Breast Augmentation Basics: What’s the Big Deal?


Breast augmentation (augmentation mammoplasty) is a commonly performed cosmetic surgery procedure that allows patients to achieve their desired fullness, balance, and shape for their breasts. The American Society of Plastic Surgeons recently reported that cosmetic breast enlargement rose by 4% in 2018, with 313,735 procedures taking place in that year alone. Implants are the most common means of adding volume, though fat transfer is also used for enhancement.

Dr. Eric Culbertson specializes in breast augmentation at San Francisco’s Jacobs Center for Cosmetic Surgery. He routinely explains to women interested in the procedure that there are many reasons why patients choose to have the surgery—in increasing numbers.

First, having larger or more symmetrical breasts can improve a patient’s quality of life and offer psychological advantages. Some women benefit from an improved self-image and heightened sense of self-esteem after breast augmentation.

The procedure can be a helpful means of restoring breast size, projection, and roundness after weight loss, pregnancy, or breastfeeding, though it is also frequently chosen to enlarge naturally small breasts.

The Origins of Modern Breast Augmentation

Today, breasts implants are safer and more accessible than ever, but this wasn’t always the case. The history of modern-day implants effectively began in the decades following World War II, with the pioneering achievements of two ambitious American doctors in the early 1960s. The first silicone-gel-based implant was introduced to the beauty market in 1963. Prior to this, in the late 1800s, various materials—ground rubber, sponges, and Teflon, to name a few—were inserted into women’s breasts to enhance their appearance.

Research continued in the decades that followed. Throughout the 1940s, unlicensed doctors experimented by injecting liquids into the chest area of patients, with injurious and sometimes fatal results. Ultimately, self-contained implants were developed, and the ’70s and ’80s saw common problems such as ruptures and capsular contracture ironed out. Failure rates decreased dramatically as a second and third generation of implants were manufactured. The 2000s saw the FDA approval of implants for cosmetic use. Styles, sizes, shapes, and fillers have proliferated since then.

Saline vs Silicone: Which Type of Implant is Best?

Depending on a patient’s preferences, various types of implants are available in the United States. (Note that when it comes to correcting the appearance of drooping breasts, a breast lift or mastopexy surgery may be advised.)

There are two basic types of devices used for breast augmentation. These medical devices are filled with either a sterile saline solution or silicone gel. Saline-filled implants and silicone gel-filled implants may have smooth or textured surfaces and come in different sizes.

When weighing the pros and cons of each form of implant, it’s important to consider the associated costs, possible side effects, and age restrictions. An experienced and well-trained plastic surgeon will be able to help each patient consider the options and choose the ideal implant for her case.

What to Expect From the Actual Surgery

During a breast augmentation surgery, the plastic surgeon makes an incision in a predetermined location. It may be on or around the breast itself, or more remotely located. While some implants are pre-filled, others are filled during the surgical procedure after insertion.

In either case, the implants are inserted into a breast pocket to sit in front of or behind the pectoral muscles. Common surgery-related side effects include swelling and bruising. Visible incision lines, though typically hidden in natural creases to decrease their visibility, will fade over time.

Generally, implants are not considered to be lifetime devices. Nevertheless, while the experience varies from person to person, they can reasonably be expected to last for a decade or longer.

To learn more about what elective breast augmentation involves and select an implant, contact Dr. Eric Culbertson and his team. Fill out an online contact form or call 415.433.0303 to discuss cosmetic surgery goals and the types of implants available with the certified plastic surgeon at The Jacobs Center for Cosmetic Surgery.