If you’ve ever considered getting breast implants, you’re not alone. As of 2019, breast augmentation (which includes breast implants as well as fat transfer—or the use of liposuction to inject fat from other parts of your body into your breasts) was the most popular cosmetic surgical procedure in the United States.
Last year alone, nearly 300,000 Americans underwent breast augmentation—also known as breast enlargement, augmentation mammoplasty, or a boob job. Here’s what you should know if you feel like you must increase your bust.
Types of Breast Implants
There are three types of implants: saline, silicone, and “gummy bear.” Saline implants are filled with sterile saltwater. They can be prefilled or filled at the time of surgery. Silicone implants are prefilled with silicon gel and come in a variety of shapes and degrees of firmness. They feel more like natural breast tissue than saline does. “Gummy bear” implants are also filled with silicone gel, but the gel is more cohesive, so the implants are thicker and firmer than traditional silicone implants.
To insert the implant, your surgeon will make an incision, create a pocket, and place the implant in the pocket. They can place it either underneath the pectoral muscle, which is between the breast tissue and your chest wall, or on top of the muscle (but still underneath your breast tissue).
“Each implant has pros and cons depending on the patient’s goals,” says Stafford Broumand, M.D., a plastic surgeon at 740 Park Plastic Surgery. “During the evaluation, I review the patient’s goals, breast shape, and anatomy to determine the best implant and incision.”
Reasons to Get Breast Implants
Some women choose to get their breasts reconstructed after a mastectomy or to correct congenital or acquired breast defects, says Norman Rowe, M.D., the founder of Rowe Plastic Surgery. Some want to balance out asymmetry or undo the effects of pregnancy, nursing, weight loss, or aging. And some just want a bigger cup size.
“Any patient who would like to change the size and shape of her breasts, wants to create a more proportionate shape, or wants [to change the fit of her clothing] is a good candidate for breast augmentation,” says Broumand. Who’s not a good candidate? “A patient with body-dysmorphic issues or who’s being pressured by family or friends,” he says.
What Breast Implants Can’t Do
Fix sagging, though that may benefit from a combo of breast implants and a breast lift. (A breast lift alone can’t fix sagging either, says Rowe: “Many women come into my office wanting perky, lifted breasts without making them any larger. This cannot be done.”) Implants also can’t correct major asymmetry in the size, shape, or orientation of your boobs, though they can improve these issues. PSA: Noticeable differences between one breast and the other are not only normal, they’re the rule.
The Cost of Breast Implants
The national average in 2019 was $3,947, which reflects only the surgeon’s fees and doesn’t include fees for the surgical facility, anesthesia, testing, prescriptions, special garments, and more. Your cost depends on where you live, which type of implant you choose, and your surgeon. Silicone implants, for example, are more expensive than saline. Plastic surgery in large cities, where the cost of living and demand is higher, tends to cost more than they do in smaller cities.
Because breast implants are an elective surgery, health insurance typically doesn’t cover them. The exception is breast-reconstruction procedures, which is often covered by insurance whether they’re done immediately after a mastectomy or years later.
Breast Implant Surgery: What to Expect
While there’s no ideal age for getting breast implants, you must be at least 18 years old—and, according to FDA guidelines, 22 to get silicone implants—and your breasts should be fully developed. Some surgeons advise waiting until you’re 21 to get implants for cosmetic reasons.
When choosing a surgeon, “you need to do your homework,” says Rowe. This means looking for a board-certified surgeon who’s experienced in performing breast augmentation. Ask whether they’re certified by the American Board of Plastic Surgery, whether they were trained specifically in the field of plastic surgery, and how many years of plastic surgery training they’ve had.
The surgery itself takes about one to two hours and is usually an outpatient procedure, meaning it’s done in an accredited office-based surgical suite or ambulatory surgery center—a nonhospital center where same-day surgeries are performed—though it can also be done in a hospital. It’s performed either under general anesthesia, meaning you’re put to sleep completely, or conscious sedation with local anesthesia. The incision will be made in one of four places: underneath the breast, just above the crease; near your armpit; around your areola (the dark circle surrounding your nipple); or, for saline implants only, in the belly button.
Preparing for Breast Implant Surgery
Your surgeon will want to discuss any previous surgeries you’ve had, past and current medical conditions, allergies and any medications you’re on, and your family history of breast cancer and mammogram and/or biopsy results. They’ll also ask about any alcohol, tobacco, or drug use; whether you plan to lose a significant amount of weight or become pregnant; and why you want implants.
Your surgeon may recommend a mammogram before surgery and then again a few months afterward. You may need to get a blood test and take or adjust medications. If you’re a smoker, you’ll need to quit for six weeks beforehand. You’ll also need to avoid aspirin and hydrate before (and after) surgery. Rowe’s advice: “Eat healthy, have a healthy lifestyle—and have realistic expectations.”
Recovering From Breast Implant Surgery
Immediately after surgery, you’ll recuperate in a recovery area. Once you’re considered stable, typically after about an hour or so, you may be discharged to go home. You can expect to be stiff and sore for two to five days. Any surgical dressings will be removed after several days, and any external sutures will be removed after about a week.
Depending on how physical your job is, you should be able to return to work within a few days to a week. While light activity can be resumed after about a week, vigorous physical activity is off-limits for at least two weeks after surgery. “Though we do limit the amount of weight patients pull, push, or carry during recovery to ensure proper healing, your strength and range of motion shouldn’t be limited long term,” says Broumand. And you shouldn’t require any sort of physical therapy.
During and after surgery, you’ll be given antibiotics to prevent infection. You may also be prescribed pain pills and medication that decreases scar tissue around the implant to keep it soft, says Rowe. Your surgeon will use sutures to close up the incisions, and they may wrap your chest with a gauze bandage or have you wear a surgical compression bra to help with healing. A special support garment is usually worn around-the-clock for several days after your surgery.
Breast Implant Maintenance
Your surgeon should examine you periodically to monitor your implants, which can be affected by pregnancy, breastfeeding, weight loss, and menopause. “There’s a misconception that implants need to be changed every 10 years,” says Rowe. “Of course, everything is affected by gravity. All breast implants eventually do drop and need to be lifted again. But when they’re done properly, they can last a lifetime.”
Originally Appeared on Glamour