Breast Augmentation


Definition of Breast Implants

Breast implants are medical devices implanted under the breast tissue or chest muscles to increase the size and alter the shape of the breasts. While they are most commonly used for breast augmentation, they are also utilized in reconstructive surgery to restore the breast’s appearance following mastectomy or injury.

Brief History of Breast Implants

The modern era of breast implants began in the early 1960s with the invention of the silicone implant. Since then, breast implants have gone through numerous iterations and improvements, including the introduction of saline implants and more cohesive gel silicone implants. Advances in medical technology and surgical techniques have made breast implants safer and more natural-feeling than earlier models.

Purpose and Benefits

The primary purpose of breast implants is to enhance the size and shape of the breasts for aesthetic or reconstructive purposes. Women may choose breast implants for various reasons, including balancing breast size, compensating for reduced breast mass after pregnancy or surgery, and reconstructing breasts after mastectomy or injury. Beyond physical appearance, breast implants can have significant psychological benefits, improving self-esteem and body image for many individuals.

Breast implants are not without controversy or complications, and it’s crucial to approach the topic with a comprehensive understanding of the risks, benefits, and diverse reasons individuals may choose this procedure. As with any medical intervention, a decision to undergo breast implant surgery should be made after careful consideration and consultation with qualified medical professionals. This lexicon aims to provide a thorough and unbiased exploration of breast implants, particularly focusing on silicone breast implants, to inform and guide those considering the procedure.

Types of Breast Implants

Silicone Breast Implants

Silicone breast implants are filled with silicone gel, a thick, sticky fluid that closely mimics the feel of human fat, making them popular for their ability to provide a more natural breast texture. These implants come in various shapes, sizes, and degrees of firmness.

Composition and Types: The outer shell of all silicone implants is made of a durable, elastic silicone. The inside, however, is filled with silicone gel. They can be round or shaped and may have a smooth or textured surface.
Cohesive Gel Implants (“Gummy Bear” Implants): These are a specific type of silicone implant, characterized by a firmer gel which maintains its shape even if the outer shell is broken. Due to their consistency, they are less likely to wrinkle or ripple and are believed to provide a more natural slope to the breast.

Saline Breast Implants

Saline implants are filled with sterile salt water. They are inserted empty and filled once they are in place, allowing for a smaller incision and slight adjustments in size after they are implanted.

Composition: They consist of a silicone outer shell filled with saline. The amount of saline can be adjusted to change the feel, firmness, and shape of the breast.
Advantages and Considerations: Saline implants are known for a firmer feel and are often less expensive than silicone implants. If a saline implant leaks, the saline will be absorbed and naturally expelled by the body. However, they might not feel as natural as silicone implants and can sometimes be more prone to rippling.

Comparison between Silicone and Saline

Choosing between silicone and saline implants is a personal decision, often based on the desired feel, look, and considerations of surgery and maintenance. Silicone implants are generally preferred for their more natural feel and appearance, especially in women with less natural breast tissue. Saline implants, while sometimes more palpable or visible through the skin, offer a variable size and a smaller incision. Each type has specific considerations regarding surgery, cost, and maintenance that should be thoroughly discussed with a plastic surgeon.

Understanding the types of breast implants is crucial for anyone considering breast augmentation or reconstruction. The choice between silicone and saline implants will depend on individual preferences, body type, and the advice of a qualified plastic surgeon. Each option carries its own set of benefits and considerations, and a detailed discussion about the types of implants will help ensure that the decision made is the best one for the individual’s needs and lifestyle.

Considerations Before Surgery

Candidacy for Breast Implants

Before deciding on breast implants, it’s important to assess whether you’re a good candidate for the surgery. Ideal candidates are those in good physical health, have realistic expectations, and understand the risks involved. Individuals might seek implants for various reasons, including cosmetic enhancement, correcting asymmetrical breasts, or reconstructing the breast following a mastectomy.

Psychological Considerations

The decision to undergo breast implant surgery should be driven by personal desire, not pressure from others. Prospective patients should have a stable and positive self-image and understand that while implants can enhance physical appearance, they do not change one’s life circumstances or bring guaranteed improvement to emotional well-being. Consulting with a mental health professional can be beneficial in understanding the motivations and setting realistic expectations.

Choosing the Right Size and Shape

The choice of implant size and shape is a critical decision and should be made considering the individual’s body type, original breast size, and personal preferences. It’s important to have a thorough consultation with the surgeon, possibly trying on different sizes in a special bra to visualize the potential outcome. The goal is to achieve proportionate and aesthetically pleasing results.

Risk Factors and Safety Concerns

Understanding the risks and long-term implications is crucial. Risks include surgical complications, such as infection or adverse reaction to anesthesia, and specific implant-related complications like rupture or capsular contracture. Discussing these risks with a healthcare provider, understanding the procedure’s safety record, and knowing the signs of complications is essential.

The Surgical Procedure

Pre-surgery Preparations

Before the surgery, patients may need to undergo various health evaluations and adjust certain medications. They should also stop smoking, avoid certain anti-inflammatory drugs, and arrange for help during the recovery period. Following the surgeon’s instructions is vital for a successful surgery and recovery.

Description of the Procedure

Breast implant surgery is usually performed under general anesthesia. The surgeon makes a cut (incision) under the breast, under the arm, or around the nipple, depending on the type of implant, the degree of enlargement desired, and the individual’s body. The implant is then placed between the breast tissue and chest muscle or under the chest muscle. After the implant is positioned, the surgeon closes the incision with sutures.

Post-surgery Recovery and Care

Recovery time varies, but many return to work within a week. Swelling, soreness, and bruising are common after the surgery. The surgeon will advise on care routines, which might include wearing a support bra, taking certain medications, and avoiding physical strain. Regular follow-up appointments are crucial to monitor the implants and overall health.

Considering these factors thoroughly and consulting with qualified professionals are key steps in the journey toward breast augmentation. Each individual’s circumstances and needs are unique, and a personalized approach will ensure the best decisions are made throughout the process.

Risks and Complications

Short-term Surgical Risks

Like any surgery, breast implant procedures come with immediate risks including infection, bleeding, reaction to anesthesia, and unexpected scarring. It’s important to understand these and know how the surgical team plans to mitigate them.

Long-term Considerations

Long-term risks include:

  • Capsular Contracture: The formation of tight scar tissue around the implant, causing firmness or hardening and sometimes pain. In some cases, it might require surgery to remove the scar tissue or the implant.
  • Breast Implant Illness (BII): A term used by women who have breast implants and describe a variety of symptoms they feel are directly connected to their saline or silicone, textured or smooth breast implants.
  • Implant Rupture: While modern implants are robust, they can still break down over time. If a saline implant ruptures, it will deflate, and the body will absorb the saline. If a silicone implant ruptures, it might not be noticeable, but it can cause breast pain or changes in the contour or shape of the breast.
  • Mammography Interference: Implants can obscure breast tissue on a mammogram. Informing the technician about implants allows them to use special techniques to get a clear picture.

Implant Rupture and Replacement

No breast implant lasts forever. Implants can rupture or develop other issues that require removal or replacement. On average, implants might need to be replaced every 10 to 15 years, although some last longer. Understanding the signs of implant failure and maintaining regular check-ups is important.

Life with Breast Implants

Physical Sensation and Appearance

Post-surgery, breasts with implants might feel different to the touch than natural breasts. While silicone implants are designed to feel like natural breast tissue, they will still feel different, especially to the individual. It’s also common for sensitivity in the nipple and breast to change post-surgery, either increasing or decreasing.

Impact on Lifestyle and Activities

Most women can return to normal activities and lifestyles after recovery, but it’s usually recommended to avoid certain high-impact activities that might damage the implants or cause discomfort. Discussing lifestyle considerations with a healthcare provider is important to understand any long-term considerations or adjustments.

Monitoring and Maintenance

Regular monitoring of breast implants through self-exams and medical check-ups is crucial. Any unusual changes in the breast’s shape, size, or feel should prompt a consultation with a healthcare provider. MRI scans or ultrasound might be recommended periodically to assess the condition of the implants.

Making informed decisions and understanding the lifelong commitment is crucial when opting for breast implants. With proper care and regular check-ups, many individuals enjoy the benefits of implants with minimal complications. However, maintaining an open and ongoing dialogue with healthcare providers ensures safety and satisfaction in the long term.

FDA Approval and Regulations

In the United States, the Food and Drug Administration (FDA) regulates the safety and efficacy of breast implants. Silicone and saline implants undergo rigorous testing and review before they are approved for public use. The FDA also monitors the performance of implants once they are on the market and can issue recalls or warnings if necessary. It’s important for individuals considering breast implants to be aware of the current FDA status and guidelines of the implants they are considering.

Patients who experience complications or issues with their breast implants have certain legal rights. This can include pursuing claims for defective products, medical malpractice, or other damages. Understanding these rights and the proper procedures to follow if complications arise is an essential aspect of informed consent. Consulting with a lawyer experienced in medical-related cases can provide guidance specific to individual circumstances.

Alternatives to Breast Implants

While breast implants are a popular option for breast augmentation, there are alternatives that individuals may consider:

Fat Transfer Augmentation

Fat transfer breast augmentation involves taking fat from another part of the body (typically areas with excess fat like the abdomen, hips, or thighs) and injecting it into the breasts. This option is generally less invasive than traditional breast implants and can provide a more natural look and feel. However, the results are usually more subtle, and there is a limit to how much the breast size can be increased.

Lifestyle and Clothing Alternatives

Some individuals may opt for non-surgical methods to enhance the appearance of their breasts. This can include special bras, inserts, or clothing styles that create the illusion of larger or more shapely breasts. While these methods don’t provide permanent changes, they can offer a way to explore different looks or provide temporary enhancement for special occasions.


Medical Journals and Studies

Journal of Plastic, Reconstructive & Aesthetic Surgery: Offers peer-reviewed articles on breast implant techniques and outcomes.
Aesthetic Surgery Journal: Provides research and discussion on breast augmentation procedures and innovations.
Plastic and Reconstructive Surgery Journal: Features studies and case reports on the long-term effects and safety of breast implants.

Regulatory and Professional Bodies

FDA – U.S. Food and Drug Administration: For guidelines, approvals, and safety alerts related to breast implants.
American Society of Plastic Surgeons (ASPS): Offers guidelines and consensus statements on best practices for breast augmentation.
International Society of Aesthetic Plastic Surgery (ISAPS): Provides international perspectives and data on cosmetic surgery trends, including breast implants.

Books and Surgeon’s Guides

Breast Augmentation: Principles and Practice” – A comprehensive guide covering various aspects of breast augmentation, including types of implants, surgical techniques, and postoperative care.
Aesthetic and Reconstructive Surgery of the Breast” by Elizabeth Hall-Findlay and Gregory Evans**: This book delves into both aesthetic and reconstructive breast surgery techniques and considerations.

Patient Resources – Sections on reconstruction and living with implants.
RealSelf – Patient reviews, stories, and Q&A with board-certified surgeons.

Systematic Reviews and Meta-Analyses

Cochrane Library: For systematic reviews regarding the effectiveness and safety of different types of breast implants.
PubMed: A resource for finding comprehensive studies and reviews on breast implant outcomes.

Personal Testimonials and Blogs

Personal blogs and websites: While not as scientifically authoritative, personal stories can provide insight into the patient experience with breast implants.

When referencing materials, it’s important to look for the most recent and comprehensive data, ensuring that the information reflects current standards and knowledge in the field of cosmetic and reconstructive breast surgery. It’s also crucial to evaluate the credibility of the sources, especially with patient testimonials and less formal publications, to provide a balanced and factual representation of the subject.

Frequently Asked Questions (FAQs) about Silicone Breast Implants

1. Are silicone breast implants safe?
A: Silicone breast implants are FDA-approved and considered safe for breast augmentation and reconstruction. However, like any surgical procedure, there are risks. It’s important to discuss these with a qualified healthcare professional and consider personal health history when making a decision.

2. How long do silicone breast implants last?
A: While breast implants do not have an expiration date, they are not considered lifetime devices. The average lifespan of a breast implant is 10 to 20 years, but implants can last longer or shorter depending on individual factors and implant type. Regular check-ups are important to assess the integrity of the implants.

3. Can you breastfeed with silicone breast implants?
A: Many women with breast implants can breastfeed, but it can depend on the type of surgery performed and other individual factors. It’s important to discuss future breastfeeding plans with the surgeon before the procedure.

4. What is the difference between saline and silicone breast implants?
A: Saline implants are filled with sterile salt water and are often filled during the implant procedure, allowing for a smaller incision. Silicone implants are pre-filled with a silicone gel that many feel more closely mimics the feel of natural breast tissue. Each type has its own set of benefits and considerations.

5. How do I know if my silicone implant has ruptured?
A: Silicone implant ruptures can be silent, meaning they don’t always show symptoms. However, changes in breast shape, size, or firmness can be indicators. MRI scans are currently the best method to detect a silicone implant rupture.

6. What is capsular contracture?
A: Capsular contracture occurs when the scar tissue that naturally forms around the implant tightens and compresses the implant, causing it to feel firm or hard and sometimes distorting the shape of the breast. It can occur with any type of breast implant.

7. How much does breast implant surgery cost?
A: The cost of breast implant surgery varies widely depending on geographic location, surgeon experience, and specific procedure details. Generally, it includes the surgeon’s fee, hospital or surgical facility costs, anesthesia fees, medical tests, post-surgery garments, and follow-up appointments.

8. What is the recovery time after getting breast implants?
A: Recovery times can vary, but many people return to work and normal activities within one to two weeks post-surgery. Complete recovery and settling of the implants might take several months.

9. Can breast implants cause cancer?
A: Breast implants have been associated with a rare type of cancer called Anaplastic Large Cell Lymphoma (ALCL), which is not breast cancer but a form of non-Hodgkin’s lymphoma. It’s most frequently associated with textured implants. Discussing the latest research and risks with a healthcare provider is important.

10. How often should I have my breast implants checked?
A: It’s recommended to have breast implants checked regularly through clinical exams and self-examinations. For silicone implants, the FDA recommends MRI screenings to detect silent ruptures three years after implantation and every two years thereafter.

This FAQ section provides a brief overview of common questions related to silicone breast implants. For more detailed or personalized information, consulting with a board-certified plastic surgeon or healthcare provider is always recommended.


Breast implants offer many individuals the opportunity to change their appearance and boost their confidence. However, it’s a significant decision that requires careful thought, research, and consultation with medical professionals. Understanding the types of implants, the surgical process, risks, and long-term considerations is crucial. Alternatives to breast implants should also be considered as part of an informed decision-making process.

This lexicon serves as a starting point for understanding the complex world of breast implants. Individuals are encouraged to seek out multiple sources of information, consult with several healthcare providers, and consider their motivations and expectations carefully. The decision to undergo breast augmentation should be made with a clear understanding of the potential outcomes, risks, and lifelong considerations.

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