What to Know Before You Change Your Breast Size. By Juno DeMelo
You’d like to go up or down a cup size -- or more. You want
implants for more curves, or to take some of the pressure off your back
with breast reduction surgery.
It sounds great. But you’ll want to know what to expect, including how those changes will hold up over time.
“Breast augmentation can be life-changing for a lot of
women,” says Juliana Hansen, MD, a professor and chief of plastic and
reconstructive surgery at Oregon Health & Science University. “But
you need to make an informed decision about the long-term consequences.”
1. Implants don’t last forever.
Breast augmentation isn’t once-and-done. It’s the first thing
that plastic surgeon Nolan S. Karp, MD, tells women who come to him for
“Most companies guarantee their implants for 10 years, though
they hardly ever need to be replaced that often,” Karp says. “I tell my
patients that implants usually last at least 15 years. So depending on
your age, you usually have to anticipate a couple more surgeries.”
Plan to schedule a yearly exam with your plastic surgeon to make sure your implants are strong and intact.
2. But breast reduction usually does last.
How long your results hold up depends on your breasts.
There are three types of breast tissue: fatty, fibrous, and
glandular. It’s really unlikely that you would develop more fibrous or
glandular tissue after surgery.
“I’ve probably done more than 2,000 breast-reduction surgeries, and 99% of the time, the tissue doesn’t grow back,” Karp says.
There’s a big exception. If you gain weight after the
surgery, you could develop more fatty tissue in your breasts. That’s why
it’s ideal to get breast reduction surgery when your weight is steady,
3. There are different types of breast implants.
Some women still get saline ones, which your surgeon puts
into your breast empty and then fills with sterile saltwater. But many
others now get silicone implants, which come prefilled with silicone
There are also different types of silicone implants. Some are
soft. Others are “form-stable.” Some people call those “gummy bear”
implants because they keep their shape even if the shell is broken.
Form-stable implants are fuller at the bottom, which may look more
natural. But unlike round ones, they can distort the breast’s natural
shape if they rotate.
Which type should you choose? “Your surgeon will look at your
anatomy and help you decide which type is right for you,” Karp says.
4. There are different techniques.
To insert the implant, your surgeon will make a single cut in one of three places:
- In the crease under your breast
- Under your arm
- Around your nipple
The type of cut you choose depends on the type of implant you
get, your anatomy, and your personal preference. Afterward, the surgeon
will close the cut with stitches and bandage it.
“You’ll have scarring with all three incisions, but we try to
hide the scars underneath the breast, in the fold of the armpit, or
right where the dark-colored skin around your nipple meets the skin of
your breast [the areola] so it won’t be as visible,” Karp says.
With breast reduction, the surgeon usually makes a cut around
the areola in a circular, keyhole, or upside-down T-shaped pattern.
Though the cut lines are permanent, they’ll fade over time.
5. Qualifications count.
“It’s really important that your surgeon is board-certified
in plastic surgery,” Hansen says. “A lot of doctors want to get into
breast surgery even though that’s not their specialty.”
If you decide to set up a consultation, ask the doctor if
they're certified by the American Board of Plastic Surgery. That
requires at least 5 years of training as a surgeon, including at least 3
years devoted to plastic surgery specifically.
Also ask how many years of plastic surgery training the surgeon has gotten.
6. Your life should go back to normal pretty quickly.
If you get breast augmentation, you can usually go home the same day.
“It’s really rare for an implant procedure done for cosmetic purposes to require an overnight stay,” Hansen says.
Plan ahead for someone to drive you home after the operation
and stay with you for at least 1 night. Your breasts might feel stiff or
sore for up to 5 days, and you should skip physical activity for a few
After breast reduction surgery, your doctor may ask you to
wear an elastic bandage or special bra to minimize swelling. She may
also place a temporary tube under your skin to drain blood or fluid.
Should you choose to breastfeed after breast enlargement
surgery, “there’s no reason why you couldn’t,” Hansen says. But breast
reduction may affect your ability to breastfeed, so talk to your doctor
if you plan to nurse.