Breast Augmentation Basics – What, Why, and How?

Understanding Breast Augmentation: The Basics

Breast augmentation is a surgical procedure that improves breast size and shape using implants or fat transfer techniques. If you’re considering this procedure, here’s what you need to know:

Breast augmentation is the most popular cosmetic surgical procedure in the United States, with approximately 300,000 people choosing it each year.

The procedure can help improve self-confidence, restore volume lost after pregnancy or weight loss, improve breast symmetry, or reconstruct breasts after mastectomy.

Many patients report significant satisfaction with their results, enjoying improved body image and expanded clothing options. However, it’s important to understand that breast augmentation is a significant decision that requires careful consideration of options, potential risks, and recovery requirements.

I’m Dr. Thomas Jeneby, and as a board-certified plastic surgeon who has performed over 9,000 breast augmentation procedures during my 19+ years of practice, I’ve guided countless patients through their breast augmentation journey with exceptional safety standards and personalized care.

Must-know breast augumentation terms:
– how to sleep after breast augmentation
– breast augmentation scars
– is breast augmentation safe

What Breast Augmentation Is & Why People Choose It

Breast augmentation, also known as augmentation mammoplasty, is a surgical procedure designed to increase breast size, improve shape, restore volume, or improve symmetry. The procedure involves placing implants behind breast tissue or chest muscles, or in some cases, using fat transferred from other areas of the body.

Setting the Stage

When you walk down the streets of San Antonio or flip through magazines, you might notice that improved breasts have become increasingly common. That’s because breast augumentation has steadily grown in popularity over the years, with approximately 300,000 procedures performed annually in the United States. It’s now the most common cosmetic surgical procedure in the country, and for good reason – most patients report significantly improved self-confidence and body image after recovery.

I’ll never forget what our patient Sarah told me after her procedure: “After having two children, I felt like my body had changed completely. Breast augmentation helped me feel like myself again. It wasn’t about looking perfect—it was about feeling comfortable in my own skin.”

People choose breast augumentation for deeply personal reasons. Some women have always felt their naturally small breasts didn’t match their body proportions. Others seek to restore volume lost after pregnancy or significant weight loss. Many patients want to correct breast asymmetry that has bothered them for years. We also perform augmentations as part of reconstruction after mastectomy and for gender affirmation procedures. Whatever your reason, it’s valid and deserves respectful consideration.

Key Benefits You Can Expect

The benefits of breast augumentation go far beyond just having larger breasts. When you choose this procedure, you’re likely to experience increased volume and fullness that can be customized precisely to your desired look and body type. Many women are surprised by how much improved symmetry improves their overall appearance, as most of us naturally have some degree of breast asymmetry.

My patients often tell me how much they enjoy their improved wardrobe options after surgery. “I can finally wear that sundress I’ve had in my closet for years!” is something I hear regularly. But perhaps most meaningful are the psychological benefits that come with feeling more comfortable in your own skin. Studies consistently show that breast augmentation positively impacts self-esteem and quality of life for many patients.

In fact, research indicates that 98% of women reported their breast augumentation results met or exceeded their expectations, and 90% experienced improved self-esteem after surgery. These aren’t just numbers – they represent real women feeling more confident in their daily lives.

Breast Augmentation vs. Breast Lift

During consultations at our San Antonio practice, I often find myself explaining the difference between breast augumentation and a breast lift (mastopexy), as they address different concerns but are frequently confused.

Think of it this way: breast augumentation increases size and improves shape but doesn’t significantly lift sagging breasts. It’s ideal if you’re happy with the position of your breasts but want more volume. A breast lift, on the other hand, raises and firms breasts by removing excess skin and tightening surrounding tissue, but doesn’t add significant volume.

For many of my patients, especially those who’ve had children or lost significant weight, combined procedures offer the best results. This approach both increases volume and corrects significant sagging (ptosis) for a more youthful, proportionate appearance.

As I often explain to patients sitting in my office: “Augmentation adds volume, while a lift repositions what’s already there. Many women benefit from combining both procedures for optimal results.”

Breast Augmentation Options & Implant Types

When considering breast augmentation, you’ll be presented with several exciting options to help achieve your desired look. The two main approaches are implant-based augmentation and fat transfer, each offering unique benefits for different body types and goals.

Comparing Approaches

I often tell my patients that choosing the right augmentation approach is like selecting the perfect foundation for a beautiful home—it needs to match your vision and stand the test of time.

Implant Fillers: Saline, Silicone, Gummy Bear, IDEAL

The world of breast implants has evolved dramatically over the years, giving you more choices than ever before:

Saline Implants feel like water balloons—literally! They’re filled with sterile saltwater and require smaller incisions since they’re filled after placement. If a rupture occurs, your body safely absorbs the saline solution. They’re FDA-approved for patients 18 and older, but may feel less natural and can show rippling, especially in women with thin breast tissue.

Traditional Silicone Gel Implants offer a more natural look and feel—like a soft gummy candy. They come pre-filled and are FDA-approved for patients 22 and older. One thing to keep in mind: they require MRI or ultrasound monitoring every 2-3 years because “silent ruptures” can occur without obvious signs.

Cohesive Gel (“Gummy Bear”) Implants are the newest generation of silicone implants. Think of them as firm gummy bears—they maintain their shape even if the shell breaks. They offer less rippling and folding but may require slightly larger incisions and have a firmer feel than traditional silicone.

Structured Implants (IDEAL) represent innovative technology combining benefits of both saline and silicone. They’re saline-filled but with an internal structure that creates a more natural feel with the safety profile of saline. They received FDA approval in 2014 and have been gaining popularity.

According to the FDA’s safety requirements for breast implants, all silicone implant patients should undergo periodic imaging to check for silent ruptures. A comprehensive study of 99,993 patients found that implant rupture is actually a rare complication, but regular monitoring remains recommended for your safety and peace of mind.

Shapes, Textures & Profiles

Beyond just the filling material, you’ll want to consider these important aspects of your implants:

Shapes matter significantly in how your results will look. Round implants provide beautiful fullness in the upper pole of the breast and are the most common choice among my patients. Anatomical (teardrop) implants are designed to mimic the natural breast shape with more fullness at the bottom—ideal for women seeking the most natural-looking results.

Textures affect how the implant interacts with your body. Smooth implants move freely within the breast pocket, creating a soft, natural feel. Textured implants have less movement and were developed to reduce capsular contracture (scar tissue formation).

I always have a serious conversation with my patients about textured implants. The FDA has identified a link between these implants and a rare cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). While extremely rare—occurring in only 1 in 3,800 to 1 in 30,000 patients with textured implants—this is something we’ll discuss thoroughly during your consultation.

Profiles determine how much your breasts will project forward. Low profile implants have a wider base with less projection, moderate profile offer a balanced medium width and projection, while high profile implants have a narrower base with more dramatic forward projection.

As I often tell my patients, “Choosing the right implant is like finding the perfect pair of shoes. It’s not just about size—it’s about finding the right fit for your unique body shape and goals.”

Fat Transfer Basics

For those seeking a more natural approach to breast augumentation, fat transfer (also called autologous fat grafting) offers an implant-free alternative.

This innovative procedure involves harvesting fat via liposuction from areas with excess fat—typically the abdomen, thighs, or flanks—then processing and purifying it to remove impurities. Finally, I carefully inject the fat into the breasts to create volume and improve shape.

The beauty of fat transfer lies in its natural benefits: no foreign materials in your body, completely natural look and feel, the added bonus of body contouring at donor sites, and no interference with future mammograms.

However, it’s important to understand the limitations: fat transfer typically provides a modest size increase (usually up to one cup size), some of the transferred fat will naturally be reabsorbed by your body, multiple sessions may be needed for your desired results, and you’ll need sufficient donor fat to harvest.

Fat transfer is perfect for patients seeking subtle improvement with the most natural possible results. It’s also an excellent option for refining the results of implant-based augmentation, particularly in the upper pole and cleavage area where implants alone may not create the desired contour.

At the Plastic and Cosmetic Center of South Texas, we offer comprehensive consultations to help you steer these choices and find the perfect breast augumentation approach for your unique body and goals.

Planning Your Procedure: Candidacy, Consultation & Preparation

Successful breast augmentation begins with proper planning. Understanding if you’re a good candidate, what to expect during consultation, and how to prepare for surgery are crucial steps in your journey.

Good Candidates for Breast Augmentation

When patients ask me if they’re right for breast augmentation, I look at several important factors. The ideal candidate is in good overall health with fully developed breasts. You should feel genuinely dissatisfied with your current breast size or shape, but also maintain realistic expectations about what surgery can achieve.

Women who are pregnant or breastfeeding will need to wait, as will those with active infections or cancer. During your initial visit, we’ll have an honest conversation about your health history, measure your BMI, assess your breast tissue quality and skin elasticity, and examine your chest wall anatomy.

I also carefully screen for body dysmorphic disorder – a psychological condition where someone becomes fixated on perceived flaws in their appearance. I’ve found that for these individuals, surgery rarely addresses their underlying concerns, and alternative support is often more beneficial.

The Breast Augmentation Sizing Session

Finding your perfect size is often the most exciting part of planning your breast augmentation! At the Plastic and Cosmetic Center of South Texas, we use several methods to help you visualize potential results.

Our advanced 3D imaging technology creates a simulation showing how different implant sizes might look on your unique body. Many of my patients also try the “rice test” at home before their consultation – filling ziplock bags with measured amounts of rice and placing them in their bra to approximate different implant volumes.

During your visit, you’ll try on special implant sizers in a bra, giving you a real-world preview of your potential new look. I also use tissue-based planning, measuring your chest width, breast tissue thickness, and other anatomical features to recommend implants that will complement your natural frame.

As I often tell my patients, “Finding the right size isn’t about going as big as possible – it’s about creating balance and proportion that works with your unique body type.”

What Happens in a Consultation

Your consultation is our chance to get to know each other, discuss your goals, and develop a personalized surgical plan. We’ll start by reviewing your medical history, including previous surgeries, current medications, allergies, and any family history of breast cancer.

I’ll then perform a physical examination to assess your breast tissue, dimensions, and skin quality. This helps me understand what we’re working with and what approaches might work best for you.

We’ll have an in-depth conversation about your goals – what size, shape, and overall appearance you’re hoping to achieve. I’ll walk you through the various implant options available, showing you the actual implants so you can feel the difference between them.

Many patients find it helpful to see my before-and-after gallery of similar body types who’ve undergone breast augmentation. This gives you a realistic idea of what’s possible. Before you leave, you’ll receive a comprehensive informed consent packet that details the procedure, recovery process, potential risks, and expected outcomes. We’ll also discuss costs and our in-house financing options.

I encourage you to come prepared with questions! The more you ask, the more comfortable you’ll feel with your decision. Many patients find it helpful to bring photos representing the look they hope to achieve.

Pre-Op Checklist

Once you’ve decided to move forward with breast augmentation, proper preparation will help ensure a smooth surgery and recovery. Here’s a timeline I recommend to my patients:

4-6 Weeks Before Surgery:
It’s crucial to stop smoking, as it significantly impairs healing and increases complication risks. If you’re over 40 or have a family history of breast cancer, we’ll schedule a mammogram to establish a baseline. Maintaining a stable weight during this period is also important for optimal results.

2 Weeks Before Surgery:
You’ll need to stop taking aspirin, NSAIDs, and certain supplements that can increase bleeding risk. Now’s the time to arrange for someone to drive you home and stay with you for at least the first 24 hours after surgery. Start preparing your recovery area at home with essentials like extra pillows, easy-to-prepare meals, and entertainment.

The Day Before Surgery:
Follow your fasting instructions (typically no food or drink after midnight), shower with antibacterial soap as directed, and try to get a good night’s sleep. I always tell my patients that a rested body recovers better!

Day of Surgery:
Wear loose, comfortable clothing that buttons in front (you won’t want to pull anything over your head), leave valuables at home, and arrive at our surgical facility at your scheduled time.

“The better you prepare,” I often tell my patients, “the smoother your recovery will be. Think of preparation as your first step in the healing process!”

Inside the Operating Room: Technique, Incisions & Recovery Timeline

Understanding what happens during your breast augmentation procedure can help ease anxiety and set realistic expectations for recovery.

The Surgical Procedure

When you arrive for your breast augmentation at our San Antonio facility, we’ll make sure you’re comfortable every step of the way. Most patients receive general anesthesia, though sometimes local anesthesia with sedation might be an option for you.

Once you’re comfortably asleep, we begin by carefully prepping the chest area with antiseptic solution and creating a sterile field. Dr. Jeneby then makes the incision in the location you both decided on during your consultation.

With precision and care, a pocket is created either behind your breast tissue or beneath your chest muscle (the pectoral muscle). This is where your new implant will live. We use advanced techniques like the no-touch method or the Keller Funnel™ to place your implant without direct handling—this specialized device significantly reduces the risk of contamination and related complications.

“I’m particularly meticulous about implant placement,” Dr. Jeneby often explains. “The dual-plane pocket technique I often use allows the implant to sit partially behind the muscle for a natural appearance at the upper portion of the breast, while the lower portion can expand more freely for a beautiful shape.”

After carefully positioning both implants to ensure symmetry and a natural appearance, the incisions are closed with layered sutures and either surgical tape or skin adhesive. The entire procedure typically takes just 1-2 hours, and you’ll be able to go home the same day.

Incision Choices & Scarring

One of the most common questions my patients ask about breast augumentation involves scarring. The good news is that modern techniques allow for well-concealed incisions that typically fade beautifully over time.

The inframammary (IMF) incision is made in the natural crease beneath your breast. It’s our most commonly used approach because it gives excellent visibility during surgery and works well for all implant types. The resulting scar hides naturally in your breast fold where it’s rarely visible, even in swimwear.

If you’re concerned about visible scarring, you might consider the periareolar incision, which runs along the edge of your areola. This scar blends into the natural color transition between your areola and breast skin. The only limitation here is that the size of your areola may restrict the size of implant we can place.

For those wanting no breast scars at all, the transaxillary approach places the incision in your armpit. We often use an endoscope (a tiny camera) to help guide precise pocket creation. This approach works especially well for saline implants.

The least common approach is the transumbilical (TUBA) technique, which involves a single small incision at your belly button. While this leaves no scar on your breasts, it’s technically challenging and only works with saline implants that can be filled after placement.

“Most of my patients are surprised by how inconspicuous their scars become,” I often tell them. “With proper scar care and patience, most scars fade significantly within a year.”

Day-by-Day Recovery Roadmap

Recovery from breast augmentation follows what I call the “72-Hour Rule.” The first three days are typically the most challenging, but after that, most women find each day gets progressively better.

You’ll head home after surgery wearing a special surgical bra, and possibly with small drains to prevent fluid buildup. Those first 72 hours bring the peak of swelling and discomfort, but we’ll make sure you have appropriate pain medication to stay comfortable. Sleeping with your upper body liftd and taking short walks around your home will help with comfort and circulation.

By days 4-7, you’ll likely notice decreasing pain—many patients switch from prescription pain relievers to over-the-counter options at this point. Any bruising will be at its peak but beginning to fade, and you’ll likely be cleared to shower. That surgical bra will remain your best friend, providing crucial support 24/7.

During weeks 1-2, most patients feel ready to return to light, non-strenuous work (typically after 5-7 days). If you have non-dissolving stitches, we’ll remove them during this period. Some patients begin gentle breast massage if directed by Dr. Jeneby to help the implants settle naturally.

By weeks 3-4, you’ll be returning to most normal activities, though we’ll still ask you to avoid heavy lifting and strenuous exercise. The swelling continues to decrease, and many women transition to a supportive sports bra at this point.

Around the 6-8 week mark, most patients are cleared for all activities including exercise. Your scars will be fading though still pink, and your breasts will be settling into their final position.

The full results of your breast augumentation become apparent between 3-6 months when all swelling resolves completely. Your breasts achieve their final softness and natural movement, and scars continue to fade.

Long-Term Follow-Up Care

Your relationship with us doesn’t end after surgery. Long-term care is essential for maintaining your results and monitoring your implants for years to come.

We’ll schedule follow-up appointments at one week, one month, three months, six months, and annually thereafter. For silicone implants, we follow FDA recommendations for an MRI or ultrasound at 5-6 years after placement and every 2-3 years thereafter to check for silent ruptures.

You’ll receive an implant ID card with information about your specific implants—keep this with your important medical records. We’ll also teach you how to perform regular breast self-exams to become familiar with your implants and notice any changes.

Some patients benefit from specific displacement exercises or massage techniques to help prevent capsular contracture. Dr. Jeneby will determine if this is appropriate for your specific case.

“Think of your breast augmentation as a long-term relationship,” I often tell my patients. “With proper care and monitoring, many women enjoy their results for many years before any revisions are needed.”

At the Plastic and Cosmetic Center of South Texas, we pride ourselves on being there for you not just during surgery, but throughout your entire breast augumentation journey.

Risks, Longevity, Costs & Choosing a Surgeon

While breast augmentation has a high satisfaction rate, it’s important to understand the potential risks, expected longevity of implants, associated costs, and how to choose the right surgeon for your procedure.

Understanding the Risks

When I talk with patients about breast augumentation, I make sure they understand all potential risks. Like any surgery, breast improvement isn’t risk-free, though serious complications are relatively uncommon.

Capsular contracture is one of the more common concerns, occurring in about 10% of patients. This happens when the natural scar tissue that forms around your implant becomes unusually firm, potentially causing discomfort or changing the breast’s appearance.

What about implant rupture? According to research on rupture rates, saline implants rupture in approximately 3-5% of patients within 3 years and 7-10% by the 10-year mark. If a saline implant ruptures, your body safely absorbs the saltwater solution, though your breast will appear deflated. Silicone ruptures are trickier since they may not be immediately noticeable (hence the recommendation for periodic imaging).

You may have heard about BIA-ALCL (breast implant-associated anaplastic large cell lymphoma) in the news. This rare type of non-Hodgkin’s lymphoma is primarily associated with textured implants, with risk estimates ranging from 1 in 3,800 to 1 in 30,000 patients. Smooth implants have a significantly lower risk.

Many women also wonder about sensation changes. Some patients experience temporary numbness or heightened sensitivity in their nipples or breast skin. While these changes are usually temporary, in some cases they can be permanent.

“I always tell my patients that while these risks exist, choosing a board-certified plastic surgeon and following all pre- and post-operative instructions significantly reduces these risks,” I often explain during consultations.

Implant Longevity and Replacement

“Will I need to replace my implants every 10 years?” This is perhaps the most common question I hear in my practice.

The truth is, breast implants don’t have an expiration date. While they’re not considered lifetime devices, the average lifespan is about 10-15 years. That said, I have patients who’ve had their original implants for over 20 years without issues!

About 20% of women will need some form of revision surgery within 10 years. Reasons for replacement include implant rupture, capsular contracture, or simply a desire to change size as your body or preferences evolve over time.

“The 10-year replacement rule is somewhat of a myth,” I explain to my patients. “While the risk of complications increases over time, if your implants are intact and you’re happy with their appearance, there’s no medical need to replace them at a specific timepoint.”

Regular check-ups are your best strategy for monitoring implant health over the years.

Costs and Financing

Let’s talk about the practical side of breast augumentation: the investment. The cost varies based on geographic location, surgeon experience, implant type, and facility fees.

According to national averages, the surgeon’s fee alone starts around $3,718 – but that doesn’t include anesthesia, facility fees, or the implants themselves. Total costs typically range from $5,000 to $10,000, with silicone implants generally costing $1,000-$1,500 more than saline options.

It’s worth noting that insurance typically doesn’t cover cosmetic breast augmentation, though they may cover reconstruction after mastectomy.

At the Plastic and Cosmetic Center of South Texas, we understand that cost is an important consideration. That’s why we offer transparent pricing with no hidden fees, in-house financing options, and multiple payment plans to fit various budgets. We even provide complimentary consultations to discuss your options without financial pressure.

Choosing the Right Surgeon

Selecting a qualified surgeon is perhaps the most important decision in your breast augumentation journey. This choice affects not just your results, but your safety and peace of mind.

First and foremost, look for board certification from the American Board of Plastic Surgery. This certification ensures your surgeon has completed specialized training in plastic surgery and meets rigorous standards.

Experience matters tremendously. Don’t hesitate to ask potential surgeons how many breast augmentations they perform annually. A surgeon who specializes in breast procedures will likely have more refined techniques and better understanding of potential complications.

I always encourage patients to thoroughly review before and after photos of the surgeon’s previous work, particularly looking for patients with similar body types to yours. This gives you a realistic preview of what your results might look like.

Don’t underestimate the importance of personal connection with your surgeon. You should feel comfortable asking questions, and your surgeon should listen carefully to your goals without pressuring you toward certain choices.

Finally, ensure your surgery will be performed in an accredited surgical facility with proper safety protocols in place.

At the Plastic and Cosmetic Center of South Texas, our surgeons are not only board-certified but have performed thousands of breast augmentations with exceptional safety records and patient satisfaction rates.

Frequently Asked Questions about Breast Augmentation

Will my implants need to be replaced every 10 years?

Not necessarily. While implants are not lifetime devices, there’s no automatic expiration date. The need for replacement is based on the condition of your implants and your satisfaction with their appearance. Some women have their original implants for 20+ years without issues, while others may need revision surgery sooner. Regular follow-ups with your plastic surgeon will help determine if and when replacement is needed.

Can I breastfeed after breast augumentation?

Most women can successfully breastfeed after breast augmentation. The ability to breastfeed depends on several factors, including the incision location and implant placement. Periareolar incisions have a slightly higher risk of affecting milk ducts or nerves important for lactation. If breastfeeding is important to you, discuss this with your surgeon before surgery so they can recommend the approach least likely to interfere.

Is the procedure reversible if I change my mind?

Yes, breast augmentation is reversible. Implants can be removed if you change your mind or experience complications. The breast appearance after removal depends on several factors, including how long the implants were in place, their size, your skin elasticity, and whether a lift is performed during removal. Some women opt for smaller implants rather than complete removal, while others choose fat transfer to maintain some volume after implant removal.

Conclusion

Breast augmentation is more than just a cosmetic procedure—it’s a transformative journey that can improve your appearance, lift your confidence, and help you feel truly at home in your body. At the Plastic and Cosmetic Center of South Texas, we walk beside you every step of the way, from the moment you first consider augmentation through your recovery and for years to come.

Looking back at what we’ve explored together:

Your breast augumentation experience is uniquely yours, with numerous options to customize your results. From implant type and size to shape and placement, every decision is custom to your specific goals and anatomy. This personalization is likely why so many women report feeling more confident and satisfied after their procedure.

Most of our patients are pleasantly surprised by the recovery process. While you’ll need about 1-2 weeks before returning to your normal routine (minus strenuous activities), you’ll see your results evolve over 3-6 months as swelling subsides and your implants settle into their permanent position.

“I tell my patients to think of recovery as a journey, not a destination,” Dr. Jeneby often says. “Each week brings improvements, and patience pays off beautifully.”

While we’ve discussed potential risks, it’s reassuring to know that choosing a board-certified plastic surgeon dramatically reduces your chances of complications. Our meticulous attention to detail and commitment to safety protocols have earned us our sterling reputation in San Antonio.

Many women worry about implant longevity. Though the general guideline suggests implants last 10-15 years, many of our patients enjoy their results for much longer without any issues. Regular check-ups with our team help ensure your continued satisfaction and monitor your implants’ condition.

We understand that breast augumentation is both a physical and financial investment in yourself. That’s why we offer transparent in-house financing options to make your change accessible. During your consultation, we’ll discuss not just the medical aspects but also create a financial plan that works for your budget.

Are you ready to take this exciting next step? Learn more about our breast augmentation services or reach out today to schedule your personal consultation at our San Antonio or Austin locations. Our board-certified surgeons are eager to understand your vision, address your questions, and develop the personalized treatment plan that will help you become the most confident version of yourself.

Your change awaits—and we’re honored to be part of your journey.