Category Archives: Augmentation Decision

Making Your Decision

Deciding whether to get breast implants is a big decision. Before going forward, you should know as much as you can about the types of implants available, how much they will cost you in the short-term and long-term, and immediate and future health considerations.

Breast Implant Types

There are two types of implants: saline-filled and silicone gel-filled. Saline implants consist of a smooth or textured silicone envelope filled with saline (salt water). Silicone gel implants consist of a smooth or textured silicone envelope filled with silicone gel (a synthetic material). Breast implants also come in different shapes and sizes.  There are different reasons why some individuals prefer certain implants over others. You can read more about the different types of implants here.

Implant Costs

In 2016, the all-inclusive cost for initial implant surgery was between $5,000 and $8,000. Silicone gel implants usually cost about $1,000 more than saline implants.

Complications, such as infection, rupture, pain, or asymmetry, are very common. You can read more about breast implant complications here. Breast implants are not lifetime devices. You should expect to need additional surgery at some point, which can cost as much, if not more, than the initial surgery. Additional surgery can be needed because of health issues or cosmetic problems, and is rare during the first year but becomes more likely every year after that.  Some women have reported developing autoimmune problems or connective tissue disorder after receiving their implants. In addition, breast implants can cause Anaplastic Large Cell Lymphoma (ALCL), a rare cancer of the immune system.

All breast implants eventually break and leak, which requires removal and/or replacement.  Leakage is more obvious with saline implants, which usually deflate quickly.  The FDA recommends breast magnetic resonance imaging (MRI) for silicone gel breast implants 3 years after surgery, and every two years after that, to check for a slow leak.  Breast MRIs to check for implant leakage cost about $2,000 and are not usually covered by health insurance, so that is a substantial expense to be aware of.

Health Considerations

Saline Implants

  • All breast implants interfere with mammography, making mammograms less accurate.
  • The silicone envelope of the implant will tear or fall apart over time. This can cause the implant to leak and deflate, which is usually noticeable.
  • If the implant ruptures, the saline solution is usually not dangerous, but after being in the body it may contain bacteria or mold that can sometimes cause infections
  • Textured implants are more likely than smooth implants to cause Anaplastic Large Cell Lymphoma (ALCL), a type of cancer of the immune system.

Silicone Implants

  • All breast implants interfere with mammography, making mammograms less accurate.
  • The silicone envelope of the implant will tear or fall apart over time, causing the implant to leak.
  • Leaks aren’t usually obvious, so silicone gel can travel to other parts of your body for years before the leak is detected. Silicone gel can be impossible to remove once it travels to breast tissue or other organs, such as the lungs or liver.
    • To avoid the health risks of leaking silicone gel, women with silicone gel implants need regular breast MRIs to check for silicone gel leaks. The FDA recommends having a breast MRI three years after getting breast implants and every two years after that.
    • Leaking silicone gel can cause pain or swelling. It could cause allergic and/or autoimmune reactions.
  • Textured implants are more likely than smooth implants to cause Anaplastic Large Cell Lymphoma (ALCL), a type of cancer of the immune system.

If you have a family history or a diagnosis of an autoimmune or connective tissue disease, you should know that implants have not been tested for safety in women with those conditions because of health concerns. You can read more about autoimmune reactions here.

What to Ask Your Plastic Surgeon if You’re Considering Implants

When you’re considering breast implants, it is often hard to know what questions to ask and who to ask. For many plastic surgeons, breast augmentation is a large part of their practice and their salary. Keep in mind that you may not receive completely objective responses, but here’s a good place to start:

Before you go in, make sure the plastic surgeon is very experienced in breast augmentation. Any physicians or dentists may call themselves cosmetic surgeons even if they aren’t well trained in surgery. That’s perfectly legal, but their patients are taking a risk.

Ideally, you will want to see a plastic surgeon who is board certified in plastic surgery (not in some other medical specialty), because that will help assure you that they received the appropriate training to perform breast augmentation. You can find out if a doctor is board-certified by the American Board of Plastic Surgery online.

However, not all board certified plastic surgeons are skilled at implanting or removing breast implants. Check online for complaints about any plastic surgeons that you are considering. If there are serious complaints about patients who were harmed by the surgeon, look for a plastic surgeon with better ratings.

Once you decide to see a surgeon, here are some questions to ask during your appointment:

  • Ask about all your options for breast enhancement. Some women may be satisfied with the results from a breast lift alone, and may not need implants to achieve the look they desire. You can also ask your surgeon about a fat transfer as an alternative to implants.
  • Ask to see before and after photographs of your plastic surgeon’s patients. Some doctors use photographs of patients whose surgery was done by other surgeons. If the doctor says that the photos are of his/her patients, ask when those patients had surgery. If it was a long time ago, ask to see more recent photos.
  • Ask to see photographs of her or his patients that were taken at least three years after the surgery. Many patients look good immediately after surgical scars have healed but their breasts look different years later.
  • Ask your doctor for a patient booklet or other written information that includes the risks of breast implants and read that information at least one week before surgery so you have time to ask questions and gather more information.
  • Ask for a copy of the informed consent form at least one week before surgery.
  • Ask whether there is a warranty on the implants and, if so, what is and isn’t included.
  • Ask whether the doctor will remove your implants for free if you have serious problems. If so, will the surgical center services also be free? What if you want them removed, but the doctor doesn’t think it is necessary?

If you’re still unsure about getting breast implants, seek advice from someone that has gone through breast implant surgery at least 5 -10 years ago. They may be able to help you make the decision that is best for you. Click here to read some personal stories from women who had breast implants.

All articles are reviewed and approved by Diana Zuckerman, PhD, and other senior staff.