Breast Augmentation

Modern cohesive silicone gel implants are engineered to last 10-20 years, and many patients keep their implants longer without issues. However, implants are not considered lifetime devices by any manufacturer. The likelihood of needing a revision increases over time, with approximately 20% of patients requiring some form of reoperation within 10 years. Regular monitoring through physical examination and, in some cases, MRI or ultrasound imaging is recommended to ensure implant integrity. When revision is needed, it does not always mean the implants have failed; sometimes patients simply wish to change size or address natural tissue changes.

Round implants are symmetrical in shape and create more fullness in the upper pole of the breast, which many patients find attractive. They also cannot rotate out of position. Anatomical or teardrop implants are shaped to mimic the natural breast slope, with more projection at the bottom. They can produce a very natural contour but carry a small risk of rotation. In practice, many surgeons find that round implants placed in the dual-plane position produce a natural teardrop appearance once settled, making them the more popular choice today.

Most women can successfully breastfeed after breast augmentation. The procedure typically does not damage the milk ducts or glandular tissue. The incision location matters: inframammary (under the breast fold) and transaxillary (armpit) approaches have the least impact on breastfeeding ability, while periareolar incisions carry a slightly higher risk of affecting milk supply. Discuss your future breastfeeding plans with your surgeon so they can choose the approach that best preserves lactation function.

The most common incision is inframammary, placed in the natural fold beneath the breast where it is well-concealed by the breast itself and by bras or swimwear. Periareolar incisions follow the lower border of the areola and blend with the natural color change. Transaxillary incisions are hidden in the armpit. With proper wound care and scar management (silicone sheets, SPF protection), scars fade significantly over 12-18 months and become difficult to detect in most patients.

Choosing the right size is one of the most important decisions. Your surgeon will take precise chest measurements, assess your existing breast tissue and skin elasticity, and consider your body proportions. Many clinics now offer 3D simulation imaging so you can preview different sizes on a digital model of your body. Trying on sizers in a bra during consultation is another helpful tool. The goal is to choose a size that complements your frame and meets your aesthetic goals. The most common regret in breast augmentation is wishing for a slightly larger size, so communicate openly with your surgeon.

The procedure is performed under general anesthesia, so you feel nothing during surgery. Post-operative discomfort varies by placement: submuscular placement typically produces more tightness and pressure in the first few days compared to subglandular placement. Most patients describe the sensation as soreness similar to an intense chest workout rather than sharp pain. Oral pain medication effectively manages discomfort for the first 3-5 days, and most patients transition to over-the-counter pain relief by the end of the first week.

Capsular contracture occurs when the natural scar tissue capsule that forms around any implant becomes excessively thick and tight, causing the breast to feel firm or look distorted. It is graded on a scale from I (soft, normal) to IV (hard, painful, distorted). Modern surgical techniques, including the use of Keller Funnel no-touch insertion, textured or polyurethane-coated implants, submuscular placement, and meticulous sterile technique, have significantly reduced capsular contracture rates to approximately 5-8%. If it occurs, treatment options include capsulotomy, capsulectomy, or implant replacement.

Implants alone can add volume and improve mild sagging by filling out the breast envelope. However, if you have significant ptosis (sagging) where the nipple sits at or below the breast fold, you will likely need a breast lift (mastopexy) in addition to or instead of implants. A combined augmentation-mastopexy is a common procedure that both lifts the breast to a more youthful position and adds volume. Your surgeon will assess your degree of ptosis during consultation and recommend the best approach.