What is breast augmentation?

If you aren’t satisfied with the shape, size or contour of your breasts, you may wish to consider breast augmentation. Also known as augmentation mammoplasty, the procedure involves using implants to enlarge the breasts.

Breast augmentation may also help after pregnancy or weight loss if you are unhappy with the size or droopiness of your breasts. Implants can also correct asymmetry or unevenness in breast size caused by developmental problems or breast cancer surgery performed in the opposite breast.

Breast augmentation is a highly individualized procedure, which you should do for yourself, not to fulfill anyone else’s desires or to fit a certain type of ideal image.

It is the most commonly performed cosmetic surgical procedure in the United States and experts at Cleveland Clinic Cosmetic & Plastic Surgery Center have perfected techniques for the ultimate results.

Am I a candidate for breast augmentation?

One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation:

• You are worried by the feeling that your breasts are too small
• Clothes that fit well around your hips are often too large at the bustline
• You feel self-conscious wearing a swimsuit or form-fitting top
• Your breasts have become smaller and lost their firmness after childbirth
• Weight loss has changed the size and shape of your breasts
• One of your breasts is noticeably smaller than the other

How do I prepare for breast augmentation?

To help prepare for your breast augmentation, plastic surgeons at Cleveland Clinic Cosmetic & Plastic Surgery Center may recommend a baseline mammogram before surgery if you are over 35 years old. This will help to detect any future changes in your breast tissue. Following breast augmentation, you will still be able to perform breast self-examination.

If you are a smoker, you will be asked to stop smoking well in advance of surgery. You should avoid aspirin and certain anti-inflammatory drugs that can cause increased bleeding for a period of time before surgery. Your plastic surgeon will provide you with additional preoperative instructions.

Breast enlargement is performed with either saline or silicone implants that are placed either under the chest muscle (sub pectoral) or over the chest muscle (sub glandular). Cleveland Clinic Cosmetic & Plastic Surgery Center plastic surgeons evaluate individual factors and personal preferences to determine your appropriate breast size, the location of incisions and whether the implants will be placed on top of or underneath the chest muscle.

• Before and Afters
• Specialists
• FAQs
• Consultation

Before

After

Patient before breast augmentation with saline breast implants (left) and 20 months after breast augmentation (right).

Patient before breast augmentation with saline breast implants (left) and 20 months after breast augmentation (right).

Patient before breast augmentation with saline breast implants (left) and 20 months after breast augmentation (right).

Patient before breast augmentation with silicone implants (left) and six weeks after breast augmentation (right).

Patient before breast augmentation with silicone implants (left) and six weeks after breast augmentation (right).

Patient before breast augmentation with silicone implants (left) and six weeks after breast augmentation (right).

Patient before breast augmentation with saline implants (left) and six weeks after augmentation (right).

Patient before breast augmentation with saline implants (left) and six weeks after augmentation (right).

Patient before breast augmentation with saline implants (left) and six weeks after augmentation (right).

Patient before breast augmentation (left) and two years after breast augmentation (right).

Patient before breast augmentation (left) and two years after breast augmentation (right).

Patient before breast augmentation (left) and two years after breast augmentation (right).

Patient before breast augmentation (left) and two years after breast augmentation (right).

Patient before breast augmentation (left) and two months after breast augmentation (right).

Patient before breast augmentation (left) and two months after breast augmentation (right).

Patient before breast augmentation (left) and one month after breast augmentation (right).

Patient before breast augmentation (left) and one month after breast augmentation (right).

Patient before breast augmentation (left) and one month after breast augmentation (right).

Patient before breast augmentation (left) and one month after breast augmentation (right).

Patient before breast augmentation (left), and patient two months after breast augmentation (right).

Patient before breast augmentation (left), and patient two months after breast augmentation (right).

• Steven Bernard, MD
• Risal Djohan, MD
• Gaby Doumit, MD
• Edward A. Levy, MD

• Armand Lucas, MD
• Andrea Moreira, MD
• Francis Papay, MD
• J. Vicente Poblete, MD

• Graham Schwarz, MD
• Randall Yetman, MD
• James Zins, MD

Can a woman breast-feed after breast augmentation?

Yes, if you would have been able to breast-feed without implants. Studies have shown that up to two-thirds of small-breasted women are not able to breast-feed successfully. Implants are not likely to have much effect on that either way. There is no known risk to the infant, regardless of the type of implant is used.

Is the sense of touch in the nipples usually preserved?

Most women do not lose the sense of touch of the nipples. Several factors have an influence on your chance of losing sensitivity, including the larger the implant, which leads to a more likely loss of sensitivity.

The location of the incision is another important factor: the primary medical journal report on the TUBA approach (transumbilical breast augmentation, which is the insertion of breast implants through an incision made in the belly button) shows that the incision in the navel resulted in 0.8 percent chance of losing all nipple sensitivity, where the other methods resulted in 3.0 percent chance of losing all nipple sensitivity.

Overall, there is only a very small chance of losing the sense of touch in the nipples. On average, one percent lose the sense of touch completely. About half of the women who have implants notice a change in sensitivity (either increased or decreased), which may require two years to return to normal.

Do breasts with implants feel hot or cold?

Implants can feel either hot or cold. The implants store heat or cold, changing their temperature slowly. Similar to how other body parts act, implants tend to be somewhere between body temperature and the temperature of the surroundings, and change slowly when your surroundings change.

For example, spend an hour in a pool or a cool room wearing a bikini, and your breast implants will cool below body temperature feeling cool to the touch, and remaining cool until they gradually warm up. Or, spend an hour lying in the sun, or in a hot tub, and the implants will warm above body temperature, and your breasts will feel warm to the touch.

Heat will not harm the implant. But, if you put a localized source of high heat directly on the breast, like a hot water bottle or heating pad, the implant will gradually warm up, and your breast skin will then be getting heat from both outside and inside and can potentially burn the breast skin.

One of the best ways to decide if cosmetic surgery is right for you is by meeting with a cosmetic or plastic surgeon at the Cleveland Clinic Cosmetic & Plastic Surgery Center.

During this first consultation, you and your surgeon will discuss your goals and expectations. Your surgeon will also:

• Review your complete medical history (including past and current medications)
• Evaluate the part of your body that you want treated
• Give recommendations
• Answer any questions you have
• Learn more about a physician consultation

How is breast augmentation performed?

Usually performed under general anesthesia, incisions are made in inconspicuous areas of the breast to minimize visible scarring. There are a variety of incisions used to perform the procedure:

• In the lower crease of the breast (inframammary incision)
• Around the lower portion of the areola, or dark-colored skin around the nipple (periareolar incision)
• In the armpit (transaxillary incision)
• Under the breast fold (sub-mammary incision)

Through these incisions, the plastic surgeon creates a pocket to place the implant. To maximize the accuracy of future mammograms, implants are generally placed under the muscle (subpectorally).

Some breast enlargements can be performed in a minimally invasive manner using endoscopes and small incisions made in the armpit, with the major benefit being less scarring for the patient. The procedure, which takes about two hours, is typically performed on an outpatient basis.

Are there different options for breast augmentation?

Breast implants are made up of a silicone shell filled with either saline (a salt water solution) or silicone gel. Silicone gel has a thick, sticky fluid consistency that closely mimics human fat, offering a more ‘natural’ look and feel if capsule contracture (shrinking and tightening of the scar tissue around a breast implant) does not occur. Saline implants have the disadvantage of sometimes feeling like a water balloon to touch, especially in patients with thin, soft tissue.

Cleveland Clinic also has the cohesive gel “Gummy Bear” implants available through studies sponsored by the Food and Drug Administration (FDA). This implant is anatomic in shape and maintains its shape, not leaking when cut with a knife. Patients must agree to participate in the FDA study to qualify for this implant. Details can be discussed with your plastic surgeon.

The FDA recommends silicone gel-filled implants be available to women age 22 and older for breast augmentation, or women of any age for breast reconstruction. Saline-filled breast implants are available to those women age 18 and older, and women of any age for breast reconstruction.

With the many concerns that arose from reports that leaking from silicone-filled breast implants may have caused health problems, the FDA limited the use of silicone implants in the early 1990s. Since then, numerous scientific studies have failed to produce evidence that silicone implants actually harm women’s health.

What results can I expect?

Breast augmentation will make your breasts fuller and enhance their shape. Like many women who have had the procedure, you may have a boost in self-confidence. Generally, the results of breast enlargement surgery are long-lasting. Breast augmentation cannot, however, stop the natural effects of aging that eventually alters the size and shape of virtually every woman’s breasts. Long-term follow-up with your plastic surgeon is strongly recommended.

What is involved in recovery?

Breast enlargement surgery is usually performed as an outpatient procedure. If this is the case, be certain to plan for someone to drive you home after surgery and stay with you at least the first night following surgery.

You will be given medication to take at home. Stiffness and soreness in the chest for the first two to five days is normal. These side effects, along with some swelling and bruising will subside over two to three weeks. Any surgical dressings will be removed within several days and you may be instructed to wear a support bra.

Physical activity is limited for the first several weeks, with most patients able to return to work and their normal activities within two to three weeks. Each year, thousands of women undergo successful breast augmentation surgery. Yet, all surgical procedures involve some risk

Is breast augmentation safe?

Both saline-filled and silicone gel-filled breast implants present potential risks, including:

Why Choose Us

Experts at Cleveland Clinic Cosmetic & Plastic Surgery Center will discuss any questions or concerns you may have prior to surgery. If you’re considering breast augmentation, look for a board-certified plastic surgeon with specialized training and significant experience performing breast augmentation. Consider going to a plastic surgeon who is affiliated with a major medical center, such as Cleveland Clinic Cosmetic & Plastic Surgery Center. Ask your plastic surgeon about credentials, training and how many breast augmentation procedures he or she has performed.

Is this procedure covered by health insurance?

Like all cosmetic procedures, breast augmentation is not covered by health insurance. Ask to talk with a financial representative from Cleveland Clinic Cosmetic & Plastic Surgery Center who can explain the costs of the procedure and payment options.

This information is provided by the Cleveland Clinic and is not intended to replace the medical advice of your doctor or health care provider. Please consult your health care provider for advice about a specific medical condition.

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