What Is Breast Augmentation?

Breast augmentation is less a single operation than a set of choices. Do you use an implant or your own fat? If an implant, silicone gel or saline — and does it sit in front of the chest muscle or behind it? Each combination suits a different body and a different goal, which is why two people can have "the same operation" and quite different experiences. This guide compares the options side by side, so the consultation conversation makes more sense.

The video at the top of this page, "Breast Augmentation Surgery," runs about seven and a half minutes. Its own description frames the operation plainly: a surgical procedure to enhance the size and shape of the breasts, often chosen by someone who feels her breast size is too small for the body contour she wants. That personal-reasons framing is worth keeping in mind as you read — augmentation is elective surgery, and the goal is defined by the patient, not by a medical threshold.

First choice: implant or fat transfer?

Most augmentations use an implant — a soft shell filled with silicone gel or salt water (saline) — placed inside a pocket created in the breast. Implants offer the more predictable change in size and shape, and the wider range: small corrections and large ones come from the same basic operation, with the implant size and profile doing the work.

The alternative is fat transfer: fat is taken by liposuction from somewhere you have some to spare, processed, and injected into the breast. There's no implant and no foreign material, and the result tends to look and feel very natural — but the increase is modest, some of the transferred fat is reabsorbed over the following months, and more than one session is sometimes needed. In short: implants for a defined, larger change; fat transfer for a subtle one, if you have suitable donor fat.

Second choice: silicone or saline, in front or behind?

Silicone gel implants are pre-filled and generally feel closer to natural breast tissue. Saline implants are inserted empty and filled once in place, which can mean a smaller incision, but they can feel firmer and, if one leaks, the change in size is obvious quickly as the salt water is harmlessly absorbed. Neither is simply "better" — it's a trade between feel, incision and how a leak would show itself, and your surgeon will also explain the follow-up checks each type needs.

Placement is the other trade. In front of the chest muscle (subglandular) usually means a shorter recovery; behind the muscle (submuscular) puts more of your own tissue over the implant, which can soften its outline and edge feel, particularly if you're slim. The second video on this page, "Breast Augmentation Plastic Surgery Video performed by Board Certified Surgeon" — about seven and a half minutes, recorded in an accredited in-office surgery suite in Louisville in 2007 — shows one surgeon's approach to the same operation, a useful reminder that technique details vary between surgeons even when the choices are the same.

How the operation itself unfolds

Whichever combination you choose, the shape of the day is similar. Augmentation is usually done under a general anaesthetic. Through a short incision — commonly in the crease under the breast, around the lower edge of the areola, or occasionally in the armpit — the surgeon creates the pocket, positions the implant or places the fat, checks symmetry, and closes. Most people go home the same day, wearing a supportive surgical bra, with specific instructions about arm movement, sleeping position and lifting while things settle.

Not the same as other breast operations

Augmentation changes size and shape; it doesn't remove tissue or treat disease, and it helps to keep it separate in your mind from the operations it gets confused with. A lumpectomy removes a lump plus a margin of tissue, and a mastectomy removes the whole breast, usually for cancer or to reduce a high cancer risk. Implants do appear in that world too — as one way of rebuilding the breast after mastectomy — but reconstruction after cancer surgery is a different pathway, with different timing and decisions, from a cosmetic augmentation. Augmentation also doesn't lift a drooping breast on its own; where droop is the main concern, a lift is a separate operation that is sometimes combined with augmentation.

One thing augmentation doesn't change: screening. Implants sit behind or in front of the muscle, not inside the breast tissue itself, and routine breast screening still applies — tell the imaging team you have implants so they can use the views designed for them, as our guide to what a mammogram involves explains.

The longer trade: recovery and upkeep

The first days bring tightness, swelling and bruising — the chest often feels stretched rather than simply sore — and most people take at least a week away from desk work and longer before strenuous exercise or heavy lifting, on their team's advice. The shape you see early isn't the final one; implants in particular can sit high at first and settle over weeks.

The honest long-term point is that implants aren't lifetime devices. Over the years an implant can leak or rupture, the tissue around it can tighten (capsular contracture), or you may simply want a change — any of which can mean further surgery. Add the ordinary risks of any operation — infection, bleeding, changes in nipple sensation, scarring — and the decision is best made as a long-term commitment with follow-up, not a one-off purchase. If new pain, swelling, hardening or a change in shape appears at any point, that's a reason to contact your surgical team rather than wait.

References & further reading

• MedlinePlus — Breast augmentation surgery: https://medlineplus.gov/ency/article/002984.htm
• NHS — Breast enlargement (implants): https://www.nhs.uk/conditions/cosmetic-procedures/cosmetic-surgery/breast-enlargement/
• U.S. Food & Drug Administration — Types of Breast Implants: https://www.fda.gov/medical-devices/breast-implants/types-breast-implants
• American Society of Plastic Surgeons — Breast Augmentation: https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation

MedicalVideos.com has published trusted medical videos since 2007. The site was founded by Dr. Mohamed Ibrahim, MD, PhD — physician-scientist.

Frequently Asked Questions

How long do breast implants last?

There's no fixed expiry date, but implants aren't considered lifetime devices. Many people have further surgery at some point — for a leak or rupture, tightening of the surrounding tissue, or a change they want — so plan on long-term follow-up with your surgical team rather than a fit-and-forget result.

Will breast augmentation affect breastfeeding?

Many people breastfeed successfully after augmentation, but it can't be guaranteed: the incision route and how much gland tissue and milk ducts are disturbed vary, and sensation changes can play a part. If future breastfeeding matters to you, raise it at the consultation — it can influence the choices made.

Can I still have mammograms with implants?

Yes. Screening still applies and remains important. Tell the imaging team about your implants in advance: additional views that move the implant aside are used so as much breast tissue as possible can be seen.

Is fat transfer safer than implants because it's my own tissue?

It's different rather than simply safer. Fat transfer avoids an implant and its long-term upkeep, but it carries its own considerations — some fat is reabsorbed, the size increase is limited, and the liposuction donor site is a second area to recover. Your surgeon can weigh both routes against your body and goals.

This article is for general education only and is not medical advice. It does not replace consultation with a qualified clinician. If you are considering breast augmentation or have symptoms that worry you after surgery, please seek care from your own doctor or surgical team.

Dr. Mohamed Ibrahim, MD, PhD

Physician-scientist · Founder, MedicalVideos.com

Dr. Ibrahim founded MedicalVideos.com in 2007 to make medical and surgical education freely accessible to students, clinicians, and patients.

Last reviewed: 11/07/26