Breast Augmentation

Breast augmentation is performed for cosmetic and reconstructive purposes.

Women who choose cosmetic breast enlargement often do so to boost their self-confidence, improve self-image, and balance out body proportions. Breast augmentation with implants is also performed to reconstruct a natural breast shape after a mastectomy. 

Breast augmentation is the most common type of cosmetic procedure in the US. For many women, it’s not just about having larger breasts. They choose the procedure to correct asymmetry, restore breast volume after pregnancy, and correct other concerns. Skilled plastic surgeons approach breast augmentation as an individualized procedure that is tailored to the unique desires of each woman.

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What is Breast Augmentation?

Breast augmentation, often referred to as a “boob job,” is a surgical procedure that uses implants or fat transfer to change the size and shape of the breasts. A plastic surgeon may recommend the procedure to give the breasts a rounder appearance, improve breast symmetry, and restore lost breast volume. Breast augmentation may be combined with breast lift surgery to address sagging.

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Breast Augmentation Procedure

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Silicone or saline breast implants are placed under the breast tissue or chest muscles. Fat transfer is another technique that is used to improve breast shape and size, although it is typically reserved for women who only need minor changes to their breasts.

Excess fat is harvested from another area of your body, such as your hips, thighs, or abdomen. The fat is purified and injected into the breast area just under the skin. Some plastic surgeons use fat transfers as part of the implant procedure to correct dimples and sculpt the breast shape.

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Benefits of Breast Augmentation

Breast augmentation surgery can:

  • Increase fullness
  • Restore perkiness
  • Balance body proportions
  • Improve self-confidence and self-image
  • Reconstruct breast mound after trauma or mastectomy

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Advantages and Disadvantages of Breast Augmentation Surgery

Pros: Long-lasting results – average of 10 years or longe; Larger, fuller breasts; Balanced, youthful silhouette; Range of implant sizes, shapes, textures, and materials.

Cons: Risk of scar tissue that distorts implant shape; May be affected by weight loss or pregnancy; May need replacement; Risk of chronic breast pain, infection, bleeding, and changes in sensation; Risk of implant rupture or leaking

Breast Augmentation FAQs

These are the most frequently asked questions about breast augmentation.

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  • What types of scars are associated with breast augmentation?

    Any type of surgery produces scars. An experienced plastic surgeon uses the minimum number of incisions for breast enlargement. Additionally, the incisions are made in areas where scarring is not obvious, such as in the breast crease, around the areola, and in the armpit area. 

  • What are the different types of breast augmentation surgery?

    There are four basic techniques that are used for breast augmentation. Some plastic surgeons combine techniques in certain cases to achieve the best result.

    Inframammary

    Inframammary breast augmentation requires a short incision in the crease below the breast (the inframammary fold). The scar from this technique is usually one to two inches and is well-concealed. Inframammary breast enlargement allows the surgeon to use larger implants compared to other techniques.

    Peri-areolar

    Peri-areolar breast augmentation requires an incision around the edge of the areola, and the scar is camouflaged within the darker pigmentation of the skin. This type of incision is most often used when a breast lift is performed in conjunction with the breast enlargement.

    Trans-axillary 

    Trans-axillary breast augmentation requires a small incision in the armpit area, and the implant is inserted from the side of the breast area. The technique also involves the use of a specialized camera and instruments for optimal positioning of the implant. Trans-axillary augmentation produces a small scar within the armpit, and there is no scar on the breast.

    Trans-umbilical

    For the trans-umbilical technique, the plastic surgeon makes an incision just above the belly button. The implants are inserted through the incision and positioned in the breast area. There is no scar in the breast area, only around the belly button.

  • How do you prepare for breast augmentation surgery?

    Prior to your breast augmentation surgery, meet with a qualified plastic surgeon to discuss the feasibility of the procedure. The surgeon also describes the various implant options. Each type of implant produces a slightly different aesthetic based on size, feel, and appearance. Ensure that you understand the limitations of breast enlargement, such as not correcting sagging breasts.

    Discuss the risks and potential complications of breast augmentation with the surgeon, as well as any challenges with mammograms and breastfeeding. The appointment should also include a thorough review of the costs of the surgery. Please note that cosmetic breast augmentation is not covered by insurance, and you are responsible for the entire cost. Some insurances may cover a portion of breast augmentation after a mastectomy, but you should verify coverage with your insurance carrier.

    Your plastic surgeon may require a baseline mammogram prior to the surgery. You may also need to stop taking certain medications and stop smoking. Discuss these aspects of the procedure with your plastic surgeon and your primary care doctor.

    Arrange for someone to take you to the surgical appointment and pick you up after you are released from recovery. You’ll also need someone to stay with you for at least the first 24 hours.

  • What can you expect from breast augmentation surgery?

    Breast augmentation surgical is performed in a surgical facility or hospital, and you may be released the same day. General anesthesia is required for the surgery.

    During the procedure, the surgeon makes an incision (usually either inframammary, axillary, or peri-areolar). A pocket for the implant is created by separating the breast tissue from the connective tissue and muscles. The surgeon makes the pocket either on top of or under pectoral muscle. The implant is inserted through the incision into the pocket and positioned under the nipple.

    Silicone implants are pre-filled, and saline implants are not filled. Once a saline implant is positioned in the breast area, it is filled with sterile saline. Once the surgeon is satisfied with the position of the implant, the incision is closed with sutures, and the breast area is wrapped with compression bandages.

  • What are your implant options?

    You can tailor the final results of your breast augmentation surgery by choosing specific types of implants. You can opt for a dramatic size increase or simply increase by a cup size. Additionally, you can choose between round and tear-drop, as well as textured and smooth implants. Your cosmetic surgeon each of the options.

    • Type of Implant: Saline, silicone gel, and gummy bear (highly cohesive silicone) implants
    • Shape: Round implants help to fill out the top portion of the breast, while tear-drop implants have more of a gentle slope. Both can look natural but will depend on whether saline, silicone gel, or gummy bear implants are used.
    • Size: Choose an implant size to balance your proportions or go for a more dramatic increase in size.


  • Which type of implant is better?

    All breast implants have advantages and disadvantages. Discuss your aesthetic goals with the plastic surgeon and ensure that you understand the recommendations for implant style, shape, and size.

    If you opt for silicone implants, the FDA recommends MRI check-ups biannually to check for ruptures. There is no added risk of rupturing with a mammogram, so you should continue to have regular checks. Recently, textured implants have been identified as possible links to BIA-ALCL. Discuss this medical condition with your plastic surgeon.

  • How much does breast augmentation cost?

    The cost of breast augmentation surgery varies based on several factors. Although it is tempting to look for ways to reduce costs for elective surgery, you should balance cost with the expertise and reputation of the surgeon. Look for a surgeon who specializes in breast surgery, and browse before and after pictures of actual patients. You can assess the quality of the look, as well as look for a style that suits your goals.

    At a minimum, your plastic surgeon should be board-certified, have specialized training and expertise in cosmetic surgery, and be licensed in your jurisdiction. Ask about where the procedure will be performed. The surgical facility should be accredited.

    Many plastic surgeons offer financing options to help patients afford the cost of breast augmentation. This is a better option that bargain shopping for your surgery. If you are having breast augmentation after mastectomy, discuss your coverage with your insurance carrier.

    In New York, NY, you can expect to pay between $6,000 and $7,000 for breast augmentation. The prices vary based on the type of procedure, type of implants, location where the surgery is performed, and experience of the surgeon. You may also incur costs for the medical professional who administers the anesthesia, as well as other fees.

  • How long does recovery take?

    Breast augmentation is an outpatient procedure, and most patients go home after a few hours in recovery. The exception is reconstructive breast augmentation. Women who have breast reconstruction may need to stay in the hospital overnight or for a few days. You may be able to walk later in the day after your surgery, or your surgeon may want you to rest for the first 24 hours. After a few days, you will be allowed to leave your home and walk around more. You’ll still need to take it easy because the incisions are not healed yet.

    The surgeon may use dissolvable sutures, or you may need to return to the surgeon’s office 10 to 14 days after the procedure to have sutures removed. You may also have drainage tubes that need to be removed. You may need to wear a compression garment or sports bra for a period of time until the tissues heal. This helps to minimize swelling and helps hold the implants in place. Following the aftercare instructions from the surgeon ensures that the results of procedure are as expected.

    You can expect discomfort, swelling, and bruising for a few weeks after the surgery. Pain may be more noticeable for the first seven days. Avoid exercise for at least two to four weeks, and you’ll need to be cleared by your surgeon before increasing your activity level. You may be able to return to work after two weeks.

    Expect breast tenderness and sensitivity with any movement or physical contact with your breasts. If you notice any warmth or redness in your breast, or if you develop a fever, contact your surgeon in case you have an infection. 

    Follow-up appointments are scheduled with your surgeon to assess your healing and recovery. During the appointments, your surgeon provides instructions on your activity level, whether you can increase activity or need to continue resting.

    When the incisions first heal, the scars will be pink in color. Over the next 12 months, scar color changes to be slightly darker than your natural skin tone. 

  • When will you see the results?

    Initially, you will have some swelling in your breast area. This will make your breasts look larger than expected. If the implants are placed under the pectoral muscle, the implants will also look higher than expected. Swelling gradually subsides over the next six to eight weeks. You can see the final results after three months.

    If you are having a fat transfer in your breasts, approximately 40% of the fat cells will not survive and will be absorbed by your body over the first three months. You may need additional fat injections to sculpt the breast shape and size. After a year, the injected fat tissue will be permanent. As with any fat cells in your body, the transferred fat will shrink and expand with changes in your weight.

  • Are there risks associated with breast augmentation surgery?

    Although rare, there are risks involved with breast augmentation, as there are with any type of surgery. Complications include implant leaking or rupture, capsular contracture (hard, painful scar tissue formation around the implant), and visible skin wrinkling over the implant. There is some evidence of textured implants being linked to BIA-ALCL (lymphoma) as well as BII (breast implant illness), but the FDA reports that evidence does not indicate that getting breast implants alone do not cause these medical conditions. Discuss BIA-ALCL and BII with your surgeon.

  • Will I be able to breastfeed after the surgery?

    Most women can safely and successfully breastfeed after getting breast implants. However, breast surgery can damage milk ducts, and this may affect breastfeeding.

  • What post-operative precautions should I take?

    The following precautions are recommended after having breast augmentation surgery.

    • Have routine mammograms. It is safe to have mammograms with breast implants, so continue having annual screenings.
    • Periodic monitoring for silicone implants. The screenings can be done with ultrasound, mammogram, or MRI to check for ruptures.
    • Manage weight changes. Pregnancies and weight fluctuations may impact the results of the surgery. Revision surgery may be required to restore breast shape and size, as well as to correct any sagging.


  • Will my breasts sag after breast augmentation?

    The natural aging process does cause sagging in the breasts. Implants do not reduce or increase the risk of sagging. You may opt for breast implant revision surgery or a breast lift in the future.

  • Are there other augmentation options for breasts?

    There are some non-surgical options for breast augmentation, but the results are not comparable to getting implants. Rather, these other options are recommended for correcting small issues, such as dimples and minor asymmetry. Breast lift surgery, though, may be worth considering if your natural breasts sag or hang low on your chest. Breast augmentation and breast lift surgery can be combined into a single procedure, or you can have a breast life later when your breasts start to develop sagging.

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