What You Should Know Before Breast Augmentation (Frequently Asked Questions)

Posted on September 4, 2013 by: Dr. Ronald DeMars

1.)    How do I choose the right breast implant size?

During your consultation, you should speak openly with your doctor about the general size and look you are hoping for. For example, if you have an A-cup and are hoping to be a C or D-cup, you can mention that to your doctor and he/she can help you decide what breast implant size is the best option for you. Many factors such as quality of skin, existing breast tissue, and location of nipples can all play a role. Your frame, or chest cage, should also be taken into consideration as it can play a significant role.

Another good way to show your doctor the look you are going for is to search photo galleries for women who have a very similar pre-operative breast size as you (also try to find one who has  the most similar chest cage size and body composition as you) who ended up with a size you like.

2.)    What should I expect during a breast augmentation consultation?

You should go into the consultation knowing three things:

a.)    Why you want the breast augmentation

b.)    What your and your family’s medical history is

c.)     What general goals you have for your breast size, shape and appearance

From there, you can expect your doctor to ask you several questions regarding the points above, and a breast exam where the doctor will consider many factors of your body and breasts including your body composition, chest cage size, quality of skin, nipple location, amount of breast tissue present, and more. The doctor will also likely take photos for your patient records. During this time your doctor should also discuss with you the different types of breast implants and different sizes, and the different breast augmentation techniques (under the breast, under the nipple, or in the arm pit). You will also learn about what to expect before, during and after the surgery.

The consultation is your time to ask any questions or discuss any concerns about the procedure, so be sure to speak up and ask whatever you’d like to know!

3.)    How should I prepare for surgery?

Your doctor will advise you on exactly what you need to know before your surgery, but in general you should refrain from smoking 1-2 weeks before your surgery, avoid specific medicines that could complicate surgery or the recovery (including ibuprofen and aspirin), schedule time off work if necessary, and arrange for a ride home post-operation and help at home for a day or two afterward.

4.)    What is the normal breast augmentation recovery time?

Everyone is slightly different, but in general you should expect at least 2 full days to rest. Most women are able to return to work after about 5-7 days, and are also able to take part in light activity at that time. Do not expect to be doing moderate or heavy exercise for at least four weeks after your surgery. You can expect the swelling to be completely gone within about 4-8 weeks.

5.)    How much pain should I expect?

Patients vary in how they experience pain. For most women the worst discomfort is over by the third or fourth day. Again, everyone is different and has varying levels of pain tolerance. Your doctor should be able to talk with you about pain medication or pain pump options. Be sure to let him/her know about any allergies to medications that you may have, or other medicines or supplements that you are currently taking.

6.)    Do I need to come to the office after my breast augmentation?

Yes. You can likely expect that your doctor would like to see you one week after the surgery and one month after the surgery to make sure that there are no complications and that you are healing properly.

7.)    How often will I need to get my breast implants replaced?

Breast implants should not be considered “lifetime devices” although they have the possibility to last a life time. In general, you might expect to have your breast implants replaced every 12-15 years, though some women’s may last longer or shorter.  Of course, if there is a breast implant rupture you will want to have them replaced. Saline implant ruptures are quite obvious as the implant will deflate and the saline gets absorbed, harmlessly, into your body. However, silicone breast implant rupture can go unnoticed.  The FDA recommends an MRI every 2-3 years for silicone implants to make sure that there is no  ( omit this….Capsular Contracture or) rupture. If the MRI shows no indication of a rupture, and your breast implants are still soft and normal looking, you may be able to go longer without having them replaced.

8.)    What happens if a breast implant ruptures/breaks?

When a saline breast implant breaks, usually due to blunt force or an old implant, it will likely deflate quickly as the saline solution leaks out of the implant shell. (It can leak slowly, in some cases, but is more rare.) Your breast will lose its size or shape, and your body will absorb the saline solution. This is almost always harmless. You will also need to have the silicone shell removed and a new implant replaced.

When a silicone breast implant breaks, it’s possible you may not even know! This is called a “silent rupture.” It can happen very slowly and sometimes it will not be noticed for years, or until the implant is removed. If it does happen, it is often harmless as the silicone usually does not make its way past the capsule (normal scar tissue) that has developed around the implant. If it does leak outside the capsule, it can make its way to other areas of the body where it cannot be removed. Therefore, refrain from mammograms as they can cause implants to leak or rupture and opt for MRIs instead.  Also, if you have silicone implants and notice any change in the size or shape of your breasts, or have any unusual feelings (pain, numbness, etc.) contact your doctor immediately.

9.)    What’s the difference between Silicone and Saline breast implants?

In general, silicone implants are a silicone envelope filled with silicone gel, a product that feels more like human fat. Because of this women often feel that silicone implants look and feel the most real. They are often slightly more expensive as well.  They are pre-filled and inserted at their exact size during the procedure. Silicone implants are available for women 22 and older.

Saline implants are also a silicone envelope, but are filled with sterile salt water. During the procedure they are inserted while empty and then filled to the desired size. They are generally slightly less expensive than silicone implants and are available for women 18 and older.

*Both breast implants are available to women of any age for breast reconstruction.

10.) Are breast implants safe?

Yes, breast implants are very safe and see very little complications. Like any procedure, there are some risks, such as capsular contracture (when the scar tissue distorts the shape of the breast), pain, infection, loss of breast or nipple sensation (usually temporary) or implant leakage or rupture. Be sure to talk to your doctor if you have any safety concerns regarding implants.

11.) What are the different options for how the breast augmentation is accomplished?

Breast implants can be placed in front of or behind the muscle. The incisions for this can be below the breast, at the edge of the areola (nipple), or less commonly in the armpit. The procedure may also be accompanied by one of several types of lift if necessary. The implants themselves come in a multitude of varieties with smooth or textured surfaces and several shapes. During your consultation, you and your doctor should discuss all of the details of each option so you can choose the one that is best for you.

12.) Can I still breast feed after a breast augmentation?

Not all women can breast feed, but if you were able to breast feed before the surgery, it would be unlikely you would lose that ability.

13.) What if I don’t like them?

It is very rare that a patient does not like their new breast look. However, if you are displeased for any reason with the size, shape or appearance of your new breasts, you should contact your doctor and discuss the options. If you prefer your original breast size, implants can be removed.

14.) Can you make my breasts look like [celebrity name]’s breasts?

It is always OK to bring photos of the look you would like, but with the infinite variety in the human form, it is unlikely that you will look exactly like someone else.


Dr. Ronald DeMars is a board certified plastic surgeon serving the Portland area. Many of his plastic surgery patients come from Beaverton, Gresham, Tigard, Vancouver, Lake Oswego, West Linn, and Seattle.

Do you have more questions, or would like to discuss your own individual specific questions with Dr. DeMars? Call his office at (503) 253-3458 to set up a consultation or contact Dr. DeMars’ office here. We look forward to hearing from you!