Two implant surface types are available to augmentation patients, smooth and textured. Textured implants have small bumps on their surface. These implants were developed in hopes of reducing the risk of contracture, a complication some women develop after augmentation. You can read more about contracture and other complications in our FAQs. Smooth implants have a smooth rather than bumpy surface. Many surgeons prefer smooth implants for their softer, more natural feel.

Women have the choice of implants filled with cohesive silicone gel or with saline (salt water solution). Both types of fill have been used since the earliest days of breast implantation.  Unlike the older pre 1990 silicone implants with a more liquid fill, modern implants are filled with silicone that has a “gummy bear” consistency. 

While there is no evidence that exposure to silicone can cause any disease in human beings, some women prefer to have their implants filled with saline. In the unlikely event of a rupture in the outer shell of the implant, saline, a completely bio absorbable salt water solution  would be simply absorbed into the body and the implant would deflate. Silicone is not bio degradable and therefore a woman would not likely notice any change in implant volume if there was loss of integrity in the shell of a silicone filled implant. Because of this, the FDA recommends a periodic MRI to confirm integrity of silicone filled implants. Most surgeons and patients agree that saline filled implants do not have the natural feel of silicone filled implants.

There are two shape options for implants: teardrop and round. Generally, round implants conform best to the natural shape of the breast and offer women favorable results. Teardrop or contoured implants may be a fit for women who have had parts of the breast removed during a previous surgery, such as mastectomy reconstruction. Round implants may be either smooth or textured, while shaped implants are always textured.

Implants can be placed either behind the breast tissue, subglandular, or behind the pectoralis chest muscles submuscular. About 75 percent of augmentation is done in the submuscular plane. Studies show that a submuscular placement may reduce the chance for scar tissue contracture and allows for easier mammography following surgery. Submuscular placement typically offers better results for thin women or women hoping to drastically enlarge their breasts. Subglandular placement may offer women with sag in their breasts better results.

This procedure involves an incision in the fold underneath the breast and tends to allow the surgeon more direct control of implant positioning. About 70 to 80 percent of breast augmentations are performed using an inframammary fold procedure. The incision placement allows for minimal effects on the milk-producing areas of the breast. The same incision may also be used if complications arise or additional surgeries are needed. 

Inframammary fold augmentation works well for older patients or mothers, since age and pregnancy allows for a natural amount of sag in the breast. This natural sag allows for the surgical incision to be well hidden for most women. Young women, thin women, or women who have not had children yet and have no crease under their breasts may have a more visible scar with this procedure.
 

During this procedure, an incision is made in the armpit, or axilla, and is used to insert an implant either above or below the muscle. Some surgeons will use an endoscope, which is a small, fiber-optic camera, to help them complete the surgery. About 10 percent of breast augmentations are done using a trans-axillary procedure. The advantage of trans-axillary augmentation is that there is no scar on the breast itself. 

A potential disadvantage of this approach is that getting symmetrical implant positioned is somewhat more difficult, and correction of post-operative problems will likely require additional incisions on the breast. Also, there is potential for thickened scars that are visible with sleeveless clothing, bathing suits or while arms are raised.

In this procedure, an incision is made around the nipple-areolar complex and the scar tends to blend into the edge of the areola. Since the incision is very near milk-producing parts of the breast, women who receive peri-areolar augmentation may have more problems with breastfeeding and nipple sensation following surgery. This is the preferred incision for women with very small breasts who do not have any fold under their breasts.

This is one of the most frequently asked questions by women considering this surgery. Many studies have shown that women who get implants are not at an increased risk for getting breast cancer. In addition, implants do not delay the detection of breast cancer. Numerous studies - as well as evidence from the National Cancer Institute - show that having implants does not hinder the patient or their physician in finding breast tumors. Finally, breast implant patients who do get breast cancer have the same chance of obtaining remission, or being free of cancer for 5 years, as women without implants.

Many women in their 40s and 50s have undergone breast augmentation surgery with good results. The most common patient for this surgery is a woman in her 30s with two children who has been considering this operation for many years. Whatever your stage in life, we encourage you to schedule a consultation to find the best path toward your cosmetic goals.

Pregnancy will change the size and shape of a woman's breasts whether she has implants or not. These changes may adversely affect the cosmetic appearance of any augmented breast. It is usually recommended that pregnancy be postponed until 6 months after the surgery. Breast-feeding with implants is still possible and has been shown to be safe for the baby and the mother.

Women with sagging breasts, which is called "ptosis", can also receive breast implants. Depending on how much the breast sags, an additional surgery may also be necessary. For breasts with nipples that droop below the lower crease of the breast, a breast lift surgery (or mastoplexy) is often required as well. This surgery will also add scars all the way around the nipple-areola unlike most breast augmentation surgeries. Without this additional surgery to remove excess skin, placement of the implant may not adequately correct the sagging.

This is often one of the most difficult decisions, and for many reasons, has the most potential for disappointment. During your consultation, your plastic surgeon will work with you to identify what size of breast you desire from augmentation. "Breast size" as measured by bra-size is variable and is often not a good way to measure final size. As a general rule, every 125-150cc of implant volume equals an increase in a single cup size. However, every patient's body is different. By working with your surgeon and their clinical team, you can set obtainable and healthy expectations together. It is helpful for you to bring in a bra the size you would like to be to help in finding the right sized implant for you.

At your consultation you will receive a detailed summary of all costs associated with breast augmentation surgery at U-M Health and an explanation of our payment policies.

Most women will have loss of some feeling or sensation following breast augmentation surgery. For most of them, this lasts 6-12 months before returning to normal. 15% of women, however, have permanent alterations in nipple sensation.

It is recommended that patients begin walking immediately after surgery. However, women should not perform any intense physical exercise for six weeks following the operation. Physical exercise including weight lifting, biking, jogging, and other forms of intense activities may cause implants to shift position or cause wound healing problems that may alter the appearance of the breasts after surgery.

This depends on your job and its physical demands. Some general guidelines are: Upper arm movements, like reaching, should be avoided for the first 1-2 weeks. Lifting anything heavier than 5 pounds should be avoided for 6 weeks after the operation. This lifting restriction may prevent some women from returning to work.

The pain from breast augmentation surgery is usually in the moderate range and generally can be well controlled with medication in the first 1-2 weeks following the surgery. It is important to note that severe or untreatable pain following surgery can mean infection or another complication.

Women may start driving a car one week after surgery as long as they are not taking any pain medications.

It is unlikely that you will experience long term changes in physical functioning. Depending on the size of the implant, most women find no trouble performing most physical activities following the surgery. Weight lifting or lifting heavy objects will not affect the implant once the area has properly healed.

Yes. Placement of the implant below the breast tissue, as in subglandular placement, does not affect the ability of the breast to produce milk. Similarly, submuscular placement, or implant placement below one of the chest muscles preserves proper breast functioning. With the peri-areolar incision, an increased risk of breast-feeding problems may exist. In one study, 7/8 patients reported problems with breast-feeding following peri-areolar breast augmentation surgery. For women who choose the infra-mammary or trans-axillary incision, (incisions under the breast and through the armpit), breastfeeding is usually not a problem. Be sure to discuss your breast feeding needs with your surgeon during your consultation.

Sometimes additional surgeries may be required for augmentation patients. To reach optimal symmetry, you may desire follow up breast lifts or other supporting procedures. Additional surgeries may be needed if you face any complications during your augmentation, like implant rupture or capsular contracture. In addition, implanted breasts will age just like any other body part and in the future some woman choose to have additional operations to correct the results of gravity and aging. During your consultation, you and your surgeon should discuss the possibility of additional procedures after breast augmentation.