Ask the Expert: What Do I Need to Know About Breast Augmentation?

Don’t just rely on your friends’ opinions — get the latest information about breast augmentation surgery from a board-certified plastic surgeon.

Breast augmentation is a common surgery, but why take a chance with second-hand information? Instead, base your medical decision on the advice from an expert in the field.

Alex K. Wong, MD, an associate professor of surgery in the Department of Surgery at the Keck School of Medicine of USC who specializes in breast reconstruction and aesthetic surgery, shares several points he discusses when counseling patients about this type of surgery.

1. Both silicone and saline are safe choices.

Unlike the implants of 20 years ago, today’s silicone implants “could be the most studied device known to man,” says Wong. “The difference between the two types is the fill. Both have silicone shells, but a silicone implant is filled with silicone gel as opposed to saline. There is also a new type of ‘gummy bear’ implant, which is a stable gel implant that feels more like a real breast. Whereas the traditional silicone implant looks like an M&M, a gummy bear implant is breast-shaped and movable,” he adds.

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2. While minimal, breast augmentation can have risks.

According to Wong, surgery for breast implants is safer than ever before. Additionally, the surgery has been simplified over the years and can now be performed safely in a clinic on an outpatient basis. Still, there are risks to consider, including:

  • Bleeding, blood clots, infection and breathing problems due to surgery or anesthesia
  • Small scars, usually in an area where they do not show
  • Thickened, raised scars
  • Uneven position of nipples
  • Different sizes or shapes of the two breasts
  • Loss of feeling in the nipple area
  • Difficulty breastfeeding
  • Visible rippling of the implant

3. Post-recovery time can be as short as a weekend.

It depends on the patient, but using the latest procedure, the incision is so small that there is no drain. “This means that you could take off Friday and Monday for the outpatient surgery and post-recovery time, then be back to work on Tuesday,” Wong says. “There is, however, a six-week long-term recovery time with no lifting or strenuous exercise.”

4. Breast implants aren’t permanent.

“Contrary to what most patients think, breast implants typically last only 10-15 years,” Wong explains. “Pregnancy, weight loss, scarring or leakage over time are all factors that could lead to another surgery.”

5. There are different ways to place breast implants.

Before your surgery, you’ll discuss the best way to place your breast implants. There are multiple surgical procedures to consider:

  • The most common technique is by placing the implant through an incision on the underside of the breast where the skin naturally folds. Scarring might be more visible, especially if you are younger or have not had children.
  • Placing an implant through an incision under your arm can be done through an endoscope. There is no scar around your breast, but there might be a visible scar under your arm.
  • The implant can be placed through an incision around the edge of your areola, though this type of surgery might cause more problems with breastfeeding and loss of nipple sensation.
  • A saline implant can be placed through a cut near your belly button. Once the implant is in place, the surgeon can fill it with saline.
  • Extra fat around the abdomen can be liposuctioned, then transplanted as a graft to the breasts for small-volume augmentation.
  • Some patients even opt for a tummy tuck at the same time as getting breast implants. These are two different procedures that can be done at the same time. When these procedures are done simultaneously, implants can be inserted from above the belly button, which will leave the breasts without scars.
  • Another option is to remove extra abdominal tissue between your belly button and waistline and use it to form a new breast. This is done more commonly for breast reconstruction.

6. Different people prefer different aesthetic outcomes.

“A successful breast augmentation will be symmetrical. Both breasts will be the same size, and the position for the implants should be centered beneath the nipple — not too high or too low,” Wong says. “These are signs of an experienced surgeon. The size, however, is completely subjective.” Your doctor should discuss your preferences before the surgery.

Above all, Wong suggests choosing a board-certified, highly trained surgeon who makes you feel comfortable and understands your expectations.

“As a teaching hospital, we not only perform the surgeries often, but we teach students how to perform the procedure,” he says. “We also end up repairing a lot of mistakes that other surgeons make. To avoid this, make sure you choose a highly trained plastic surgeon with a lot of experience.”

by Heidi Tyline King 

Looking for a board-certified plastic surgeon who can advise you on breast augmentation? If you are local to Southern California, schedule an appointment with one of the experts at Keck Medicine of USC by calling (800) USC-CARE (800-872-2273) or visiting