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Breast Augmentation: 7 Considerations

Posted on: March 28th, 2019 by Shany Batbold

7 Considerations to Make before Breast Augmentation Surgery

Breast augmentation — playfully known as a “boob job” — remains the most common cosmetic surgery procedure and boasts one of the highest rates of satisfaction. You probably know women who have breast implants, but you just can’t tell!*

Deciding you want breast implants is only the first step. You then need to work with a board-certified experienced surgeon to make a series of other decisions. The following seven considerations will be important to your satisfaction with your breast enhancement procedure:


#1 – Your motives & goals

In most cases, women seek breast implants to achieve a more curvaceous silhouette and feel happier and more confident about their body. If you see your chest as too small, implants can be a way to bring the size up to your own aesthetic ideal — whether that means natural looking and proportionate, or ultra voluptuous.*

Some women get implants as a corrective measure. You can use them to even out mismatched breast sizes. They can also be inserted as part of a breast lift (mastopexy), to help restore fullness and perkiness where there is lost volume and sagginess due to pregnancy, breastfeeding, extreme weight loss or the passage of time.*

Women with breast cancer, or a high chance of it, may have their breasts reconstructed with implants after a mastectomy (removal of one or both breasts). Angelina Jolie did it in 2013, saying, “There have been many advances in this procedure in the last few years, and the results can be beautiful.”*

Before delving into implant and surgery specifics, clarify your own motives and end goals with an experienced, board-certified plastic surgeon. It will better equip your surgeon to guide you through other considerations related to your breast augmentation procedure.*

#2 – Size

Breast implant size is the consideration that gets the most attention. After all, the difference between a C-cup and a DD is major!*

Do you simply want to bring your breast size into natural-looking harmony with your other proportions? Celebrities who’ve gone this more subtle route can be hard to spot, but include Kate Hudson, Gwen Stefani, Blake Lively, and allegedly Taylor Swift and Sarah Jessica Parker. Or do you want to have fun with it, and go for wow-factor?*

Think through the experience of having larger breasts. For instance, if rigorous sports are important to you or you have a delicate back, you might not want to select a very large size. Also consider your personal style. Picture how different bust sizes may enhance or detract from various looks and types of clothing.*

Take some time with the decision, and discuss it with your plastic surgeon. They can help you understand how various implant sizes will work with your physique, skin elasticity, breast tissue, lifestyle and aesthetic goals. While at your consultation, your surgeon can also help you imagine the result by allowing you to try implants of various sizes in a bra. If you’re having trouble deciding between one size and the next up, bear in mind that in a study of 225 women with breast implants 85% considered their new size to be just right, but 13% said they wished they had gone larger.*

#3 – Shape

In addition to size, implant shape significantly impacts the final look of your breasts. For instance, a wider implant will have a lower profile (will project less) than a narrower implant of the same volume. The main two shapes are:*


The most common, round implants come with profiles from nearly flat to almost fully spherical like a ball. A big advantage to round is that they can rotate while still retaining their look. They are also available in a wide range of firmnesses.*


Also called pear or teardrop, they offer a natural look that goes from tapered at the top to fuller at the bottom. Normally made of a firmer, highly cohesive “gummy bear” silicone, they come in a variety of specific silhouettes. The shell has a textured coating designed to prevent the implants from rotating. After about two weeks, risk of shifting begins to diminish as the implants integrate into their permanent position.*

Work with a surgeon who will have an honest conversation with you about the shape and profile that will make you the happiest.*

#4 – Fill

Breast implants are filled with either silicone or saline, each presenting its own advantages and considerations. Both types will eventually need to be replaced. Many women opt to do this every 10-15 years, but modern implants often last much longer.*

Silicone Implants:

They’ve come a long way since the first breast augmentation surgery in 1962. The new generation contains a silicone gel that is highly cohesive and fatlike so can look soft and natural without being runny or prone to rippling. Rupture is rare and normally due to intense pressure or trauma, but it is reassuring to know that the gel wouldn’t simply pour out!*

Despite some claims over the years, no adverse health effects have ever been proven for cohesive silicone implants. However, because a rupture or leak would be difficult to detect, you’ll want an MRI scan every two to three years. A nice bonus to having regular MRIs is that they can simultaneously screen for cancer, providing a more sensitive check than a mammogram and without the radiation.*

Saline Implants:

One advantage of implants filled with saline (sterile salt water) is that they can use a smaller incision. This is because the shells are implanted when they’re empty and compressed, then they are filled through a small tube.*

The best candidates for saline are usually women with enough existing breast tissue to provide generous implant coverage. This is because the inflated implants tend to be higher profile and less soft than silicone, and they’re more prone to rippling.*

On the question of safety, some prefer saline over silicone. In the unlikely event of a leak, as long as the saline is sterile, it’s just salt water so perfectly safe for the body to absorb. However, saline leakage could mean visible deflation until corrective surgery takes place.*

Fat Transfer:

A relatively new alternative to implants, fat transfer breast augmentations were up by 72 percent in 2016. The procedure can provide a more subtle means of breast enhancement, adding up to two cup sizes. It entails injecting your breasts with living fat removed from elsewhere in your body, so offers the added body-contouring perk of helping slim down a problem area.*

Depending on your target breast size, you may need several fat-transfer sessions. Typically about 30% of the fat disappears within a couple months of the procedure. Fat survival is unpredictable, but the remaining 70% could potentially provide permanent results.*

#5 – Placement

Cosmetic breast implants can be placed in either of two location types: subglandular or submuscular.*


Implants are placed on top of the pectoral muscle but under the fatty breast tissue. This location tends to work best for women with enough existing breast tissue to provide the edges of the implant with natural-looking cover. Some women choose subglandular due to the slightly faster recovery time, or because they’re afraid that submuscular implants may interfere with upper body strength. Subglandular placement normally results in greater upper-breast fullness than submuscular does.*

Subpectoral (or Submuscular): 

Placing implants under the pectoral chest muscle can make them look more natural. The muscles offer additional coverage, plus they apply gentle pressure at the top of the implants for a more gradual, sloped profile. Submuscular placement also can reduce the chance that your body will adversely react to the implant with capsular contracture. And because the implant is less likely to affect ducts and glands, many experts recommend submuscular for women planning to breastfeed.*

Ask your doctor to help determine the best placement for you.*

#6 – Incision location

The best surgical site for you will depend on factors including your implant size and type, plans to breastfeed, and desire to keep incisions hidden. These four locations are the most common:*

Under Breast (Inframammary Crease): 

Camouflaged in the natural fold or crease under the breast, this can be the best incision location for inserting larger implants. It also affords your surgeon the most control over placement and may be the easiest to keep sterile during the procedure. On the con side, it is usually the least hidden of these four incision locations.*

Aureola (Periareolar): 

Implants are inserted through an incision along the edge of the aureola, the colored area encircling the nipple. This can work especially well for smaller implants or in combination with a breast lift. The incision can be nearly invisible, particularly on fair skin. Periareolar is the incision location most likely to affect nipple sensitivity or make breastfeeding difficult.*

Armpit (Transaxillary): 

Women who are especially concerned about hiding their surgical incisions may choose this very discreet location. However, one drawback is that your doctor will have less control over breast pocket creation and exact implant placement. Another is that the incision point cannot be reused when it’s time to replace your implants.*

#7 – Shell texture

Implant shells are normally made of silicone and come in two general finishes:


The slippery texture allows implants to move and bounce freely, like natural breasts. Compared to textured, the smooth surface is more resistant to bacteria and enables more accurate MRI checks.*


Anatomical, teardrop or pear shaped implants need to be textured to reduce risk of rotation. With any shape of implant, texturization means less movement in general, which some people prefer.*

Next steps

Make an appointment with an expert, board-certified plastic surgeon for a thorough consultation about breast augmentation. Together, you can review these seven important considerations. Once your surgeon has a clear idea of your motives, expectations and preferences, they can provide you with more accurate details, for instance, about cost, length of surgery, and pre- and post-op instructions.*

Then, all that’s left to do is schedule a time to “meet” your new, lovely breasts!*

* Individual results may vary and are not guaranteed.