Breast augmentation — also known as augmentation mammoplasty — is a surgical procedure to increase breast size. During breast augmentation, breast implants are placed under the breast tissue or chest muscles.

For some women, breast augmentation is a way to enhance self-image and self-confidence. For others, breast augmentation is part of breast reconstruction after surgery for breast cancer or other conditions affecting the breast.

If you're considering breast augmentation, consult a plastic surgeon. Make sure you understand what surgery involves, including possible risks, complications and follow-up care.

A woman's reasons for choosing breast augmentation are highly personal.

Breast augmentation might help you:

  • Enhance your breast appearance if you feel your breasts are too small or you're concerned that one breast is smaller than the other
  • Adjust for a reduction in the size of your breasts after pregnancy
  • Reconstruct your breast after having breast surgery for cancer or other conditions
  • Improve your self-image or self-confidence

Discuss your goals with your surgeon so that you can develop a realistic expectation of what breast augmentation can do for you.

Breast augmentation poses various risks, including:

  • Scar tissue that distorts the shape of the breast implant (capsular contracture)
  • Breast pain
  • Infection
  • Changes in nipple and breast sensation, usually temporary
  • Implant leakage or rupture

Correcting any of these complications might require additional surgery, either to remove or replace the implants.

A 2011 Food and Drug Administration (FDA) review found a possible association between breast implants and anaplastic large cell lymphoma (ALCL) — a rare cancer of the immune system. However, the connection isn't well-defined or clearly supported. The number of women in the general population who have ALCL is exceedingly low, and the number is even lower among women who have breast implants.

Initially, you'll consult with a plastic surgeon about your preferences for size, feel and overall appearance of your breasts. The surgeon will describe specific types of implants — smooth or textured, round or shaped like a teardrop, saline or silicone — as well as options for surgical techniques.

Review any documentation carefully and keep copies of all pertinent information for your records.

Before you decide to go ahead with surgery, consider some important factors about breast augmentation:

  • Breast implants won't prevent your breasts from sagging. To correct sagging breasts, you might need a breast lift in addition to breast augmentation.
  • Breast implants aren't guaranteed to last a lifetime. Implant rupture is a possibility. Also, your breasts will continue to age after augmentation — and factors such as weight gain or weight loss might further change the way your breasts look. Any of these issues might lead to additional surgery.
  • Mammograms might be more complicated. If you have breast implants, routine mammograms might require additional, specialized views.
  • You might need routine MRI scans. The Food and Drug Administration recommends monitoring silicone breast implants with routine MRI scans every two years, starting three years after the initial implant surgery. Debate continues, however, on whether the benefit of routine MRI scans justifies the cost. There's also a concern that routine MRI scans have the potential to lead to unnecessary surgery.
  • Breast implants might hamper breast-feeding. Some women are able to successfully breast-feed after breast augmentation. For others, however, breast-feeding is a challenge.
  • Insurance might not cover breast implants. Unless it's medically necessary — such as the need for implant reconstruction after a mastectomy — breast augmentation isn't covered by insurance. Be prepared to handle any expenses that accompany breast augmentation, including related surgeries or future imaging tests.
  • You might need additional surgery after breast implant removal. If you decide to have your implants removed, you might need a breast lift or other corrective surgery to help your breasts maintain an aesthetically pleasing appearance.

If you decide to have the surgery, you might need lab tests or a baseline mammogram ahead of time. Your doctor might adjust certain medications before the surgery as well. For example, it's important to avoid aspirin or other medications that can increase bleeding.

If you smoke, your surgeon will ask you to stop smoking for a certain period of time before the surgery.

Arrange for someone to drive you home after the surgery and to stay with you for at least the first night.

Breast augmentation can be done in a surgical center or hospital outpatient facility. You'll probably go home the same day. Rarely, the procedure requires a hospital stay.

In select cases, breast augmentation is done with local anesthesia — in which you're awake and only your breast area is numbed. In most cases, though, breast augmentation is done under general anesthesia — in which you're asleep for the surgery.

During the procedure

To insert the breast implant, your surgeon will make a single cut (incision) in one of three places:
  • In the crease under your breast (inframammary)
  • Under your arm (axillary)
  • Around your nipple (periareolar)

After making an incision, the surgeon will separate your breast tissue from the muscles and connective tissue of your chest. This creates a pocket either behind or in front of the outermost muscle of the chest wall (pectoral muscle). The surgeon will insert the implant into this pocket and center it behind your nipple.

Saline implants are inserted empty, and then filled with sterile salt water once they're in place. Silicone implants are pre-filled with silicone gel.

When the implant is in place, the incision will be closed — typically with stitches (sutures) — and bandaged with skin adhesive and surgical tape.

After the procedure

Soreness and swelling are likely for a few weeks after surgery. Bruising is possible, too. Expect your scars to fade gradually over time, although they won't disappear completely.

While you're healing, it might help to wear a compression bandage or sports bra for extra support and positioning of the breast implants. Your surgeon might prescribe pain medication as well.

Follow your surgeon's instructions about returning to regular activities. If you don't have a physically demanding job, you might be able to return to work within a few days to a week. Avoid strenuous activities — anything that could raise your pulse or blood pressure — for at least two weeks. While you're healing, remember that your breasts will be sensitive to physical contact or jarring movements.

If your surgeon used sutures that don't absorb on their own or placed drainage tubes near your breasts, you'll need to have them removed at a follow-up appointment.

If you notice warmth and redness in your breast or you run a fever, you might have an infection. Contact your surgeon as soon as possible. Also contact your surgeon if you experience shortness of breath or chest pain.

As you anticipate the outcome of breast augmentation, keep your expectations realistic.

Breast augmentation can change the size and shape of your breasts. The surgery might even improve your body image and self-esteem. If you're looking for perfection, however, you might be disappointed.

Also, remember that your breasts will continue to age after augmentation. Weight gain or weight loss might change the way your breasts look, too. If you become dissatisfied with the appearance of your breasts, you might need a revision operation to correct these issues.

During your consultation, Mayo Clinic doctors trained in plastic surgery (plastic surgeons) will discuss different surgical options and available techniques for breast augmentation with you. Your plastic surgeon will work with you to determine the most appropriate surgical option and the size and type of breast implant appropriate for you. Your plastic surgeon will discuss with you your expectations, possible risks and complications, associated costs and other considerations.

In breast augmentation surgery, your surgeon may make incisions in the crease under your breast (inframammary incision), at the edge of the colored skin around the nipple (periareolar incision) or under your arm (transaxillary incision). Your surgeon positions the breast implant under your breast tissue (subglandular placement) or under the pectoralis muscle beneath the breast (submuscular placement). Breast implants are filled with a sterile, saltwater solution (saline) or elastic gel (silicone). Your incision scars may fade over time, but they will never completely disappear.

  • Experience. Mayo Clinic doctors trained in plastic surgery (plastic surgeons) perform breast augmentation surgery.
  • Team approach. Mayo Clinic board-certified plastic surgeons work together as a team to perform your surgery.
  • Individualized treatment. Mayo Clinic doctors work with you to determine the most appropriate surgical options for you. Doctors will discuss your concerns and explain the potential benefits and risks of breast augmentation surgery.

At Mayo Clinic, we assemble a team of specialists who take the time to listen and thoroughly understand your health issues and concerns. We tailor the care you receive to your personal health care needs. You can trust our specialists to collaborate and offer you the best possible outcomes, safety and service.

Mayo Clinic is a not-for-profit medical institution that reinvests all earnings into improving medical practice, research and education. We're constantly involved in innovation and medical research, finding solutions to improve your care and quality of life. Your doctor or someone on your medical team is likely involved in research related to your condition.

Our patients tell us that the quality of their interactions, our attention to detail and the efficiency of their visits mean health care — and trusted answers — like they've never experienced.

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Mayo Clinic works with hundreds of insurance companies and is an in-network provider for millions of people. In most cases, Mayo Clinic doesn't require a physician referral. Some insurers require referrals or may have additional requirements for certain medical care. All appointments are prioritized on the basis of medical need.

Doctors trained in plastic and reconstructive surgery and cosmetic surgery perform breast augmentation surgery at Mayo Clinic in Arizona.

For appointments or more information, call the Central Appointment Office at 800-446-2279 (toll-free) 8 a.m. to 5 p.m. Mountain Standard Time, Monday through Friday or complete an online appointment request form.

Doctors trained in plastic surgery and cosmetic surgery perform breast augmentation surgery at Mayo Clinic in Florida.

For appointments or more information, call the Central Appointment Office at 904-953-0853 8 a.m. to 5 p.m. Eastern time, Monday through Friday or complete an online appointment request form.

Doctors trained in plastic surgery perform breast augmentation surgery at Mayo Clinic in Minnesota.

For appointments or more information, call the Central Appointment Office at 507-538-3270 7 a.m. to 6 p.m. Central time, Monday through Friday or complete an online appointment request form.

See information on patient services at the three Mayo Clinic locations, including transportation options and lodging.

Mayo Clinic doctors trained in cosmetic surgery and plastic surgery study breast augmentation surgery and other cosmetic procedures.

Publications

See a list of publications by Mayo doctors on PubMed, a service of the National Library of Medicine.

Aug. 16, 2012