When it comes to appearance, there’s no doubt that Americans are a bit obsessed with breasts. Breasts are a symbol of femininity, and if you’re not happy with yours it can really knock your self-confidence, no matter how much you believe you should love your body as it comes. Although there is no doubt that beauty comes in every shape and (cup) size, we also live in a time when women are empowered to make whatever choices about their bodies are best for them—including whether to get breast implants. You might be curious about breast implants for a number of reasons: Maybe you were never happy with your breasts. Perhaps you lost one or both due to cancer. Transgender women often find that breast implants help their external appearance match what’s in their hearts and minds. Others opt for breast implants to balance out uneven breasts. In short, there are a variety of reasons—from health to personal preference—that women decide to get breast implants, and ultimately, no matter the reason, there should be no shame in considering changing your body if you believe it will make you happier. No matter the reason you’re looking into breast implants, it can be hard to find reliable information that is backed by science. Reality TV and Hollywood stereotypes paint a certain picture about women who go under the knife, but the truth is that breast augmentation is the most common form of plastic surgery: In 2016 the surgery was performed 290,000 times in America, according to the American Society of Plastic Surgeons. That was an increase of 4 percent from the year before. Whether you’re preparing for your upcoming breast augmentation or just beginning to consider getting breast implants, we want you armed with all the knowledge you need. HealthyWay took the most common questions about boob jobs to the doctors who perform them every day. Here are your breast implant questions, asked and answered.
Q: What are the different types of breast implants, and how do I choose which is best for me?
A: All breast implants have an exterior made from silicone. It’s what’s inside that makes them different. Breast implants are either prefilled with a silicone gel, or they are filled with a saline solution once they are inserted. Each has advantages and disadvantages. Saline breast implants are slightly less expensive, and since they can be filled once they’re inserted, doctors are able to insert them through a smaller incision, says Scott Newman, MD, a plastic surgeon based in New York City. However, because saline breast implants need to be filled, the implants have valves on them, “which makes the product less reliable,” he says. Silicone breast implants, on the other hand, are prefilled. They generally require a slightly larger incision to be inserted into the breast tissue. However, because silicone gel comes in varying thicknesses, the person receiving the implant has more control over what the breasts will feel like. Which brings us to…
Q: Will my breast implants feel (and look) real?
A: There are a lot of stereotypes about what breast implants feel and look like post-surgery. Many women worry their new breasts will be too big or too hard. However, it’s entirely possible to work with your doctor to get breast implants that look and feel natural. Here are a few things to consider:
Your breasts will feel different depending on what type of breast implants you choose.
“Saline implants often feel different than natural breast tissue and that’s the main advantage to silicone implants: they feel more natural and believable,” Newman says.
Saline breast implants are also more likely to be seen or felt through the skin.
This is an effect known as rippling, says Dana Goldberg, MD, a Florida-based board-certified plastic surgeon. That said, advancements in silicone technology have made silicone breast implants less likely to experience rippling. “Silicone implants have been modified several times since their invention,” she says. “Current implants have what is known as generation five gel, also called gummy bear gel. This gel tends to settle less over time, which can help maintain more fullness in the upper breast and minimize rippling.”
To get the results you want, do your research and talk with your doctor ahead of time.
Goldberg says most patients want natural-looking results, with breasts that are proportional to the rest of their figure. Your doctor can walk you through the sizes and shapes of breast implants to help you decide what will suit your body best. “Most women in the U.S. choose implants with a smooth, round silicone shell … but there are also textured implants and anatomic-shaped implants,” she notes. According to a Simply Breasts resource, anatomical implants are more of a teardrop shape that mimics the fullness at the bottom of a natural breast and avoids the noticeable protrusion at the top of round implants. Doctors may encourage women who opt for anatomical implants to choose ones with a textured surface, which promotes healing and prevents the implants from rotating in the surgical pocket.
Q: How much do breast implants cost? And will insurance cover breast implant surgery?
A: As with many medical procedures, the cost for breast implants varies widely depending on where the procedure is done and individual factors around your needs as a patient. In 2016, the average cost of breast implant surgery was $3,719, according to the American Society of Plastic Surgeons. Note that you may need to pay additional costs for hospital fees and anesthesia. Insurance does not typically cover breast augmentation (although if you’re having reconstruction the answer may be different). It’s important to note that not only does insurance not cover the procedure, but most plans won’t cover costs due to complications from the surgery. Additionally, some plans do not cover costs associated with the treatment of breast disease—including breast cancer—in individuals with implants. Because of this, it’s important to thoroughly review your insurance plan to understand what effect breast implants may have on future coverage. It’s also worth noting that it’s fairly expensive to get breast implants removed, and that surgery typically is not covered by insurance either. In 2016, the average cost for breast implant removal was $2,506.
Q: What is the breast implant surgery like?
A: Going under the knife isn’t for the faint of heart, which keeps many people from getting breast implants. So, what’s the surgery like? The good news is that it’s relatively easy, as surgeries go. The bad news is that any surgical procedure carries risks. In general, breast implant surgery is done at an outpatient facility and takes between one and two hours, although it can be longer in more complex cases or for people having a reconstruction. The surgery can be done under general anesthesia or under deep sedation, so you and your doctor will work together to decide which option is best in your case. Once you are under anesthesia, the surgery begins. An incision is made around the areola or near the fold on the underside of the breast. (Saline breast implants can even be inserted through a small incision in the belly button, Goldberg notes.) Next the implant is put in place, and finally the incision is closed up. Of course, that’s a fairly basic overview of the breast implant surgery. “The specifics of the surgery are very individualized,” Newman says. If you are seriously considering breast implants, it’s best to talk to a surgeon who can discuss what the surgery would be like for you given your unique anatomy and medical history.
Q: How bad is the recovery?
A: The worst thing about breast implant surgery isn’t usually the actual procedure, but the recovery. However, most patients experience a fairly easy recovery from breast augmentations. “In typical cases where implants are placed under the chest muscle, most of my patients will return to work by the second or third day,” Newman says. “Most patients will take pain medicine for the first day. By the second day discomfort is typically present, but normal routines can be resumed.”Of course, it will take you a bit longer to get back to the gym, but your day-to-day routine shouldn’t be interrupted for too long. Many patients also experience some tightness and pressure in their chests as they adjust to the implants. “I tell women who have children that the discomfort after surgery feels a lot like engorgement from [linkbuilder id=”6085″ text=”breast milk”] coming in,” Goldberg says. “For women who haven’t had children, it feels like you did way too many pushups.” Speaking of milk….
Q: Will I be able to breastfeed with breast implants?
A: It depends. Of course, not all women are able to breastfeed under normal circumstances anyway, but previous breast implant surgery can add a complicating factor. However, getting breast implants shouldn’t interfere too much with your ability to lactate. “Not all women are able to breastfeed, so no surgeon can promise a patient she will be able to breastfeed after surgery,” Goldberg says. “That said, most patients will be able to breastfeed. A small implant placed through an incision in the breast fold gives the best chance of being able to breastfeed since the breast ducts to the nipple are not cut during surgery.” If you have a strong desire to breastfeed and are not yet done having children, talk to your doctor about what surgical options will be best for you.
Q: Will I have the same level of feeling and sensation after getting breast implants?
A: For many women, breasts and nipples are important erogenous zones, so many patients want to make sure that they will not lose sensation if they get breast implants. While you might lose sensation immediately after surgery, it’s likely that normal sensation will return, the pros say. “In my practice it’s rare for a patient to lose nipple sensation, although it’s common to see a loss (or change) in sensation temporarily,” Newman says. This is most common in patients who have the breast implant inserted through their nipple or areola. Goldberg says that in her experience most patients regain full sensation within six to 12 months. However, if preserving sensation is a priority for you, make sure that your doctor knows that and can make plans accordingly. “Since the main nerve to the nipple comes from the side of the rib cage, implants that are wider than the natural breast have a much higher chance of affecting sensation,” Goldberg says.
Q: Do breast implants really need to be replaced every few years?
A: “If you only want to have one surgery in your life, then implants are not for you,” Goldberg says. Right now, it’s recommended that most breast implants be replaced every 10 years. However, Newman says he expects this to change as technology around implants continues to improve. “As additional data is collected I do expect that this timeframe will eventually be lengthened,” he says. “Implant companies currently offer 10-year warranties for some implants.”
Q: What’s the difference between breast implants and a breast lift?
A: Breast implants involve putting additional material into the body, while breast lifts involve reshaping the tissue that you have naturally. Adam Schaffner, MD, a board-certified plastic surgeon and the director of the Plastic Surgery Institute of New York, explains: “A breast augmentation (placing breast implants) increases the size and upper pole fullness of the breast,” he says. “A breast lift raises the position of the nipple-areolar complex and the breast tissue. They may be performed at different times or during the same operation.” Sometimes getting breast implants can naturally lift your breasts, Newman adds. “Breast augmentation alone does tighten the breast, so there are cases where the breast can be lifted just from inserting an implant,” Newman says. “There are times that I have been able to give a patient the lift they want just by inserting an implant, but these cases need to be determined individually.”
Q: Are breast implants linked to cancer?
A: “There has never been a link found between breast implants and breast cancer, period,” Newman says. “The question more so is whether breast implants affect breast cancer detection and they absolutely do.” Luckily, it’s usually a positive effect. “In fact, there is some data to suggest that breast cancers are easier to find in breast augmentation patients, and when they are found, they’re typically found at an earlier stage,” he says.
Q: What else should I consider before getting breast implants?
A: Deciding whether to permanently change your body is a big decision that shouldn’t be made with only the physical considerations in mind. It’s important to think about how you’ll feel about your breasts and body after surgery, and not to expect your breast implants to automatically fix any body image issues you might have. “It is important that patients have realistic expectations about results,” Newman says. “A good plastic surgeon will give a patient significant time and will understand a patient’s true motivation. Implants will simply change someone’s physical appearance and, while that often does result in increased self-confidence, it will not change underlying psychological concerns.” Want more information on breast implants? Use this search tool from the American Society of Plastic Surgeons to help you find a board-certified plastic surgeon near you.