Breast Augmentation - FAQ
When were breast implants introduced?
Breast augmentation (breast implants) was first performed in 1962 and over one million patients have undergone breast augmentation (breast implants) in the United States. The first breast implants were filled with liquid silicone. Saline (salt water) breast implants were introduced in 1965. Both silicone and saline implants are currently approved for use in the United States. Breast augmentation is the most common cosmetic procedure performed in the United States.
Clin Plast Surg. 2009 Jan;36(1):1-13, v Is breast augmentation safe and effective?
Researchers in the area of breast augmentation (breast implants) believe that saline filled implants are generally safe and effective. Safety issues will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 2000 May; 105 (6): 2143-2149 . Are most patients satisfied with breast augmentation?
The satisfaction rate for patients getting breast augmentation (breast implants) is high. Satisfaction rates will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 2000 May; 105 (6): 2143-2149. Plast Reconstr Surg. 2006 Mar; 117 (3): 757-767. Clin Plast Surg. 2009 Jan;36(1):23-32, v.
How long is the recovery after breast augmentation (breast implants)?
The recovery for breast augmentation (breast implants) is variable from patient to patient. In my practice most of my patients return to work in two or three days after breast augmentation (breast implants) unless they have a job that requires a large amount of physical exertion. Some factors can delay return to work or normal activity after breast augmentation (breast implants), and this possibility should be considered when making a decision about breast augmentation (breast implants). Recovery will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 2002 Jan; 109 (1): 273-290. Is follow up with my surgeon important after breast augmentation surgery?
Yes. Follow up with your surgeon after breast augmentation (breast implants) is very important and it is the responsibility of the surgeon and the patient to ensure that proper follow up is performed. Proper follow up after breast augmentation (breast implants) surgery improves the safety of the procedure. Follow up will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
What breast augmentation implant is best for me?
There are many options in for breast augmentation implant devices. The options for breast augmentation (breast implants) include but are not limited to the type of filler inside the implant, pre-filled and post-filled implants, the type of shell (outer surface) of the implant, the size of the implant, and the shape of the implant (round, high profile, contoured or anatomic). The choice of the implant type for breast augmentation is made by the patient, after discussing the options with a well trained Plastic surgeon. Breast implant choices will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 2004 Oct; 114(5): 73E-81E.
What size breast implants should I choose with my breast augmentation?
There is no definitive rule regarding an exact or ideal size of breast implants in breast augmentation surgery. Some general common sense guidelines can be considered when choosing a breast implant size when getting breast augmentation (breast implants). Many patients want to get breast augmentation procedure (breast implants) to be more in proportion. To be in proportion is a reasonable goal for most patients seeking breast augmentation (breast implants). With that goal in mind, the size of breast implants will vary from patient to patient. When getting breast augmentation surgery (breast implants) one wants to choose an implant size large enough so that it will make a difference (the implant should not be too small). At the same time, if the goal after breast augmentation (breast implants) is to generally be in proportion, then the implant should not be so large that the patient has other problems related to the size of the breast implants, such as back aches as seen in women with extremely large breasts. In summary, while there is not an ideal or exact implant size that can be chosen for any one patient there is a reasonable range of sizes that can be determined for patients when the goal is to be more in proportion. Breast implants can be placed that are generally considered to be larger than in proportion, but the patient should be aware of the potential problems that result from extremely large implants. The patient has the choice of implant size for augmentation mammaplasty (breast implants), and that choice should be done in an informed manner after a consultation with a properly trained Plastic Surgeon. Breast implant size will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring. What is the best incision site to place breast implants?
The sites that are commonly used for breast augmentation (breast implant placement) are inframammary incision (incision underneath or at the bottom of the breast), the periareolar incision (around the nipple areolar process), and the transaxillary incision (through the armpit). The inframmamary (incision underneath or at the bottom of the breast) approach to breast augmentation (breasts implants) is the standard to which all the other incision sites must be compared. The choice of scars position to perform breast augmentation (breast implants) is made by the patient after consultation with Dr. Herring. There are advantages and disadvantages to each scar position and these will be explained by Dr. Herring prior to the breast augmentation (breast implant) procedure. An important factor in the final appearance of the scar after breast augmentation (breast implants) is the individual’s natural scar forming tendencies. The tendencies to form “good” scars or “bad” scars after breast augmentation (breast implants) is determined in part by individual genetics. There are techniques and treatments to optimize scars with breast augmentation (breast implants) that will be discussed with Dr. Herring. It is important to obtain lifetime follow-up after breast augmentation (breast implants) for this reason, and other reasons as well. Some data indicates that the lowest re-operation rate (low re-operation rate is desirable) after breast augmentation (breast implants) is obtained with the inframammmary incision (incision underneath or at the bottom of the breast). There are other issues related to incision site choice for breast augmentation (breast implants) that Dr. Herring will discuss with you at your consultation. Clin Plast Surg. 2009 Jan;36(1):33-43, v-vi. Clin Plast Surg. 2009 Jan;36(1):49-61, vi. Clin Plast Surg. 2009 Jan;36(1):45-8, vi. Do I need breast augmentation (breast implants) alone, or a mastopexy ( breast lift ) alone, or a combination breast augmentation (breast implants) and a mastopexy ( breast lift )?
The best operation, or operations, for each patient depends on the specific physical situation of that patient and the patient’s goals. If the patient has no breast sagging, or very little breast sagging, and simply wishes to have larger breasts, then a breast augmentation (breast implants) alone is probably the best choice. If the patient has a moderate amount of sagging, the the breast augmentation (breast implants) alone or the mastopexy (breast lift) alone may be reasonable choices. If the patient has severe sagging, then a mastopexy (breast lift) alone or a combination breast augmentation (breast implants) and may be the best choice. The choice between breast augmentation (breast implants) alone, or mastopexy (breast lift) alone, or a combination breast augmentation (breast implants) and mastopexy (breast lift) will be discussed with Dr. Herring at the time of your consultation. Clin Plast Surg. 2009 Jan;36(1):105-15, vii; discussion 117. Clin Plast Surg. 2002 Jul;29(3):401-9, vi. Clin Plast Surg. 2002 Jul;29(3):337-47, v.
How long will breast augmentation with saline implants last?
There is no set expiration time of breast implants after breast augmentation (breast implants), but because they are mechanical devices, they will sometimes leak or deflate. The implants used in my practice are manufactured by Mentor® and are backed by a lifetime product replacement policy. If they do leak or deflate, then the implant can be replaced with another surgical procedure. When getting breast augmentation it is important to understand that additional surgery may be needed or desired after initial surgery. Breast implant longevity will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 2000 May; 105 (6): 2143-2149. My patient seen below had breast augmentation (breast implants) approximately ten years ago. She has had no other breast surgery after the initial surgery ten years ago. Her appearance is still very good ten years after surgery and her breasts have a soft natural feel as well. Post operative observation by your Plastic Surgeon after breast augmentation (breast implants) is important. Without post operative observation, your surgeon can not know if the technique, the implant, and the after surgery care has been optimal. 
Is there any danger if breast implants leak after my breast augmentation surgery?
After breast augmentation (breast implants) surgery with saline filled implants, the implants can sometimes leak or deflate. While there could be some general health risks if the saline implants leak after breast augmentation (breast implants) surgery, the risks of implant leakage after augmentation mammaplasty (breast implants) are generally considered to be low. The deflated implant can be replaced with another implant with an additional augmentation mammaplasty (breast implant) procedure. Implant leakage issues will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring. Clin Plast Surg. 2009 Jan;36(1):15-21, v. Does augmentation mammaplasty with saline breast implants cause breast cancer?
There have been studies done regarding breast implants and breast cancer and it is generally believed at this time that saline breast implants used for augmentation mammaplasty do not cause breast cancer. Breast cancer issues will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast Reconstr Surg. 1997 April; 99 (5): 1346-1353. Plast Reconstr Surg. 2007 Dec; 120 (7 Suppl 1): 70S-80S. Plast Reconstr Aesthet Surg. 2008; 61(2): 124-129. Does augmentation mammaplasty with saline breast implants cause problems with diagnosis of cancer?
Breast augmentation (breast implants) does make mammography more challenging and can cause difficulty seeing some of the breast tissue during the exam. There are many variables related to breast cancer diagnosis after breast augmentation (breast implants) that include but are not limited to, the type of exam performed (screening versus diagnostic), the technique of the exam, the type of machines used for diagnosis (mammography, digital mammography, ultrasound, and magnetic resonance imaging), the specifics of the breast augmentation procedure (breast implants), and the experience of the radiologist with performing studies in augmentation mammaplasty (breast implant) patients. Despite lower accuracy of some studies after breast augmentation (breast implants), some studies have shown no difference in factors related to breast cancer in patients after breast augmentation (breast implants) (see studies listed below). Breast cancer surveillance issues will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring. Example Study 1: Effect of breast augmentation on the accuracy of mammography and cancer characteristics. Despite the lower accuracy of mammography in women with augmentation, the prognostic characteristics of tumors are not influenced by augmentation”.
JAMA 2004 Jan 28; 291(4): 442-450. Example Study 2:
Breast cancer diagnosis and prognosis in augmented women.
“Based on these findings, the authors conclude that despite the diminished sensitivity of mammography in women with implants, augmented and non-augmented patients are diagnosed at a similar stage and have a comparable prognosis”.
Plast Reconstr Surg. 2006 Sep; 118(3): 587-593. Example Study 3:
Breast implants and breast cancer: a review of incidence, detection, mortality, and survival.
“In summary, breast implants are not associated with an increases risk of breast cancer incidence or death, and these patients do not experience delayed detection or poorer post-breast cancer survival”
Plast Reconstr Surg. 2007 Dec; 120(7 Suppl 1): 70S-80S. I have read a lot about breast augmentation surgery, and I have talked with several physicians, and I am very confused with all this conflicting information.
Medical opinions will vary from doctor to doctor regarding breast augmentation (breast implants). When opinions vary, it generally does not mean that one is right, and one is wrong, but rather that based on study and personal experience, surgeons have different opinions and recommendations regarding breast augmentation (breast implants). Reasonable physicians can have differing opinions regarding breast augmentation (breast implants), and those differing opinions should not be cause for undue concern. It is very important for patients to be well informed before making any decision about any surgical procedure including breast augmentation (breast implants), and in that process it is commonplace to get differing opinions from physicians. It is very important to know that your surgeon is properly trained to perform breast augmentation (breast implants), which increases the likelihood of getting a mainstream opinion and a good final result. While it is impractical to review the entire medical literature on this web site with regard to breast augmentation (breast implants), the previously mentioned scientific articles are in generally respected journals in this area of Plastic surgery.
Important considerations when learning about emerging (new) technology or products in Plastic surgery: When studying emerging technology, it is important to consider peer reviewed scientific studies to answer questions of efficiency and safety. In some circumstances, new technology is touted as the “magic wand” for a particular procedure, and scientific studies sometimes suggest otherwise. Scientific studies should be done in a manner where the persons acting as researchers have no conflict of interest and no other motive for a particular finding other than seeking the honest truth. Any person with a conflict, such as ownership in company that profits from the sale of an emerging technology, could bias the final findings of a study. Many scientific publications, such as the journal Plastic and Reconstructive Surgery, have very strict rules regarding conflict of interest which gives studies published in that journal high credibility in this regard (conflict of interest). While peer reviewed journals can have studies that draw different conclusions, information in these peer-reviewed journals is generally considered to be a primary source for accurate unbiased information. Any other issues you have questions about will be discussed with you at the time of your breast augmentation (breast implant) consultation with Dr. Herring.
Plast. Reconstr. Surg 2006 Dec 118(7): 1649-52.
Where Can I find information about the Food and Drug Administration positions on breast augmentation (breast implants)? Breast Implants Homepage FDA Breast Implant Consumer Handbook - 2004 For more information on Breast Augmentation, contact Cape Fear Plastic Surgery in Fayetteville, North Carolina.
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