Breast augmentation is a surgical procedure to enhance your breasts through the placement of breast implants under your breast tissue or chest muscles. Some women consider large breasts more attractive than small or average-sized breasts. For these women, breast augmentation may improve self-image and self-confidence. In recent years, breast augmentation has been one of the most popular types of cosmetic surgery among women in the United States. If you're considering breast augmentation, be sure you understand fully what surgery entails, set realistic expectations, and consider the possible risks and complications associated with breast implants.

Why it's done Your reasons for choosing breast augmentation are highly personal. Breast augmentation may help you: Enhance your breast appearance if you feel your breast size is too small Adjust for a reduction in the size of your breasts after pregnancy Reconstruct your breast after having breast surgery for cancer or other conditions Correct a defect in the development of your breasts, such as having breasts of unequal sizes Improve self-image The best candidate for breast augmentation is a woman looking for an improvement — but not perfection — in her appearance. The outcome of the procedure may fall short of the ideal look you imagined. Discuss your goals with your surgeon so that you can develop a realistic expectation of what's to come.

Risks Be aware of the risks associated with breast augmentation surgery: Repeat surgery. You may need more surgery down the road, either to replace the implants or to remove them altogether. In clinical trials studying the safety and effectiveness of saline-filled breast implants, as many as one in four women required a second operation within five years of the initial surgery. Rupture. Implants can rupture, causing fluid to leak into your breast and surrounding tissue. This can happen as a result of a blunt-force injury — if you're thrown against the steering wheel in a car accident, for example — or from tiny cracks in the implant shell that can occur over time. If you have a saline-filled implant, a rupture will cause your implant to lose its original size or shape. If you have a silicone gel-filled implant, a rupture may not be as obvious. Your surgeon may use imaging tests, such as magnetic resonance imaging, to check for signs of rupture or other implant problems. Deflation. A rupture or a slow leak can cause an implant to collapse, deflating the size of your breast. This may result in breasts that are noticeably different in size or in a change to the cosmetic appearance of your breast, such as sagging or wrinkling. Capsular contracture. Fibrous scar tissue forms a capsule around your breast implant. The scar tissue may build up over time and constrict your implant — a painful and potentially disfiguring condition. Surgery is usually necessary to correct capsular contracture. Infection. One potential complication of breast augmentation surgery is infection. Medications may help, but antibiotics aren't always successful in treating infections of this type. Removing your breast implants may be necessary if you develop a severe infection. You may have to wait six months to a year after implant removal before you can get new implants placed. Hematoma. Blood and other fluids can pool around the implant, causing pain, infection or other problems. If you develop a hematoma, you might need to go back into the operating room so that your doctor can find the cause of the bleeding. Pain. You could experience significant pain after surgery — more than what's considered normal — which indicates a bigger problem, such as implant rupture or capsular contracture. To remedy the problem, you may need surgery to remove or replace the breast implants. Dissatisfaction with the results. You might experience changes in the sensation of your breasts and nipples, or you might be able to feel the implant beneath the surface of your breast tissue.

How you prepare Initially, you'll consult with a plastic surgeon about your preferences for size, feel and overall appearance of your breasts. Your surgeon will describe the surgical techniques and provide you with educational materials about the breast implant you select and the surgical procedure. Review these documents carefully and keep copies of all pertinent information for your records. Your surgeon may also send you for lab tests or for a baseline mammogram before your surgery. If you're a smoker, you'll be instructed to stop smoking four to six weeks before your surgery. You may also be told to avoid aspirin, anti-inflammatory drugs or other medications that may increase your bleeding risk during surgery. Before you decide to have surgery, consider some important factors about breast augmentation: Breast implants aren't lifelong devices. Your breast implants will likely need to be removed and replaced at some point. You might need more surgery after breast implant removal. If you have your breast implants removed for any reason, you may experience unacceptable cosmetic changes — such as wrinkling, dimpling or droopy excess skin — which might require replacing the implants. Or you may need a breast lift (mastopexy) to remove excess skin and reposition your nipple. Breast implants won't prevent your breasts from sagging after pregnancy. Some women actually need to consider a breast lift in addition to breast augmentation to correct sagging breasts. Also, depending on how it's done, breast augmentation surgery may make breast-feeding more challenging. Mammograms may be more complicated. Additional, specialized views are necessary when obtaining images of your breasts. The quality of the mammogram will depend on the experience and expertise of your technician and the facility you select.