Does breast augmentation increase the risk of breast cancer?

No, in fact, good long term studies in the USA, Denmark, Canada, and Sweden have shown a lower than expected risk of breast cancer in augmentation patients.  Mammograms recommended by the American Cancer Society starting at age 40 for non-high risk women and 35 for those with a very strong family history are recommended.

Will I need another operation? 

 Most likely, yes.   There is a possibility of deflation, rupture, contracture, malposition, or a lift.  Usually this occurs several years or decades after the procedure. 

Are silicone implants dangerous? 

NO! The silicone in today's implants are gel like and usually do not flow into the body when ruptured.  Additionally,  during the last 15 years extensive study of silicone implants has taken place.  The US Food and Drug Administration  acknowledged the lack of evidence that silicone causes any human systemic diseases.  There is evidence that more silicon enters the body with lipstick or underarm deodorants than a ruptured silicon implant.

Will I be able to feel the implant?

This depends on your body type.  If you can feel your ribs below the breast then you will probably be able to feel the edge of the implant.  Silicone is softer than saline, but both can ripple and be seen through thin tissue coverage usually in the lower outer breast, but beneath bras and most bathing suits depending on how skimpy.

Is it possible to go too big? 

There are limits to the size of implants that can be placed.  The tissue coverage will only stretch so far.  The larger the implant, the larger the pocket will need to be created, thus increasing the likelihood of unevenness. .  I recommend the smallest implant that is effective for you.  Our exclusive imaging software can help.  The smaller the implant, the less likely you are to have natural tissue stretch occur over time.  

Do I need to exchange the implants?

 Some  plastic surgeons have recommended exchange every ten years, but there is no reason  to exchange an implant unless it is ruptured.  Saline deflation is usually obvious, but silicone has a silent rupture.  The FDA has recommended an MRI every couple of years after the first three years of implantation of the silicone implant.

Do I have to have an armpit incision?

No, there are three primary places for the incisions; armpit, around the areola, and under the breast.   Each approach is a little different and there is not a right or wrong way.  Your surgeon should review the pros and cons to each.    

What is the rupture rate of implants?

Most  implants survive intact for 10 years.  The rupture rate will increase after 10 years as natural wear and tear on the shell surface can eventually cause a small hole.

Will I have a cleavage? 

This is unknown for each patient.  Since most implants are placed below the muscle, the attachments at the muscle and the division of the muscle during surgery are the primary determinant of where the implants settle.    Since the muscle is different on both sides of the chest, even the same division of the muscle may allow different settling of the implants.  No one can predict where the implant will settle.  So do not expect perfection.  The goal is improvement. 

Will I have pain?

Any incision and dissection of muscle and tissue will cause discomfort.   So expect some pain which is helped by medication and  by an excited positive attitude.  The hardest time is the first 24-36 hours but dissipates quickly after that.  So, most people can return to work within 5-7 days, depending on their work requirements. 

Where should surgery be performed?

 It is important to perform surgery only at a hospital or surgery center.    All hospitals and most surgery centers have Board Certified Anesthesiologists and properly tested equipment and staff.  All Board Certified Plastic Surgeons who are members of the American Society of Plastic Surgery (ASPS) agree to only operate in accredited facilities, and each has hospital privileges.  If your surgeon recommends operating in his/her office you should beware of that.  Office based surgery will usually utilize nurse anesthetist and may not have as much back up support for emergencies.  Non-Board certified plastic surgeons such as Board certified oral surgeons may perform cosmetic procedures but have no hospital privileges for admitting patients with complications.  For safety reasons, I would discourage the use of non-board certified plastic surgeons.