to ask about implant type, sensation, nipple position and appearance, bruising and pain, plus long-term questions about implant lifespan, breastfeeding, rupture, the likelihood of further operations and the cost of any repeat surgery.

• Prepare by getting physically fit, maintaining a healthy weight and trying to quit smoking.
• Ask whether any medications need to change, tell the surgeon about health conditions and allergies, and confirm whether you will stay overnight or go home.
• Choose a surgeon you feel comfortable with who will discuss benefits and risks honestly.
• A GP needs to make the referral to the surgeon you choose for cosmetic surgery.
• Check the AHPRA register to confirm your surgeon is a Fellow of the Royal Australasian College of Surgeons (RACS) and to see whether serious disciplinary action has been taken.
• Medicare generally does not cover cosmetic surgery; check your private health policy for any cover.
• Costs usually include surgeon and anaesthetist fees, clinic or hospital fees, the implants, and medication, dressings and support garments.
• Ask what implant type is recommended and why, whether sensation will change, how the nipples will be affected, and what bruising, swelling and pain to expect.
• Ask how long implants last, whether you will be able to breastfeed, how many of the surgeon's patients have had a ruptured or failed implant, how likely further operations are, and whether extra surgery would cost more.

Read the original on healthdirect.gov.au →

How soon will I recover?

Procedure page section · Reviewed November 2025

Recovery depends on your health before surgery and your surgeon's advice; you may be asked to take a week off work and avoid moderate exercise for around five weeks. Tubes draining fluid, dressings and a compression bandage are common, along with pain and discomfort from swelling and bruising. Pain relief, extra support garments, time off work, help at home and a follow-up visit are often needed. healthdirect says to contact your surgeon or go to a hospital emergency department if you develop fever, severe pain, nausea or vomiting during recovery.

• Recovery varies with your pre-surgery health and your surgeon's advice.
• You may be asked to take about a week off work and avoid moderate exercise for around five weeks.
• Drain tubes, dressings and a compression bandage may be used, and pain, swelling and bruising are normal early on.
• You may need pain relief, support garments for a few weeks, time off work, help with daily tasks and a follow-up appointment.
• Fever, severe pain, nausea or vomiting during recovery means you should contact your surgeon or go to a hospital emergency department.

Read the original on healthdirect.gov.au →

When should I see my doctor?

Procedure page section · Reviewed November 2025

healthdirect lists the symptoms that mean contacting your surgeon straight away after surgery: a temperature above 38°C or chills; nausea, vomiting, shortness of breath or diarrhoea; heavy bleeding from the wound; bleeding or fluid leakage that starts more than a day after surgery; redness around the implant that is worsening or spreading; and increasing pain or tenderness. In an emergency, go to hospital or call triple zero (000).

• Contact your surgeon straight away for a temperature over 38°C or chills.
• Nausea, vomiting, shortness of breath or diarrhoea after surgery need urgent review.
• Heavy bleeding from the wound, or bleeding or fluid leakage starting more than one day after surgery, needs urgent review.
• Redness around the implant that worsens or spreads, and increasing pain or tenderness, should be reported.
• Fever, vomiting or heavy bleeding also warrants going to your nearest hospital.

Read the original on healthdirect.gov.au →

What complications can happen?

Procedure page section · Reviewed November 2025

Like any operation, breast implant surgery carries risks that should be discussed in detail with a surgeon. healthdirect lists bleeding or a haematoma, infection, changed sensation or numbness in the breast skin or nipple, swelling or a fluid collection, injury to surrounding tissue and implant rupture. Rarer serious risks include an allergic reaction to the anaesthetic, blood clots in the legs that can travel to the lungs, and breast implant-associated cancer — implants previously linked with cancer are no longer available. Severe chest pain or trouble breathing means calling triple zero (000) for an ambulance.

• Possible problems include bleeding or a haematoma, infection, altered sensation or numbness, swelling or fluid collections, injury to nearby tissue and implant rupture.
• Rarer serious risks include allergic reaction to the anaesthetic and blood clots in the legs that can travel to the lungs.
• Breast implant-associated cancer is listed as a rare serious risk; implants linked with cancer in the past are no longer available.
• Risks should be discussed in detail with your surgeon before you consent.
• Trouble breathing or severe chest pain requires calling triple zero (000) for an ambulance.

Read the original on healthdirect.gov.au →

Are there alternatives to breast augmentation?

Procedure page section · Reviewed November 2025

healthdirect states that breast augmentation may not be right for everyone and lists counselling to help with accepting your body shape, wearing a padded bra, and other types of surgery that do not involve implants as alternatives.

• Counselling to help you accept your body shape is offered as an alternative.
• Wearing a padded bra is a non-surgical alternative.
• Other surgery that does not use implants may also be an option.

Read the original on healthdirect.gov.au →

Resources and support

Procedure page section · Reviewed November 2025

healthdirect recommends discussing the decision with your doctor first and links to the Australian Society of Plastic Surgeons, the Agency for Clinical Innovation breast implant safety patient information sheet, an Australian Government fact sheet on cosmetic surgery, and the TGA guide to the five questions to ask before getting a medical implant (available in community languages). It also gives the healthdirect helpline on 1800 022 222 (NURSE-ON-CALL in Victoria), staffed by registered nurses 24 hours a day, seven days a week.

• Discuss the decision with your doctor before going further.
• The Australian Society of Plastic Surgeons and the Agency for Clinical Innovation publish patient information on breast implants.
• The Australian Government has a cosmetic surgery fact sheet, and the TGA publishes a guide to questions to ask before a medical implant.
• The healthdirect helpline (1800 022 222, NURSE-ON-CALL in Victoria) is staffed by registered nurses 24/7.

Read the original on healthdirect.gov.au →

Breast Augmentation: What it is, Types, Surgery & Recovery

Treatment overview · Medically reviewed, last updated 2021-08-24

Cleveland Clinic's overview of breast augmentation, a common cosmetic surgery that uses breast implants or fat transfer to increase the size and shape of the breasts. It covers the implant types (saline, structured saline, silicone, form-stable, round, smooth, textured), fat transfer augmentation, why people choose the procedure, how common it is, the consultation and preparation, the steps of surgery (anaesthesia, incision, implant placement, closing), what happens afterwards, benefits, side effects and complications, cancer screening with implants, recovery time, when to call the doctor, insurance, reversibility and breastfeeding.

• Breast augmentation is a surgical procedure that increases the size and shape of your breasts using breast implants or fat transfer.
• Two main types: breast implants and fat transfer augmentation; certain implants are only FDA-approved for certain ages.
• Saline implants are filled with sterile salt water; if they break, your body absorbs the saline naturally.
• Silicone implants are filled with silicone gel; if they break the gel can stay in the shell or leak into the breast, and regular checks with your surgeon may be needed.
• Form-stable ("gummy bear") implants keep their shape even if the shell breaks, are made of thicker gel and need a longer incision.
• Round implants make breasts look fuller and don't change the look of the breast if they rotate; smooth implants feel softest and move most naturally.
• Textured implants encourage scar tissue to adhere so they move less, but breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) occurs most frequently with textured surfaces.
• In fat transfer augmentation, liposuction takes fat from the belly, flanks, back or thighs and injects it into the breasts; it is usually for a relatively small increase in size.
• People choose augmentation to change size, correct asymmetry, restore size after pregnancy or weight loss, correct unevenness after other breast surgery, or to improve confidence.
• Around 300,000 people in the United States have breast augmentation surgery every year; it is the most popular type of cosmetic surgery.
• At consultation your surgeon reviews medications, allergies, smoking, prior surgeries and breast history; you should have realistic expectations and be in good mental and physical health.
• Preparation may include a blood test, adjusting medications, stopping smoking, avoiding aspirin and anti-inflammatory drugs, and stopping recreational drugs.
• Arrange a driver and someone to stay the first night; take at least three days off work, or at least three weeks for a labour-intensive job.
• Surgery is done under general anaesthesia or IV sedation; incisions can be at the inframammary fold, around the areola (periareolar) or through the armpit (transaxillary).
• Implants are placed either under the breast tissue in front of the muscle or behind the pectoral muscle, depending on implant type and how much size is increased.
• Stitches are usually removed in about one week; no heavy lifting for at least four weeks and no sports for up to six weeks.
• Full recovery takes about six to eight weeks on average; recovery varies by augmentation type and overall health.
• Side effects include soreness, nipple sensitivity, bruising, bleeding and swelling; immediate complications include infection, wound healing issues and hematoma.
• Longer-term complications include capsular contracture (scar tissue), implant sagging, symmastia, seroma (fluid around the implant) and implant rupture or deflation.
• BIA-ALCL is a rare immune-system cancer reported with textured implants; symptoms such as size or shape changes, swelling or lumps may appear two to eight years after surgery.
• Breast implants are not guaranteed to last a lifetime; pregnancy, weight loss and menopause may change the appearance of augmented breasts.
• Implants can make mammograms harder to read; the American College of Radiology and related bodies recommend breast examinations at an ACR-accredited facility, which can take special views.
• Breast augmentation is usually considered elective cosmetic surgery, so insurance generally does not cover it; reconstruction after cancer may be covered.
• Yes, augmentation is reversible: implants can be removed, replaced or repositioned by a plastic surgeon.
• Augmentation can affect nerves and ducts involved in lactation; implants placed below the muscle affect milk production less than those above, and periareolar incisions are more likely to reduce milk production.

Read the original on my.clevelandclinic.org →

Breast Implants: Types, Surgery, Recovery & Risks

Treatment overview · Medically reviewed, last updated 2021-08-31

Cleveland Clinic's guide to breast implants: artificial silicone shells filled with silicone gel or saline, inserted by plastic surgeons for augmentation or reconstruction. It covers candidacy, reasons for getting implants, how common they are, how long implants last, which implants feel and look most natural, age limits for saline and silicone implants, sizing and placement, the four incision types, the procedure, recovery timeline, follow-up schedule, advantages, risks and the questions to ask your provider.

• Breast implants are artificial devices (prostheses): silicone shells filled with silicone gel or saline, inserted by plastic surgeons.
• Candidates should be finished developing, in good physical health and have realistic expectations.
• People get implants to restore previous breast size after pregnancy, weight loss or aging, to correct asymmetry, to restore breasts after mastectomy, or to boost confidence.
• About 3.5 million people in the United States have breast implants; roughly 60% contain silicone gel; about 35 million people worldwide have implants.
• Breast augmentation is the procedure that makes breasts larger; breast implants are the devices used in many augmentations.
• Implants typically last about 10 years; the older they get, the more likely they are to rupture; signs include changes in size, shape, firmness or swelling, though rupture can also have no signs.
• Silicone implants tend to feel more natural than saline; smooth shells feel more natural and move more freely than thicker textured shells.
• The FDA approved highly cohesive silicone gel ("gummy bear") implants in 2012; teardrop-shaped implants usually come with a textured shell so they don't rotate.
• You must be at least 18 years old for saline-filled implants and the FDA recommends at least 22 years old for silicone-filled implants.
• Providers assess mental health and social factors, including body dysmorphic disorder concerns and whether a partner is pressuring the decision.
• Implant size is matched to body structure: larger implants suit broader shoulders or wider hips, while oversized implants on a small frame can cause back, neck and shoulder pain.
• Preoperative sizing lets you try sample implants under clothing in front of a mirror before choosing size and shell type.
• Two placement options: submuscular (beneath chest muscles) and subglandular (between chest muscles and breast tissue).
• Four incision types: periareolar (around the areola), inframammary (breast crease), transaxillary (armpit) and transumbilical (belly button).
• After surgery breasts are wrapped in a supportive bra or compression band; you need a driver and someone to care for you for the first 24 hours.
• Full recovery is on average six to eight weeks; the first several days are the most painful, with swelling, bruising and slight incision bleeding.
• Pain usually decreases after five to seven days; light daily activities and desk work can resume after one to two weeks, but avoid running, heavy lifting and arms above head.
• Return to work is typically between two and six weeks, depending on how physically demanding the job is.
• Advantages: implants are durable (about 10 years), implant surgery has a relatively low risk of complications, and implants can boost self-esteem.
• Risks include short- and long-term complications, the need for additional surgery (removal, replacement, scar-tissue removal or repositioning), BIA-ALCL and breastfeeding complications.
• Implants increase size but do not lift; a breast lift can be combined if sagging is a concern.
• Follow-up: bandages and possibly stitches removed after one to two weeks, then reviews at four to six weeks, three months and six months.
• Ask which implant type and size suit your body, how long implants last, what happens on rupture, what autologous breast augmentation is, and the full list of risks.

Read the original on my.clevelandclinic.org →

Fat Transfer Breast Augmentation: Procedure, Results & Risks

Treatment overview · Medically reviewed, last updated 2022-08-18

Cleveland Clinic's guide to fat transfer breast augmentation: liposuction removes fat from areas such as the belly, hips, back, legs or arms, and the purified fat is injected into the breasts to increase cup size by one to two sizes. It explains how the procedure differs from implants and reconstruction, who is and is not a candidate, how the outpatient surgery is performed, that results are lifelong (settling over up to six months), the risks, benefits and cons, recovery, when to call the doctor, and the effect on breast cancer risk and mammograms.

• A fat transfer breast augmentation uses fat from your own body to enlarge your breasts: fat is suctioned from several areas and injected into the breasts.
• Breast augmentation is cosmetic surgery to increase breast size and enhance shape; the two types are breast implants and fat transfer.
• Breast augmentation is for healthy people improving appearance and is not medically necessary; breast reconstruction after cancer always uses implants.
• Good candidates want slightly larger breasts without implants; people with little body fat, obesity, drastic weight fluctuations or who smoke may not be suitable.
• It is an outpatient procedure under general anaesthesia: fat is harvested by liposuction, purified in a centrifuge, then injected into different tissue layers of the breasts.
• Results are described as lifelong: fat cells settle over up to six months and remain for life, though extra fat is injected because some cells die after transfer.
• Risks include bleeding and bruising, fat cell death (necrosis) or fat migration, infection, and benign breast cysts or calcifications.
• Benefits over implants: a natural look and feel, the donor areas (belly, hips, back, legs or arms) become slimmer, and no implant-related risks such as rupture or capsular contracture.
• Cons: only one or two cup sizes of increase, breasts may still sag (a breast lift would be needed), and multiple procedures may be required.
• Recovery: chest wrapped with an elastic bandage and surgical bra, about a week off work, pain bruising and swelling for up to three weeks, swelling may last up to six months.
• Sleep on your back, take antibiotics and pain relievers as directed, and wear loose clothing to ease recovery.
• Call your provider for excessive bleeding, swelling or bruising, nausea and vomiting, severe pain, or signs of infection such as yellow discharge or fever.
• Fat transfer does not increase breast cancer risk and mammograms still work well afterwards, though it can cause microcalcifications that may need further tests such as ultrasound, MRI or needle biopsy.

Read the original on my.clevelandclinic.org →

Breast Augmentation (Augmentation Mammaplasty)

Procedure overview

The ASPS overview of breast augmentation: a procedure that uses breast implants or fat transfer to increase breast size. It explains that augmentation can restore volume lost after weight reduction or pregnancy, create a rounder shape or correct natural asymmetry, lists what the surgery can and cannot achieve, and points patients to implant safety, fat transfer and breast lift information.

• Breast augmentation (also called augmentation mammaplasty) uses breast implants or fat transfer to increase the size of the breasts.
• It can restore volume lost after weight reduction or pregnancy, achieve a rounder shape, or improve natural size asymmetry.
• When fat from another part of the body is used, the procedure is called fat transfer breast augmentation.
• Surgery can increase fullness and projection, improve the balance of breast and hip contours, and enhance self-image and confidence.
• Augmentation does not correct severely drooping breasts; a breast lift may be required alongside it for sagging breasts to look fuller and lifted.
• A lift can often be done at the same time as augmentation, or may require a separate operation.
• Implants are also used for breast reconstruction after mastectomy or injury.

Read the original on plasticsurgery.org →

Breast Augmentation Candidates

Patient guidance

ASPS guidance on who may be a candidate for breast augmentation. The page stresses that the procedure is deeply personal and should be chosen for oneself, lists the medical and developmental factors surgeons look for, and describes the common reasons people seek augmentation.

• The decision is deeply personal and should be made for yourself rather than to satisfy someone else.
• Candidates should be physically healthy and not pregnant or breastfeeding.
• Breasts should be fully developed and expectations should be realistic.
• Common motivations include dissatisfaction with small size, loss of shape or volume after pregnancy or weight loss, and changes with aging.
• Other reasons include an empty upper breast, asymmetry, or one or both breasts failing to develop normally.
• Reviewing before-and-after photos and recovery information beforehand helps set reasonable expectations.

Read the original on plasticsurgery.org →

Breast Augmentation Consultation

Patient guidance

What to expect at a breast augmentation consultation: the topics patients should be ready to discuss, the medical history the surgeon collects, and the physical assessment and measurements used to make a recommendation.

• Be ready to discuss your motivation, expectations and the outcome you want.
• Disclose medical conditions, allergies, previous treatments, medications, supplements and any substance use.
• Share family history of breast cancer and the results of previous mammograms or biopsies.
• The surgeon evaluates general health and risk factors, then takes detailed breast measurements and photographs.
• The examination covers size, shape, skin quality and nipple-areola placement before treatment is recommended.
• The surgeon discusses the expected outcome, risks and complications, and offers a written question checklist.

Read the original on plasticsurgery.org →

Questions to Ask Your Plastic Surgeon

Question checklist

The ASPS checklist of questions patients should take to a breast augmentation consultation, covering surgeon credentials, facility accreditation, the surgical plan, recovery support, risk handling and long-term considerations.

• Verify board certification by the American Board of Plastic Surgery and plastic-surgery-specific training.
• Ask about years of surgical training and where the surgeon has hospital privileges.
• Confirm the surgical facility is accredited, state-licensed or Medicare-certified.
• Discuss candidacy, the recommended implant shape, size and texture, and incision and placement choices.
• Ask how long recovery takes, what help you will need, the risks, and how complications would be handled.
• Ask about possible future operations, effects on breastfeeding, and how results change over time and after pregnancy.

Read the original on plasticsurgery.org →

Types of Breast Implants

Device overview

ASPS guidance on the main implant options: fill type (saline, silicone gel, structured saline) and shape or surface (form-stable "gummy bear", round, smooth, textured), with the FDA age approvals and the main trade-offs of each choice.

• Saline implants are filled with sterile salt water; if they leak the implant collapses and the body safely absorbs the fluid.
• Silicone gel implants are designed to mimic the feel of natural tissue; a leak may stay contained and the implant does not collapse.
• Structured saline implants contain an inner matrix intended to give a more natural feel.
• Form-stable "gummy bear" implants keep their shape even if the shell breaks; they use a firmer gel, need a longer incision and shaped versions can rotate.
• Round implants look fuller and do not rotate out of place; smooth implants feel softest but may ripple, while textured implants grip tissue.
• Textured surfaces are the surface most associated with breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Read the original on plasticsurgery.org →

Breast Augmentation Risks and Safety

Safety guidance

The full list of risks ASPS publishes for breast augmentation — from anesthesia complications and capsular contracture to implant-associated cancers and breast implant illness — together with the reminder that implants are not lifetime devices and that FDA-recommended screening applies to silicone implants.

• Common risks include anesthesia complications, bleeding or hematoma, infection, capsular contracture, implant rupture, changes in sensation, poor scarring and possible revision surgery.
• Rare cancers of the implant capsule (BIA-ALCL and BIA-SCC) and systemic symptoms described as breast implant illness are acknowledged.
• Most people with implants never experience serious complications, but FDA-approved devices still carry documented risks.
• Implants are not guaranteed for life; future replacement surgery may be needed.
• Ongoing breast-health exams and implant-condition checks are needed, and pregnancy, weight loss and menopause change appearance over time.
• Routine screening matters because some ruptures produce no symptoms.

Read the original on plasticsurgery.org →

Breast Augmentation Preparation

Pre-operative guidance

The medical and lifestyle steps ASPS advises before breast augmentation: tests and medication changes, stopping substances that increase bleeding, choosing an accredited surgical facility and arranging post-operative support.

• You may need blood tests and adjustments to your medications, including stopping certain drugs.
• Stop smoking and avoid aspirin and anti-inflammatory drugs that can increase bleeding.
• Recreational drugs such as cocaine must be stopped before surgery.
• Breast augmentation should be performed in an accredited outpatient or ambulatory surgical center or a hospital.
• If going home the same day, arrange a driver and someone to stay with you for at least the first night.

Read the original on plasticsurgery.org →

Breast Augmentation Procedure Steps

Procedure steps

The five steps of breast augmentation as set out by ASPS — anaesthesia, incision, implant placement, closing the incisions and the immediate result — with the incision and placement options and a caution about the transumbilical approach.

• Step 1: anesthesia with IV sedation or general anesthesia, selected for the patient.
• Step 2: incisions placed in discreet locations — around the areola (peri-areolar), in the breast fold (inframammary) or in the armpit (axillary).
• Step 3: the implant is placed either under the pectoral muscle (submuscular) or behind the breast tissue over the muscle (submammary).
• Step 4: incisions are closed with layered sutures plus skin sutures, adhesive or tape; scar quality depends on genetics, nicotine use and infection.
• Step 5: results are visible immediately after surgery.
• The belly-button (transumbilical) incision approach is associated with a higher complication rate.

Read the original on plasticsurgery.org →

Breast Augmentation Recovery

Recovery guidance

What to expect straight after breast augmentation: dressings and support garments, monitoring and discharge timing, the instructions and medications you go home with, and the pain and activity timeline during healing.

• Breasts are wrapped in gauze with an elastic bandage or support bra to limit swelling.
• Patients are monitored in recovery and typically discharged about an hour after surgery once stable.
• You receive written post-operative instructions, a follow-up appointment and possibly pain medication and an antibiotic.
• The support garment or bandeau should be worn around the clock as directed; incision-care instructions vary by surgeon.
• Take it easy for the first several days because of bleeding risk around the implant pockets, and resume exercise only when cleared.
• Acute pain usually subsides after one to five days, while soreness and swelling may persist for a few weeks.

Read the original on plasticsurgery.org →

Breast Augmentation Results

Results guidance

How breast augmentation results settle over time: shape finalising over the first weeks as swelling resolves, incision marks fading slowly, the follow-up cadence, and the fact that implants are not lifetime devices and results change with aging.

• Breasts are larger right away, but the final shape takes a few weeks as swelling subsides and the skin stretches.
• Some patients, such as those with asymmetry or very small starting breasts, may need a bandeau to help shape the result.
• Incision lines can take months — even a couple of years — to fade.
• Optimal results depend on following post-operative instructions and attending follow-up visits.
• Implants are not lifetime devices; annual exams evaluate breast health and implant integrity.
• Aging, weight fluctuation, hormones and gravity change the result; some patients later choose a lift or implant exchange.

Read the original on plasticsurgery.org →

Fat Transfer Breast Augmentation

Procedure overview

The ASPS page on fat transfer breast augmentation: liposuction is used to harvest fat from elsewhere in the body and reinject it into the breasts, offered as an option for people wanting a relatively small, natural-looking increase in size.

• Fat is taken by liposuction from other parts of the body and injected into the breasts to enhance them.
• It is an option for people looking for a relatively small increase in breast size.
• It is described as a choice for those who would prefer natural results.
• ASPS cites research on pre-expansion for mega-volume transfer, fat transfer as an alternative to implants, and techniques that substantially increase breast size using the patient's own fat.
• When fat transfer is used, the procedure is referred to as fat transfer breast augmentation rather than augmentation mammaplasty with implants.

Read the original on plasticsurgery.org →

Breast Augmentation Cost

Cost guidance

ASPS guidance on the cost of breast augmentation, including its published average surgeon fees for implant and fat-grafting augmentation, the expenses those figures exclude, and the insurance position for cosmetic surgery.

• Published average costs reflect surgeon fees only, not the total price of the procedure.
• Anesthesia, operating-room or facility fees, medical tests, garments, prescriptions and related expenses are excluded.
• The surgeon fee varies with experience, procedure type and geographic location.
• Many surgeons offer patient financing plans.
• Most insurance plans do not cover cosmetic augmentation, related complications or revision surgery.
• Some carriers exclude breast-disease coverage for implant patients.

Read the original on plasticsurgery.org →

Choosing a Plastic Surgeon

Credential guidance

The credentials ASPS says patients should look for: an ASPS member plastic surgeon board-certified by the American Board of Plastic Surgery (or the Royal College of Physicians and Surgeons of Canada), with the required training, exams, continuing education and accredited facility standards.

• Choose an ASPS member plastic surgeon board-certified by the American Board of Plastic Surgery or the Royal College of Physicians and Surgeons of Canada.
• Certification requires at least six years of surgical training after medical school, including a minimum of three years of plastic surgery residency.
• Surgeons must pass comprehensive oral and written exams and graduate from an accredited medical school.
• Continuing medical education including patient safety must be completed every year.
• Surgery must be performed in accredited, state-licensed or Medicare-certified facilities.
• The ABPS is recognized by the ABMS, and no ABMS-recognized certifying board has "cosmetic surgery" in its name.

Read the original on plasticsurgery.org →

Breast Augmentation

Procedure page · Updated 2021

The BAAPS procedure page for breast augmentation (bilateral breast augmentation, BBA) — an operation to enlarge the breasts, usually by inserting an implant beneath the breast tissue. The page describes the procedure as potentially life-enhancing but stresses that it is a big decision, major surgery with potential risks, and that the hoped-for result cannot be guaranteed. It links to the full joint patient booklet and lists the common names patients use for the procedure.

• Breast augmentation (BBA) is an operation to enlarge the breasts, usually by inserting an implant beneath the breast tissue.
• It can be a life-enhancing procedure, but having a breast enlargement is a big decision.
• It is major surgery with potential risks, and the result you may hope for cannot be guaranteed.
• The joint ABS, BAAPS and BAPRAS booklet explains the procedure and the short- and long-term risks; any further questions after consultation should be asked of your surgeon.
• The procedure is also commonly known as a boob job, enlargement, implant or breast size.

Read the original on baaps.org.uk →

Your Guide to Breast Augmentation (ABS, BAAPS & BAPRAS, Edition 2, 2021)

Patient information booklet · Updated 2021-04

The joint patient booklet from the Association of Breast Surgery, BAAPS and BAPRAS. It covers who the guide is for and what breast augmentation involves; how to seek a consultation, check a surgeon's qualifications, understand costs and the cooling-off period; the surgery itself including implant placement (sub-glandular, sub-muscular, dual plane), operation time and recovery; implant type, size, shape and texture; a full list of complications with typical frequencies; long-term consequences including mammography, BIA-ALCL and breast implant illness; alternatives such as lipofilling and mastopexy; and the UK Breast and Cosmetic Implant Registry. Editors: Lee Martin and Emma de Sousa; reviewed by PRASEAG.

• Breast augmentation is usually done by inserting an implant beneath the breast to make it look larger; it can enlarge always-small breasts or fill out breasts that have emptied, for example after pregnancy.
• It will reshape breasts to some extent and can also be used to correct unequal breast size.
• Fat transfer (lipomodelling, lipofilling or fat grafting) is an alternative in a few people but is not suitable for all and often requires more than one episode of surgery.
• Patients tend to be pleased with results, but you need realistic expectations and must understand what can and cannot be achieved, the limitations of surgery and the long-term consequences of implants.
• Your initial consultation should be with the surgeon who will do the operation; your surgeon will normally seek permission to write to your GP; a consultation fee is normal.
• At consultation you will be examined, measurements taken, and implant shapes, sizes and pocket positions discussed; some surgeons use implant sizers in a bra or 3D photography, which is only a guide — the same implant can look very different in different people.
• You should be given a cooling-off period of at least two weeks before surgery and offered a second consultation; you should not feel rushed.
• Breast augmentation is a lifetime commitment, not a one-stop permanent solution: you will need revision surgery as the years go by and must be prepared personally and financially.
• Nobody needs an urgent breast augmentation — if you are not offered a cooling-off period or are put under pressure, walk away.
• Surgeons should be listed on the GMC specialist register (gmc-uk.org); membership of ABS, BAAPS and/or BAPRAS indicates a standard set of recognised qualifications.
• Internet search listings may be promotional; a prominent listing measures marketing ability, not service quality.
• Cosmetic breast augmentation is not available on the NHS except in exceptional circumstances such as very uneven breasts, no breasts, or as part of reconstruction; after surgery abroad the NHS will only deal with emergency complications on return.
• Breast enlargement involves placing an implant under the breast tissue; implants are usually inserted through an incision under the breast at the crease, but can also go in via the armpit or around the nipple.
• Implants can sit behind the breast on top of the chest wall muscle (sub-glandular) or behind the breast and muscle (sub-muscular); your surgeon will advise which is appropriate.
• Sub-glandular placement is considered the simplest enlargement procedure and less likely to cause significant discomfort; it is also effective with some drooping.
• Sub-muscular placement provides more padding for the implant, helpful for slender patients and those with little breast tissue, reducing the chances of feeling or seeing the implant.
• Dual plane augmentation combines the two routes, placing implants partly behind the breast and partly behind the muscle; implants behind the muscle may move with muscle contraction (animation), which is normal.
• Breast enlargement surgery takes about one-and-a-half hours, usually under general anaesthetic; you may go home the same day but many patients spend one night in hospital.
• You will be mobile from day one and should be back to full exercise within six weeks; one to two weeks off work is recommended.
• At first the breasts may look high and the skin tight; this tends to settle over the first six weeks, with the long-term result emerging over 3-4 months as a more natural shape appears.
• Scars tend to be red in the first six weeks, change to purple over the next three months, then fade to white; abnormal scarring can occur.
• All implant shells are made of silicone; some have an additional polyurethane coating; shells are filled with silicone gel or saline, and implants have been used since the 1960s with evidence suggesting they are safe.
• Most patients are offered silicone gel-filled implants — they feel most natural, have a range of shapes and are durable; saline implants tend to feel less natural, ripples may be more visible and they carry a risk of deflation; all other filler materials have been withdrawn for use in the UK.
• Implants are supplied by volume and it is not possible to guarantee a cup size; the larger the implant and the slimmer the patient, the less natural the result, and an out-of-proportion implant is more likely to cause drooping, tissue stretching and palpability.
• Implants are round or teardrop-shaped (anatomical); round implants give bigger volume at the top and are the same width as tall, while teardrop implants allow width and height to be chosen separately; both come in varying degrees of projection.
• Texturing reduces capsular contracture (particularly with implants placed in front of the muscle) and reduces movement or rotation; anatomical implants tend to be textured because rotation would alter the shape, while rotation of a round implant is not noticeable.
• Textured surfaces are related to BIA-ALCL, an uncommon condition; smooth-surface implants currently appear to have no link to BIA-ALCL; smooth implants are almost always round and can take several months to settle, and may slip sideways (lateral displacement) or drop below the crease (bottoming out).
• Small quantities of silicone from implants can be taken up by the body and found in breast tissue and sometimes armpit lymph glands; silicone granuloma is inflammation and extra tissue around silicone deposits.
• Over time the implant shell may fail and gel may leak; many ruptures are discovered by accident, and a ruptured implant should be removed — replacement at the same or a later operation is a choice.
• There is no association between breast augmentation and breast cancer.
• Serious complications are uncommon, occurring in less than 1 in 100 operations.
• Bleeding (haematoma) occurs in less than 1 in 100, usually immediately but occasionally up to two weeks later; the breast becomes very swollen and tight and you return to theatre to have the blood removed — haematoma can increase the risk of later capsular contracture.
• Infection occurs in less than 1 in 1000 cases, usually apparent over the first two or three weeks; most patients with an established infection around the implant need the implant removed, and a new implant cannot be inserted immediately — three to six months should wait for the infection to resolve.
• Perfect symmetry is not an achievable goal; asymmetry can be of breast or nipple, size, shape and position, may appear more pronounced after surgery, and implants can settle differently in their pockets.
• Some patients have a naturally wide cleavage that implants will not improve; with sub-muscular placement the cleavage can appear wider, and breasts and implants may fall to the sides when lying down, which is normal.
• Stretch marks may develop, especially with larger implants, and veins may become more noticeable.
• Breasts will sag with time because they are larger and heavier; the larger the implant, the more the breast will droop, and breasts may bottom out.
• Implants do not interfere with the ability to breastfeed, though some evidence suggests milk production may be reduced in some women; there is no evidence of increased illness in children of women with silicone gel implants.
• Every patient forms a scar capsule around the implant; capsular contracture — when this scar contracts and makes the implant feel firmer — is up to 1 in 10 of all augmentations, but most of those patients will not need revision surgery.
• About 1% (1 in 100) a year need re-operation for any reason, so after 10 years about 10% will have had more surgery; capsular contracture is the most common reason and is likely to recur in 1 in 2 cases after secondary surgery.
• Around 1 in 5 patients will have reduced nipple sensation; recovery can take up to 12 months, but 1 in 10 will have some permanent numbness.
• It is common to be able to feel the implant, especially in slim patients or those with little breast tissue; this is an inevitable consequence of the operation and will not improve with time; lipomodelling can improve the situation in some patients.
• The American Core study (FDA Update 2011) suggested 1 in 10 implants had ruptured at 10 years, and half of all implants may rupture by 15 years; many ruptures are silent, contained within the capsule, and do not appear harmful.
• There is no universally agreed replacement schedule for implants and it is unusual to need exchange before ten years; if you have noticed no change you do not need regular follow-up or scans — but you should be prepared personally and financially for possible future surgery.
• Other reasons for re-operation include wanting larger implants, shape change with time or after pregnancy and weight fluctuation, rotation of teardrop implants, and intermittent swelling around implants.
• Long-term problems will not usually be covered by the package bought at the time of augmentation, and the NHS should not be expected to provide future private treatment.
• BIA-ALCL is recognised by the WHO as a condition associated with breast implants; it is not a breast cancer but a cancer of the scar tissue capsule, occurring between 2 and 28 years after insertion (average 8 years), usually presenting as swelling around the implant (seroma), and usually treated by removing the implant and capsule.
• Most BIA-ALCL cases worldwide have occurred with textured implants, with higher numbers where the texture is coarser; breast implants continue to have safety approval from the MHRA and FDA and continue to be used in reconstruction worldwide.
• Breast Implant Illness (BII) is a term used by some patients for symptoms including tiredness, brain fog, joint aches, immune-related symptoms, sleep disturbance, depression, hormonal issues, headaches, hair loss, chills, rash and neurological issues; it is not a medical diagnosis and there is no proven association with implants.
• Some patients report symptoms improve if implants are removed, but this is not true for all; research continues.
• Implants do not make breast self-examination more difficult, but they do interfere with mammography because X-rays cannot pass through the implant; tell the mammography service you have implants — special views or a different centre may be used, and some patients opt for private MRI screening.
• It is safe to sunbathe and fly with implants; implant massage is not needed and is not recommended with modern textured implants; routine implant replacement after a specified time is not recommended.
• The only alternative surgical technique to enlarge the breast is lipofilling: fat removed by liposuction from hips, thighs or tummy and injected into the breast; only a relatively small amount can be injected so multiple operations are needed for a worthwhile effect, and some fat is absorbed in the initial weeks — fat that lasts brings permanent enlargement.
• Your own fat is the only substance that can be safely injected into the breast; other materials have been tried and withdrawn — do not allow anyone to inject anything other than your own fat.
• Breast uplift (mastopexy) is a different operation that lifts the nipple and breast tissue and tightens the skin without an implant; scarring is more obvious, and uplifted breasts tend to droop again with time and gravity.
• Mild droopiness can be improved by augmentation alone, but where volume loss and droopiness both bother you, augmentation alone will not solve drooping — your surgeon should discuss augmentation with mastopexy, as one operation or in two stages.
• In the UK the national Breast and Cosmetic Implant Registry records all implants placed or removed, allowing patients to be traced in the event of a future recall and identification of trends; entry requires consent and is strongly recommended.
• Avoid any deal with a non-refundable deposit or financial inducement to proceed — even refunding a consultation fee if you proceed with surgery is considered an inducement and against GMC guidance.
• A package price covering the entire process and the cost of treating complications in the initial weeks is appropriate; the cheapest deal may not be the best.
• Before your consultation it should be possible to obtain an approximate cost from your private hospital or the surgeon's secretary; after consultation(s) you should be given a written quote.

Read the original on baaps.org.uk →

Breast Implant Safety

Safety information page

BAAPS information and guidance on breast implant associated conditions, with links to patient documents on Breast Implant Illness (BII) and BIA-ALCL, the association's updated BII statement of October 2022, joint statements on BIA-SCC and other breast implant associated lymphomas, PRASEAG guidance, the Allergan Natrelle textured implant withdrawal statement, the BAAPS/ABS/BAPRAS joint statement on breast implant safety, and BAAPS advice on PIP implants including signs and symptoms of rupture or inflammation.

• BAAPS publishes patient documents on Breast Implant Illness (BII) and Anaplastic Large Cell Lymphoma (BIA-ALCL), plus an updated BII statement from October 2022.
• In July 2023 BAAPS issued a joint statement on Breast Implant Associated Squamous Cell Carcinoma and other breast implant associated lymphomas.
• PRASEAG issued a statement on breast implants and guidance for patients following MHRA advice on BIA-ALCL, with BAAPS, BAPRAS and the Association of Breast Surgery working together.
• BAAPS issued statements on the withdrawal of Allergan (Natrelle) textured implants and a joint BAAPS/ABS/BAPRAS statement on breast implant safety (27 November 2018).
• On PIP implants the 2013 expert group found no evidence they were responsible for an increased rate of breast cancer; the gel was less cohesive than most contemporary implants and had a greater potential to cause local inflammation on rupture.
• Signs of PIP rupture, leak or inflammation include lumpiness of the breast, lumpiness or swelling of regional lymph nodes, change in shape and size, redness, tenderness, swelling and firmness; symptoms may include pain and hypersensitivity.
• Patients unsure of their implant make should contact their surgeon or provider; patients with signs or symptoms of rupture or irritation should seek advice from their surgeon.
• BAAPS advised removal or replacement of PIP implants as a precaution because of the inferior quality of the gel, regardless of rupture rate.
• Breast implants continue to have safety approval from government organisations such as the UK MHRA and USA FDA and continue to be used in reconstruction worldwide.

Read the original on baaps.org.uk →

BAAPS Consumer Safety Guidelines

Safety guidance

BAAPS fourteen-point consumer safety guidance for anyone considering aesthetic surgery: make your own decision, do your research, ask the right questions at every stage, know your surgeon and check credentials on the GMC specialist register, beware pressurising selling and non-refundable deposits, expect a two-week cooling-off period, get a second opinion if needed, time the surgery well, think about location and travel, talk to your GP, remember you can change your mind, use common sense about special offers, and take your time.

• Only you can decide whether to go ahead with aesthetic surgery, but you need specialist input to understand what is possible, suitable and the risks and benefits.
• No procedure is 100% risk free and no surgeon can give a 100% guarantee of results; research the limitations and risks before any consultation.
• Know what will happen at every stage — pre-operative assessment, the day of surgery, aftercare, recovery time, follow-up and the possibility of further procedures.
• Your consultation should be with the actual surgeon who will operate; clinic managers and nurses should not be your only point of contact.
• A specialist plastic surgeon should have the FCRS (Plast) qualification and be listed on the Specialist Register of Plastic Surgeons with the GMC.
• Avoid any marketing or selling technique that financially or temporally traps you, including booking fees and non-refundable advances; your decision should be free of incentive.
• You should expect a two-week cooling-off period following your consultation to consider your options.
• Get a second opinion if necessary; a reputable surgeon will never apply a time limit, withhold key information or upsell additional surgery.
• Avoid surgery around major life events such as moving house, changing job, bereavement, relationship breakdown or the arrival of children.
• Give careful consideration to travelling long distances or overseas for surgery; travel insurance often will not cover treatment or extra nights for elective aesthetic procedures.
• Your GP can offer unbiased advice with no vested interest and may discuss functional, psychological and social benefits.
• You can cancel right up until the time you go to sleep for surgery.
• Don't be tempted by special offers or rushed into a quick surgery slot; anything that seems too good to be true probably is.
• Take as much time as you need after an initial consultation; a surgeon might recommend two consultations before booking a procedure.

Read the original on baaps.org.uk →

Continuing Education Activity

StatPearls review section · Last updated 2023-07-18

The review's opening summary: breast augmentation increases breast size, most often with an implant and less commonly with fat transfer, and is among the most commonly performed plastic surgery procedures in the United States. It frames the activity around indications, contraindications, complications and the role of the interprofessional team before and after surgery.

• Objectives are to identify the different techniques, describe the indications, review the complications and improve care coordination among the team.
• The FDA restricted silicone-filled implants for cosmetic enhancement from 1992; reconstructive patients continued to receive them after mastectomy.
• The activity is written for the interprofessional team involved in pre- and postoperative care.

Read this section on ncbi.nlm.nih.gov →

Introduction

StatPearls review section · Last updated 2023-07-18

Breast augmentation is a surgical procedure in which breast size is enhanced, either by placing an implant or, less commonly, through fat transfer. The section traces FDA policy on silicone implants from the 1992 restriction to the 2006 reversal, describes the shift towards cohesive gel and form-stable implants, and sets out monitoring advice and the fact that implants are not permanent devices.

• Extensive research failed to confirm the disease fears that led to the 1992 silicone restriction, and the FDA allowed general use of silicone-filled implants again in 2006.
• By 2017 the majority of patients undergoing augmentation received cohesive gel silicone implants, with makers introducing different levels of gel firmness.
• The FDA recommends MRI screening every two years in patients with silicone implants to detect subclinical leaks, but adherence is incomplete and MRI readings can be false positive.
• Higher gel cohesion may lower rupture rates, but the review states that eventually all implants will rupture or break.

Read this section on ncbi.nlm.nih.gov →

Anatomy and Physiology

StatPearls review section · Last updated 2023-07-18

The anatomy relevant to augmentation: the breast sits on the anterior chest wall below the clavicle, bounded medially by the sternum, laterally by the latissimus dorsi and inferiorly by the inframammary fold, with the pectoralis muscles forming its posterior boundary.

• The inframammary fold is a dermal structure formed by fusion of the superficial and mammary fascia.
• Blood supply comes from the subdermal plexus with major contributions from the internal mammary artery, external mammary artery and intercostal perforators.
• Nerve supply is mainly through the intercostal plexus, with most contribution from the third to fifth intercostal nerves.

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Indications

StatPearls review section · Last updated 2023-07-18

Implants are placed for reconstruction after mastectomy, for developmental disorders such as hypomastia, and for elective reasons related to self-image. Hypomastia may follow normal development or involution, especially after pregnancy, and people of all personality types may seek the procedure.

• Reported motivations include reconstruction, developmental under-development of the breast and elective enhancement of self-image.
• The review notes that when surveyed after surgery, the vast majority of women would undergo the operation again.

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Contraindications

StatPearls review section · Last updated 2023-07-18

Most patients have no contraindications, but the review lists the conditions that should prevent surgery and the patient factors that should pause it.

• Absolute reasons not to operate include active infection of the breast, active cancer and pregnancy.
• Relative reasons include a history of autoimmune disease, current radiation treatment, unstable medical conditions and known sensitivity to silicone.
• Psychological instability or unrealistic expectations are also given as reasons not to proceed.

Read this section on ncbi.nlm.nih.gov →

Equipment

StatPearls review section · Last updated 2023-07-18

Routine operating-room equipment is usually sufficient. Extras depend on the approach: a lighted retractor or headlight for visualising the pocket, an endoscope for umbilical or axillary approaches, and sometimes an implant sleeve used as part of a no-touch technique.

• A no-touch technique limits handling of the implant to reduce implant trauma and bacterial contamination.
• Endoscopic equipment may be required when the umbilical or axillary route is used.

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Personnel

StatPearls review section · Last updated 2023-07-18

The operating team normally consists of the surgeon, a scrubbed assistant, an anaesthesiologist and a circulating nurse working together in the operating room.

• Standard theatre roles apply: surgeon, scrubbed assistant, anaesthesiologist and circulating nurse.
• The team structure is described as the same as for other routine surgical procedures.

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Preparation

StatPearls review section · Last updated 2023-07-18

Patients are prepared for surgery as for any other surgical procedure, following the usual preoperative pathway.

• Preparation follows the routine preoperative work-up used for any operation, including assessment and consent.
• The review places emphasis on informed consent and on the pre-operative teaching that reduces later problems.

Read this section on ncbi.nlm.nih.gov →

Technique or Treatment

StatPearls review section · Last updated 2023-07-18

Two main implant types are described, saline-filled and silicone-filled, both with a silicone outer shell that can be smooth or textured. Implants can sit above or beneath the pectoralis muscle, be reached through inframammary, transaxillary or peri-areolar incisions, and are usually done as an outpatient operation under general anaesthesia.

• Saline implants are inserted empty and filled through a port, typically with a 25 to 50 mL range specified by the manufacturer.
• Saline implants are FDA-approved from age 18 for augmentation and at any age for reconstruction; silicone gel implants are approved from age 22.
• Silicone implants suit patients with thin soft-tissue coverage better, showing less rippling and a softer, more natural feel.
• Texturing prevents rotation in shaped implants and may lower capsular contracture in the subglandular pocket, but not in the submuscular pocket.
• No single placement method is uniformly accepted as best; the choice is made jointly by patient and surgeon.
• The operation generally takes 45 to 90 minutes; most patients return to light work within a week, with full activity taking up to six weeks.

Read this section on ncbi.nlm.nih.gov →

Complications

StatPearls review section · Last updated 2023-07-18

Complication rates are described as low, but no implant is a lifetime device. Early problems include infection, bleeding and sensory change; later problems include malposition, deflation or leak and capsular contracture, which may require further surgery.

• Surgeons commonly estimate a 15 to 20 year lifespan for implants, with no uniform recommendation on routine replacement.
• Early complications listed are infection, scarring, asymmetry, haematoma, seroma, breast pain, poor cosmetic outcome and changes in nipple or breast sensation.
• Later complications listed are implant malposition or displacement, implant deflation or leak, and capsular contracture.
• Capsular contracture is graded 1 to 4 and may require surgical correction or implant removal when severe.
• Staphylococcus epidermidis and Cutibacterium acnes are the microorganisms most commonly isolated in studies of capsular contracture, supporting a suspected biofilm or low-grade infection mechanism.
• A slim possibility of breast implant-associated anaplastic large cell lymphoma (ALCL) is reported, possibly linked to a particular type of implant texturing, although the exact relationship is not yet determined.

Read this section on ncbi.nlm.nih.gov →

Clinical Significance

StatPearls review section · Last updated 2023-07-18

The procedure remains highly popular, and the review stresses that clinicians treating women with implants should be aware of them, because the implants are relevant to other conditions and to screening.

• The American Society of Plastic Surgeons reported approximately 290,000 augmentation procedures performed in the United States in 2016.
• The vast majority of patients report improved self-esteem and satisfaction with the decision.
• Doctors treating these patients for other conditions should have an awareness of the procedure and of implants in general.

Read this section on ncbi.nlm.nih.gov →

Enhancing Healthcare Team Outcomes

StatPearls review section · Last updated 2023-07-18

Risk reduction is described as a team effort: informed consent, nurse-led preoperative instruction, smoking cessation, pharmacist medicines checks and early recognition of problems. Outcomes are reported as good, with most patients pleased with the result.

• Many past litigations arose primarily from a lack of informed consent, which the pre-operative visit is meant to address.
• Patients should be instructed to stop smoking and make positive lifestyle changes so results last longer.
• Pharmacists contribute by checking allergies and explaining medicines, which can reduce infection and help pain control.
• Surveys cited in the review indicate about 70 to 80 percent of patients are satisfied and feel the outcome was perfect.

Read this section on ncbi.nlm.nih.gov →

References and Further Reading

StatPearls reference list · Last updated 2023-07-18

The review cites twelve sources spanning secondary augmentation, transgender breast contouring, anatomical versus round implants, fat grafting, capsular contracture risk factors, cosmetic-tourism infection, subclinical implant infection, outcomes series and long-term follow-up.

• The full reference list, with links to each PubMed record, is reproduced in the references section of this page.
• Every citation can be checked at source through its PMID link.

Read this section on ncbi.nlm.nih.gov →

Breast augmentation surgery

Medical Encyclopedia article · Page last reviewed 2025-02-17

The MedlinePlus overview of breast augmentation: enlarging or reshaping the breasts by placing an implant behind the breast tissue or under the chest muscle fascia. The article covers the two implant fills (sterile saline and silicone), the outpatient or hospital setting, general versus local anaesthetic, the four usual incision routes, how implant and technique choices affect pain, appearance, implant integrity and future mammograms, the reasons for surgery, the risks (including capsular contracture, implant rupture, breast implant-associated lymphoma and reported systemic symptoms), what to arrange before the operation, what happens afterwards, and the expected outcome.

• Augmentation is done by placing an implant behind the breast tissue or beneath the chest muscle, and implants are sacs filled with either sterile salt water or silicone.
• The operation is performed at an outpatient surgery clinic or in a hospital, most often under general anaesthetic, with local anaesthetic as an alternative.
• Four incision routes are described: the natural fold under the breast (the most common), the armpit using an endoscope, the edge of the areola, and, for saline implants only, a route near the navel through which the empty implant is tunnelled and then filled.
• An areola-edge incision may bring more difficulty with breastfeeding and more loss of nipple sensation, and may carry a higher risk of capsular contracture.
• Implant type, implant size and the chosen operation influence post-operative pain, the appearance achieved, the chance of later breakage or leakage, and the extra views future mammograms will need.
• Reasons for the procedure include increasing breast size, changing breast shape and correcting a congenital deformity; patients are told to expect improvement rather than perfection.
• Risks shared with any operation are listed as reactions to medicines, breathing problems, bleeding, blood clots and infection.
• Breast-specific risks include difficulty breastfeeding, numbness around the nipple or surrounding skin, small or thickened raised scars, uneven nipple position, differences in size or shape between the two breasts, implant breakage or leakage, visible rippling, infection requiring implant removal, the need for more breast surgery and puncture of the lung.
• A capsule of scar tissue normally forms around a new implant; when it thickens it can change the breast's shape, harden the breast tissue or cause pain.
• A rare immune-system cancer, breast implant-associated lymphoma, has been reported with some implants, presenting as a mass or swelling around the implant with breast pain and treated by removing the implant and the tissue around it.
• Some people report systemic symptoms after implants — grouped under breast implant illness, which the page says is not yet established as a recognised illness — including fatigue, memory and concentration problems, joint and muscle pain, anxiety, hair loss, depression, rash, autoimmune disease, inflammation and weight change; some improve after removal and some do not.
• Before surgery patients should ask about a screening mammogram, disclose any pregnancy possibility and every medicine or supplement they take, review diabetes, heart disease and other conditions, stop smoking (which slows healing and raises clot risk), prepare the home and arrange transport and help for one to two days.
• During the week before surgery, blood thinners such as aspirin, ibuprofen, naproxen and vitamin E are commonly paused on the surgeon's advice, and fasting and morning-medicine instructions come from the surgical team.
• Afterwards the breasts are wrapped in bulky gauze or a surgical bra, drainage tubes are removed within about three days, and massaging from around day five may be suggested to reduce capsular hardening after checking with the provider.
• Outcomes are usually very good, scars are permanent and most visible during the first year before fading, a supportive bra may be worn for a few months, and later tests may be advised to confirm the implants are intact.

Read the original on medlineplus.gov →

Cosmetic breast surgery - discharge

Patient instructions · Page last reviewed 2025-02-17

Home-care instructions after cosmetic breast surgery — augmentation, lift or reduction. It covers what happens in hospital, what to expect once home, activity and driving limits, dressing and wound care, pain medicines and general self-care, and the symptoms that should prompt a call to the surgical team.

• Surgery is done under general or local anaesthetic and takes an hour or more; patients wake with a gauze dressing or surgical bra and may have drainage tubes in place.
• Most people go home the same day, though some stay one to two nights in hospital.
• Pain, bruising and swelling are normal and settle over days to weeks, and reduced sensation in the breast skin or nipple may return gradually.
• Short walks are encouraged early to support circulation; returning to work or other activities commonly takes 7 to 14 days or longer.
• Heavy lifting, strenuous exercise and overstretching the arms are avoided for 3 to 6 weeks, and driving should wait at least two weeks and until drowsiness-inducing pain medicines have stopped.
• Drainage tubes are removed at a visit within a few days and stitches within two weeks; surgical glue dissolves on its own and does not need removing.
• Dressings stay in place as instructed, incisions are kept clean, dry and covered, and are checked daily for redness, pain or drainage.
• Once dressings are no longer needed, a soft wireless supportive bra is worn day and night for 2 to 4 weeks; bathing is limited to showering after drains come out, with baths, hot tubs and swimming deferred until stitches and drains are out and the surgeon agrees.
• Scars may take several months to more than a year to fade, and sunblock of SPF 30 or higher is advised whenever the scars are exposed.
• Smoking is not permitted because it slows healing and raises the risk of complications and infection; alcohol is avoided while taking narcotic pain medicines, and aspirin, ibuprofen and other medicines or supplements need the surgeon's approval.
• The surgeon should be contacted for increasing pain, redness, swelling, yellow or green drainage, bleeding or bruising at the incision, medicine side effects, a temperature of 100°F (38°C) or higher, numbness, loss of motion, or sudden swelling of the breast.

Read the original on medlineplus.gov →

Surgical wound care - open

Patient instructions · Page last reviewed 2026-01-01

General MedlinePlus instructions for looking after a surgical incision that has broken open and is being left to heal rather than re-closed with stitches. It explains healing from the inside out, hand hygiene before dressing changes, removing and replacing dressings, cleaning and irrigating the wound, disposal of used supplies, and the signs that mean a call to the provider. The breast augmentation article links this page for wound care after breast surgery.

• A wound left open heals from the inside out, and the dressing absorbs drainage so the surface skin does not close before the tissue underneath has filled in.
• Hands should be washed before every dressing change — an alcohol cleanser, or soap and water for 15 to 30 seconds including under the nails, with jewellery removed.
• The skin around the wound is cleaned with saline or mild soapy water; alcohol, peroxide, iodine and antibacterial cleansers are avoided because they can damage wound tissue and slow healing.
• Where irrigation is advised, a syringe of saline or soapy water is held about 2.5 to 15 cm from the wound to wash away discharge, then the area is patted dry.
• No lotion, cream or herbal remedy goes on or near the wound without the provider's agreement; dressings are used once only and soiled material is bagged before disposal.
• Contact the provider for more redness, pain, swelling or bleeding, a wound that looks larger, deeper, dried out or dark, thicker or foul-smelling discharge, or a temperature of 100.5°F (38°C) or higher.

Read the original on medlineplus.gov →

Breast lift

Medical Encyclopedia article

MedlinePlus Medical Encyclopedia article on breast lift (mastopexy), listed by MedlinePlus among the cosmetic breast procedures alongside augmentation and reduction, and referenced from the cosmetic breast surgery discharge instructions.

Read the original on medlineplus.gov →

Breast reduction

Medical Encyclopedia article

MedlinePlus Medical Encyclopedia article on breast reduction (reduction mammoplasty), indexed on the Plastic and Cosmetic Surgery topic page and referenced from the cosmetic breast surgery discharge instructions as a related procedure.

Read the original on medlineplus.gov →

Breast augmentation - series

Medical Encyclopedia image series

Illustrated image series walking through breast augmentation, one of three breast procedure series (with lift and reduction) published in the MedlinePlus encyclopedia and linked from the breast augmentation article page.

Read the original on medlineplus.gov →

Breast lift (mastopexy) - series

Medical Encyclopedia image series

Illustrated image series covering breast lift (mastopexy), including the incision patterns used, published in the MedlinePlus encyclopedia.

Read the original on medlineplus.gov →

Breast reduction (mammoplasty) - series

Medical Encyclopedia image series

Illustrated image series covering breast reduction (mammoplasty) and its indications, published in the MedlinePlus encyclopedia.

Read the original on medlineplus.gov →

Breast lift (anatomy video)

Anatomy video

MedlinePlus anatomy video explaining the breast lift procedure, embedded and recommended from the breast augmentation article page.

Read the original on medlineplus.gov →

Plastic and Cosmetic Surgery

Health topic page · Page last reviewed 2024-12-17

The MedlinePlus health topic hub for plastic and cosmetic surgery. It summarises the body areas people most often have reshaped — including increasing, reducing or reshaping sagging breasts — and links out to the encyclopedia articles and image series, the breast lift video, ASPS plastic surgery statistics, ClinicalTrials.gov searches for breast implants and plastic surgery, and patient handouts including the breast augmentation article in this library.

• Breast surgery appears among the most commonly requested cosmetic changes: enlarging, reducing or reshaping sagging breasts.
• The page indexes the breast augmentation, lift and reduction encyclopedia articles, their image series and the breast lift anatomy video.
• It links to FDA breast implant information, American Society of Plastic Surgeons statistics and ClinicalTrials.gov searches for breast implants and plastic surgery procedures.
• English and Spanish versions exist for the topic page and most of the linked resources.

Read the original on medlineplus.gov →

Saline breast prosthesis

Article section

The history, surgical handling and cosmetic trade-offs of salt-water-filled implants.

• First commercial saline prosthesis presented by Laboratoires Arion (France) in 1964.
• Inserted empty through a short incision, then filled with saline and contoured for symmetry.
• Good-to-excellent size and contour results, but rippling can show in women with little breast tissue.
• With ample breast tissue and submuscular placement, results match those of silicone-gel implants.

Read this section on Wikipedia →

Silicone-gel breast prosthesis

Article section

Five generations of silicone-gel implant design, from the 1963 Cronin–Gerow teardrop to today's cohesive gel.

• Invented in 1961 by Frank Gerow and Thomas Cronin; manufactured by Dow Corning; first used in 1962.
• Second-generation thin shells proved fragile, with higher rupture, leakage and capsular contracture rates.
• Polyurethane coating reduced contracture but was dropped in the U.S. over TDA, a carcinogenic breakdown product; still used in Europe and South America.
• Fifth-generation semi-solid cohesive gel reduces leakage and migration, with lower contracture and rupture rates in 2004–2005 studies.

Read this section on Wikipedia →

Alternative-composition breast prosthesis

Article section

Historic fillers — soy oil, polypropylene string, cartilage, wool, rubber, Teflon-silicone — described as harmful and discontinued.

• Listed as the third category of prosthetic breast.
• The article describes these filler substances as harmful to the woman's body.

Read this section on Wikipedia →

Structured breast prosthesis

Article section

Nested saline-filled shells approved in 2014 in the U.S. and Canada; now discontinued.

• Approved by the FDA (U.S.) and Health Canada in 2014.
• Three nested silicone-rubber shells; saline fills the two spaces between them.
• Inserted folded and empty, then filled with saline in the pocket.

Read this section on Wikipedia →

Types of surgical incision

Article section

Five incision routes for placing a prosthesis: inframammary, periareolar, transaxillary, transumbilical and transabdominal.

• Inframammary gives the best access; periareolar is short but raises contracture and duct/nerve risks.
• Transaxillary, TUBA and TABA routes avoid scarring the breast skin.
• Incision choice shapes scar visibility, access, and breastfeeding risk.

Read this section on Wikipedia →

Implant-pocket placement

Article section

Four placements relative to the pectoralis major muscle: subglandular, subfascial, subpectoral (dual plane) and submuscular.

• Subglandular is closest to the natural plane but more prone to rippling in thin tissue.
• Dual-plane (subpectoral) covers the upper implant with muscle while letting the lower half expand — with some risk of animation deformity.
• Submuscular places the implant fully under the muscle without releasing its lower origin.
• A 2026 series of 198 dual-plane II patients reported 1.0% revisions for superior malposition and 0.5% delayed mastopexy.

Read this section on Wikipedia →

Post-surgical recovery

Article section

Scar healing, return to normal activities and exercise limits after augmentation mammoplasty.

• Scars heal at about 6 weeks and fade over several months, depending on skin type.
• Most patients resume normal daily activities at about 1 week after surgery.
• Submuscular placement means longer convalescence and more pain, because chest muscles were cut.
• No exercise or strenuous activity for about six weeks; gentle arm movement is encouraged early.

Read this section on Wikipedia →

Medical complications

Article section

Surgical risks and breast-specific complications, including reported rates and the 2019 Allergan recall.

• Usual surgical risks: adverse anaesthetic reaction, haematoma, seroma and wound infection.
• Breast-specific complications: pain, altered sensation, wrinkling or asymmetry, skin thinning, impeded breastfeeding and symmastia.
• Implant surgery and tissue-expander complications occur in about 6–7% of patients.
• By 10 years, about 20% of aesthetic and 50% of reconstruction patients needed explantation of a failed prosthesis.
• In 2019 the FDA recalled all Allergan Biocell textured implants over BIA-ALCL, a lymphoma linked to their surface.

Read this section on Wikipedia →

Rupture of the prosthetic breast

Article section

How the body's fibrous capsule can compress an implant until it ruptures, intracapsularly or extracapsularly, and how rupture is detected.

• The immune system encases any implant in a collagen capsule; thickening can compress and rupture it.
• Intracapsular rupture keeps filler inside the capsule; extracapsular rupture lets it migrate into the thorax, causing granulomas or lymphadenopathy.
• Rupture is often unnoticed at first because saline and silicone gel are biologically inert.
• Causes include surgical damage, later thoracic surgery, shell degradation, trauma and mechanical pressure such as capsular contracture or mammography.
• Manual examination detects about 30% of ruptures; MRI detects about 86%.
• The FDA advises an MRI at 3 years after surgery, then every two years for suspected rupture.
• Reported saline rates: 3–5% rupture at 3 years and 7–10% at 10 years; ~10–13% overfilling cut the 8-year deflation rate to 1.83%.

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Capsular contracture

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The scar capsule tightening around an implant until it deforms or breaks the device — causes, prevention and treatment, plus revision surgery.

• Causes include bacterial contamination, shell rupture, filler leakage and haematoma.
• Lower contracture rates are associated with submuscular placement, textured surfaces, minimal implant handling and antibiotic irrigation.
• Treatment ranges from open capsulotomy with implant replacement to non-surgical options (massage, ultrasound, leukotriene inhibitors, pulsed electromagnetic field therapy).
• Indications for revision surgery: complications, capsular contracture, shell rupture, gel leakage and rupture-and-deflation.

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Systemic sickness

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Study evidence on whether silicone-gel implants cause systemic or autoimmune disease — consistently no causal link found.

• Reviews since the 1990s report no causal relation to systemic or autoimmune disease, though some women report neurological and rheumatological symptoms.
• A 2004 Danish study found no higher autoimmune incidence than the general population.
• European and North American cohorts found augmentation patients generally healthier than the general population, with lower standardized mortality ratios.
• A fibromyalgia association reported in 2001 was criticised as methodologically flawed; the FDA found no support in the literature.
• A 25,000-woman Canadian mortality study (2006) found breast prostheses do not directly increase mortality.

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Fat-graft breast augmentation

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Autologous fat injection for reconstruction, congenital defect correction and aesthetic enhancement — history, evidence and risks.

• Indications: post-mastectomy reconstruction, trauma and explantation deformity; micromastia, tuberous breast deformity and Poland syndrome; and primary aesthetic augmentation.
• Developed by Melvin Bircoll; in 1987 Eduardo Krulig injected grafts with a syringe and blunt needle using a disposable fat trap.
• Up to about 300 ml of body fat can be injected in three equal-volume injections across subpectoral, intrapectoral and submammary spaces.
• Risks: fat necrosis, metastatic calcification, cysts and palpable lumps.
• Adding adipose-derived stem cells raised graft success rates in a 2007 40-patient study.

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Fat grafting techniques

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Harvesting, centrifugal refinement, blunt-cannula injection in small aliquots, and how much of the graft survives.

• Only about 25–50% of transferred fat survives at one year, so compensatory over-filling is used.
• Small-aliquot blunt-cannula injection maximises contact with vascularised tissue and minimises fat necrosis.
• Contours are sculpted by layering grafts at different depths — from the chest wall to just under the skin.
• Operating time: about 2 hours for the first 100 cm³, then about 45 minutes per extra 100 cm³.
• Fat grafted around an implant can hide device edges and wrinkles and soften the capsule.

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External tissue expansion

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Vacuum pre-expansion of the recipient site before fat grafting, with the reported volume gains from two studies.

• In a 17-woman study, a bra-like vacuum system applied 20 mmHg for 10–12 hours daily over 10 weeks.
• Average volume gain at week 10 was about 98%, with a stable long-term increase of 55% (range 15–115%).
• A 2010 study of 25 patients (46 breasts) reported significant volume increases of 60–200% at six months by MRI, with no oil cysts or abnormality.
• MRI and 3-D volumetric imaging are used to monitor graft viability and volume maintenance.

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Post-mastectomy procedures

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Implant and flap reconstruction options, and fat-graft reconstruction as a non-implant alternative.

• Surgical options include implants, TRAM flap, latissimus myocutaneous flap and DIEP flap.
• Fat-graft reconstruction begins with 3–5 weeks of external vacuum expansion, then serial grafting sessions over about three months.
• Some reconstructions begin in the operating room at the mastectomy itself, seeding fat into the recipient site.
• Reported outcomes: natural form and near-normal sensation, with resumption of normal activities at about 3 days.

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Tissue engineering: the breast mound and explantation deformity

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Pre-expanded, fat-seeded breast mounds after mastectomy, and using fat grafts to correct empty implant pockets after explantation.

• A 2010 series: 33 women (47 breasts) pre-expanded for 10 hours daily over 10–30 days, then grafted with 150–600 ml per session across 2–5 outpatient procedures.
• Stable reconstructed volumes of 300–600 ml per breast at six months, with benign oil cysts and rare complications (pneumothorax, transient cysts).
• After implant removal, fat grafts replace about 50% of the removed volume as permanent augmentation.
• Fat cannot survive in an empty implant pocket — it must be injected into a vascularised tissue matrix.

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Fat-graft augmentation outcomes and limitations

Article section

Reported volume gains from fat grafting and why it cannot replace the volumes implants deliver.

• A 2010 study of 25 patients: mean breast volume increased 1.2× (60–80%, about 250 cm³ per breast) at six months, confirmed by quantitative MRI.
• Graft volumes of 220–650 cm³ per breast; mean operating time 2 hours; no infection, cyst, seroma, haematoma or necrosis reported.
• Structural fat grafting gives precise contour control but cannot achieve the large global volume increases implants provide.
• In one session, even patients with ample donor fat gained about one bra cup size.
• Radiotherapy of an implant-augmented breast sharply raises complication rates (contracture, infection, extrusion, poor cosmetic outcome).

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Breastfeeding and the prosthetic breast

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Whether implants interfere with breastfeeding, and which surgical choices preserve lactation.

• Women with implants can breastfeed, but surgery that cuts into the nipple-areola complex can damage ducts or nerves.
• IMF, transaxillary and transumbilical approaches avoid the nipple-areola complex.
• Subglandular placement and oversized implants interfere most with lactation; small implants in a submuscular pocket interfere least.
• Filler leakage into milk is considered a minimal risk: silicone is indigestible and saline digestible.
• A 1996 study found no causal link between prostheses and impaired breastfeeding function.

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Breast-filler toxicity and platinum toxicity

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Theoretical filler transfer to milk, and the platinum catalyst used to make silicone gel — both reviewed as minimal risks.

• Breast-filler toxicity is described as a minimal risk to a nursing infant because silicone is indigestible and saline digestible.
• Platinum (Pt 78) is the catalyst that turns liquid silicone oil into gel; trace platinum could theoretically accumulate in bone marrow.
• The FDA found the platinum in modern implants is not ionised and poses no biological risk, with no reported cases of trace-platinum toxicity.

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Psychology of breast-augmentation patients

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Mental-health characteristics of women seeking augmentation, and the outcomes they report after surgery.

• Pre-operative studies report more prior psychotherapy, low self-esteem, depression and body dysmorphia than in the general population.
• Post-operative surveys report improved physical health, appearance, social life, confidence, self-esteem and sexual functioning.
• Most women report long-term satisfaction with their implants, even after revision surgery.
• About 8% of Danish augmentation patients had a pre-operative psychiatric hospitalization history.

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Mental health and mortality findings

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Suicide and mortality findings, and measured self-esteem gains — with the article's conclusion on causation.

• A 2007 longitudinal study found higher suicide rates among women with implants over time, alongside higher alcohol- and drug-related death risk.
• The article's conclusion: surgery does not increase suicide risk — it is the psychologically affected woman who is more likely to seek augmentation.
• A 2007 study reported self-esteem gains of 20.7–24.9 points on the 30-point Rosenberg scale after surgery.
• Plastic surgeons are advised to assess mental health before operating, to judge whether implants can genuinely help.

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