1. In general, you should be in good physical health. This means no active infections, untreated cancer or serious illnesses.
2. If your breasts are sagging, flattened, elongated, asymmetrical or lacking adequate cleavage or volume, there is a good chance that you’re an excellent candidate for this surgery.
3. Most surgeons prefer that you do not smoke or consume significant amounts of alcohol.
4. Because this surgery can permanently alter your appearance, it’s important for you to be in a healthy frame of mind when you decide on this surgery.
5. While this is a surgery that will change how you look, it’s important to remember that it cannot fix body image issues or give you a wildly different appearance. You should maintain realistic expectations and listen to your surgeon’s honest assessment of your goals.
6. The best candidate for breast augmentation understands the risks as well as the rewards. The surgery is generally considered safe, and implants are FDA-approved, but with any surgery, there are some risks.
7. You understand that breast enhancement should be done strictly for yourself and because you believe it will increase your own happiness or confidence. You should never get cosmetic work done because someone else wants you to.
8. You should have the ability to properly rest and recover post-surgery. You will not be able to perform certain tasks or do any heavy lifting, so it’s important for you to have help in place.
9. For saline implants, the FDA requires you to be at least 18 years old. If you want silicone implants, the minimum age is 22.

Who is not a candidate for breast augmentation?

Generally speaking, anyone who is in reasonably good mental and physical health can be candidates for breast implants.

However, you are likely not a good candidate for this surgery if:

• You’re pregnant or breastfeeding.
• You have breast cancer or an abnormal mammogram.
• You’re ill or battling an infection.
• You have unrealistic expectations for post-surgery results.

Though most women can qualify for breast implants, it’s vitally important that you are open and honest with your surgeon during your consultation. Even if breast implants are not right for you, he or she may be able to recommend an alternative course of action to help you achieve your aesthetic goals.

• Why you want breast augmentation surgery, your expectations and the desired outcome
• Medical conditions, drug allergies and previous medical treatments
• Current medications, vitamins, herbal supplements, alcohol, tobacco and drug use
• Family history of breast cancer and results of any mammograms or previous biopsies

Your cosmetic surgeon will also:

• Evaluate your general health status and any pre-existing health conditions or risk factors
• Examine and measure your breasts, including detailed measurements of their size and shape, skin quality and placement of your nipples and areolas
• Take photographs
• Discuss your options and recommend a course of treatment
• Discuss likely outcomes of breast augmentation and any risks or potential complication

Breast Implants: What Patients Need to Know

You will be asked to sign consent forms to ensure that you fully understand the procedure and any risks and potential complications.

Possible breast augmentation surgery risks include:

• Anesthesia risks
• Bleeding
• Hematoma
• Infection
• Changes in nipple or breast sensation
• Poor scarring
• Wrong or faulty position of the implant
• Implant leakage or rupture
• The formation of tight scar tissue around the implant (capsular contracture)
• Fluid accumulation (seroma)
• Wrinkling of the skin over the implant
• Persistent pain
• Possibility of revision surgery

These risks and others will be fully discussed prior to your consent. It is important that you address all your questions directly with your plastic surgeon.

Breast implant safety

Careful reviews of scientific research by independent groups such as the Institute of Medicine have found no link between breast implants and autoimmune or other systemic diseases.

Other important considerations:

• Breast implants are not guaranteed to last a lifetime and future surgery may be required to replace one or both implants
• Pregnancy, weight loss and menopause may influence the appearance of augmented breasts over the course of your lifetime
• Breast augmentation requires regular examinations of your breasts’ health and to evaluate the condition of your breast implants

• Get a blood test
• Take certain medications or adjust your current medications
• Stop smoking
• Avoid taking aspirin and certain anti-inflammatory drugs as they can increase bleeding
• Stop taking recreational drugs, such as cocaine

Breast augmentation surgery should be performed in an accredited outpatient or ambulatory surgical center or a hospital. This is for your safety. If your surgeon has a may informal setting, he or she may not be a board-certified plastic surgeon. If your breast augmentation is performed on an outpatient basis, arrange for someone to drive you to and from surgery and to stay with you for at least the first night following surgery.

Step 1 – Anesthesia

Medications are administered for your comfort during the surgical procedure. The choices include intravenous sedation and general anesthesia. Your doctor will recommend the best choice for you.

Step 2 – The incision

Incisions are made in inconspicuous areas to minimize visible scarring. You and your plastic surgeon will discuss which incision options are appropriate for your desired outcome. Incision options include: along the areolar edge (peri-areolar incision), the fold under the breast (inframammary fold) and in the armpit (axillary incision). A belly-button approach is associated with a higher complication rate. Incisions vary based on the type of breast implant, degree of enlargement desired, your particular anatomy and patient-surgeon preference.

Step 3 – Inserting and placing the breast implant

After the incision is made, a breast implant is inserted into a pocket either:

A. Under the pectoral muscle (a submuscular placement)

B. Directly behind the breast tissue, over the pectoral muscle (a submammary/ subglandular placement)

The method for inserting and positioning breast implants depends on the type of implant, degree of enlargement desired, your body type and your surgeon’s recommendations.

Step 4 – Closing the incisions

Incisions are closed with layered sutures in the breast tissue and with sutures, skin adhesive or surgical tape to close the skin.

Immediately after surgery, you will be taken into a recovery area for close monitoring. You may be permitted to go home when you are stable for discharge, typically after an hour or so.

Before leaving, you will be given specific postoperative instructions for your breast implant recovery and a follow-up appointment with your plastic surgeon. You may also receive medications or a prescription, but many plastic surgeons prescribe postoperative medications in advance. Your prescribed medications may include pain pills and an antibiotic to prevent infection.

Wear your support garment (a bra or elastic band, called a bandeau) around the clock as instructed by your plastic surgeon. Some surgeons may ask patients cleanse the incision sites and apply ointment, while others will ask their patients to keep tape or a bandage on. Instructions vary, so it’s important to follow all your plastic surgeon’s directions carefully. Because it is possible to bleed into the pockets around the breast implants for the first several days, take it easy until you have permission to increase your activity level. Acute pain typically subsides after one to five days, but you may experience soreness and swelling for a few weeks. Resume exercise and normal activity according to your plastic surgeon’s directions.

What to expect in Breast Augmentation

While a breast augmentation yields larger breasts right away, the final results may take a few weeks as the swelling subsides and the skin stretches. Some patients may need to wear a bandeau to help shape their breasts, especially if they have underlying asymmetry or very small breasts to start with. Incision lines may take several months, even a couple of years, to fade.

To achieve optimal breast augmentation results, follow your surgeon’s post-operative instructions and return for follow-up visits.

Breast implant replacement

Breast implants are not considered to be lifetime devices, and they may need to be replaced. You can see your plastic surgeon for an annual examination to evaluate your breast health and implant integrity.

Over time, your breasts will change due to aging, weight fluctuations, hormonal factors and gravity. As the appearance of their breasts changes with time, some patients have a breast lift or an implant exchange to restore a more youthful contour.