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Breast augmentation (also called breast enlargement, augmentation mammoplasty, or a "boob job") is a plastic surgery procedure that enhances your natural breast size and shape.
The most commonly performed cosmetic surgery procedure in the United States, this breast enhancement procedure can increase the size of your natural bust or replace volume that's been lost with age, weight loss, pregnancy, or breastfeeding.
There are a few different breast augmentation options, but the procedure is usually performed with breast implants. Implants come in a range of diameters, volumes, and projections (how far the breast extends from the chest wall), and your surgeon can help you decide on the one that’s most appropriate for your body and goals.
Related: 5 Things to Know About Choosing the Right Implant Size
These flexible devices, filled with either silicone gel or saline (saltwater), are inserted via an incision around the nipples (periareolar), under the breasts (in the inframammary fold), or in the armpit (transaxillary) and placed under or over the pectoral muscle.
Augmentation can also be done via breast fat transfer, in which your surgeon removes excess fat from one area (like the belly or thighs) via liposuction and then injects it into the breasts. In some cases, implants are paired with fat transfer, because the fat can help the implant sit more naturally.
If you're also concerned about sagging, breast implants can be paired with a breast lift, which elevates sagging breasts and raises the nipple for a perkier look.
Related: 5 Procedures for Higher, Perkier Breasts—From Least to Most Invasive
Interested in a breast augmentation?
Many factors affect your cost, including the type of augmentation you have, the experience level of your plastic surgeon, where the surgery is performed, and who administers your anesthesia.
Breast augmentation is a cosmetic surgery, so it's not covered by insurance. However, health insurance providers are legally obligated in the U.S. to cover the breast reconstruction after a mastectomy or lumpectomy.
Interested in a breast augmentation?
You’ll start with a consultation with one or more prospective plastic surgeons. Dr. Jerome Edelstein, a plastic surgeon in Toronto, says that he starts by listening to a patient’s goals and health history.
Related: 20 Questions to Ask at Your Breast Augmentation Consultation
Choosing a board-certified plastic surgeon who specializes in breast surgery will ensure that you're in the safest, most experienced hands.
Your surgeon will perform a physical exam, which includes taking measurements of the chest wall and breasts. Many surgeons also offer 3D imaging, so you can virtually see the results of different implant sizes and projections.
Then they'll make their recommendations for the surgery (including incision locations), make sure you understand the risks, and give you a run-down of the recovery process and timeline.
Dr. Edelstein notes that many surgeons also require a pre-surgery mammogram, particularly if you are over the age of 50.
Related: The 6 Most Common Reasons a Plastic Surgeon Will Turn You Down for Breast Augmentation
If you’re getting breast implants, your surgeon will help you determine the best size, type, incision location, and placement for your body and desired outcome. Data from the American Society of Aesthetic Plastic Surgeons (ASAPS) shows that 87% of implant surgeries today use silicone implants.
Some doctors offer digital body scanning and 3D modeling of various implant options (often with the Vectra 3D imaging system), while others will have you try on a variety of implants by placing them in your bra, which also allows you to feel their weight.
Your surgeon will start by making an incision around the nipple, in the fold under your breast, or in the armpit.
Then they will create a pocket, either above (subglandular) or below (submuscular) your chest muscles, and place the implants. The incision is closed with layers of internal stitches, and the skin is closed with stitches, skin adhesive, or surgical tape.
The whole surgery takes about an hour and doesn’t require an overnight stay in the hospital.
Get all the details on breast implant surgery
Most patients choose highly cohesive silicone gel implants, which are round and filled with thick silicone gel, while some opt for saline implants, which have sterile saltwater in a silicone shell. Your surgeon will help you choose the best type of implant for you, walking you through all the pros and cons.
Related: Silicone or Saline? 5 Things to Know About Picking the Right Breast Implants
Saline breast implants can be filled after they’re placed, which means incisions and scars can be smaller.
If you have silicone implants, the U.S. Food & Drug Administration advises having an MRI 5–6 years after your initial implant surgery and every 2–3 years thereafter, to check for “silent rupture”—when an implant ruptures but doesn’t cause symptoms.
Research published in the journal American Surgeon showed that mammogram results are not significantly affected by implants, so you can still be effectively screened for cancer, but you need to let your technician know that you have them.
Silicone implants can come with a smooth or textured surface. Recently, textured implants have been linked to a higher risk of BIA-ALCL, a rare type of lymphoma, according to research published in the journal Plastic and Reconstructive Surgery.
In July 2019, textured implants manufactured by Allergan were recalled by the FDA.
A breast fat transfer starts with liposuction to remove excess fat from another area, usually the belly or thighs. The fat is purified before they inject it into your breasts, contouring and restoring volume.
“The benefit to this method is that you’re using your own tissue to add volume [as opposed to a foreign object],” says Dr. Edelstein. “The drawback is that you can’t get as much enhancement as you can with an implant.”
In general, fat transfer breast augmentation can give you a breast volume increase of one cup size.
One of the most important fat transfer breast augmentation risks is that the results can be unpredictable, since only about 50–70% of the fat cells survive the transfer. You could even have more survive on one side than the other, leading to asymmetry.
RealSelf Tip: Brava, a bra-like expansion device, may or may not be necessary before your fat transfer. For some patients, the device is needed to stretch the skin to make room for the fat. Doctors on RealSelf see great results with and without Brava.
Get all the details on breast fat transfer
Breast lift surgery starts with an incision around the nipple, which may be extended from the bottom of the areola, down to the crease, and across.
Then the surgeon lifts and reshapes the tissue, removing any extra saggy skin in the process. If you want more volume, they'll either make a pocket (above or below the muscle) to place a breast implant, or they can perform a fat transfer procedure, as described above.
They then lift and reposition the nipple (which is never detached). If you're unhappy with the size of your areolas, those can be reduced as well.
Get all the details on having a breast lift or a breast lift with implants
Most people need about a week of recovery time immediately after your breast augmentation procedure, unless your surgeon uses a technique called flash recovery augmentation.
Here’s what to expect during that time:
Related: Expectation vs. Reality: 5 Women on What Breast Augmentation Recovery Was Really Like
There are several risks associated with breast implants. See our complete guide to breast implant safety.
Some of the top risks include:
Your doctor should thoroughly explain all these risks and how they’ve handled complications with past patients.
As we've mentioned, some textured implants have been linked to BIA-ALCL (a type of lymphoma, not breast cancer) and have been recalled.
A growing number of women are also experiencing a constellation of symptoms—including cognitive issues, chronic fatigue, and joint pain—known as breast implant illness (BII).
While the FDA has said that current studies show no evidence of implants causing these symptoms, research is ongoing to better understand their cause. Still, many women are opting for breast implant removal to prevent or improve BII symptoms.
Related: Breast Implant Illness Patients Are Demanding a Say in How Their Implants Are Removed
After augmentation with breast implants, your breasts will begin to “drop and fluff” as the skin stretches and muscles relax, moving the implants from initially sitting high to a more natural position. “It’ll be about six weeks before the implants even begin to settle down, but they’ll be close to 80% settled at three months,” says Dr. Eisenberg.
After a fat transfer, you’ll have more volume immediately, but your body will absorb some of the injected fat within the first three months. Within six months, most of the swelling should have resolved and your results should be fully apparent. Within a year, the new fat will act like natural breast tissue.
After a lift, you’ll see a difference right away, though your tissue will shift and settle for a few months. You should see most of your results within three to four months, with the final result visible within a year.
Related: My Breast Augmentation Gave Me a New Lease on Life
Results from breast implant surgery typically last at least a decade. It’s a misconception that implants need to be replaced every 10 years, but it is true that they’re not meant to last a lifetime. A 2011 report from the FDA showed that about 1 in 5 women with silicone implants need some sort of revision due to capsular contracture, leaks, or other concerns within 10 years. If you don't experience a complication like that, modern implants could last 20 years or more.
The results of a breast lift or fat transfer also last about decade, though your breasts will continue to age, expand, or shrink as your weight changes. They may begin to sag in late middle age, as your skin becomes less firm, which is why many patients opt for revision surgery after about 10 years.
You should still be able to safely breastfeed with implants, but research published in the International Breastfeeding Journal shows that any breast surgery (and specifically the incision around the nipple) can potentially damage milk ducts, so there is a risk of insufficient milk production.
Fat transfer breast augmentation carries a lower risk of impacting your ability to breastfeed, provided you're not also having some kind of nipple surgery.
Related: I Got a Breast Augmentation After Having Children
Interested in a breast augmentation?
ASAPS Cosmetic Surgery National Data Bank (2017)
Center for Devices and Radiological Health U.S. Food and Drug Administration: FDA Update on the Safety of Silicone Gel-Filled Breast Implants (2011)
Kam K., Lee E., Pairawan S., Anderson K., Cora C., Bae W., Senthil M., Solomon N., Lum S., The Effect of Breast Implants on Mammogram Outcomes (2015)
Loch-Wilkinson A., Beath K.J., Knight R.J.W., Wessels W.L.F., Magnusson M., Papadopoulos T., Connell T., Lofts J., Locke M., Hopper I., Cooter R., Vickery K., Joshi P.A., Prince H.M., Deva A.K., Breast Implant-Associated Anaplastic Large Cell Lymphoma in Australia and New Zealand: High-Surface-Area Textured Implants Are Associated with Increased Risk
Schiff M., Algert C.S., [...], and Roberts C.L., The impact of cosmetic breast implants on breastfeeding: a systematic review and meta-analysis