Dr. Samuel Lin is a double board-certified Plastic Surgeon and Associate Professor of Surgery at Harvard Medical School who practices in Boston, Massachusetts. Dr. Lin received his Bachelor’s degree in Biomedical Engineering at Northwestern University and was enrolled in the Honors Program for Medical Education at Northwestern University, Feinberg School of Medicine, Chicago, Illinois. Dr. Lin completed a one-year fellowship appointment in Microvascular Reconstructive Surgery at the world-renowned University of Texas M.D. Anderson Cancer Center in Houston, Texas. He has also been named a Top Influencer in #PlasticSurgery. Dr. Lin is board certified by both the American Board of Plastic Surgery and the American Board of Otolaryngology-Head and Neck Surgery. Dr. Lin is board certified by two ABMS boards. He is Program Director of the BIDMC-Harvard Plastic and Reconstructive Surgery residency, and Co-Director of the Harvard Aesthetic and Reconstructive Plastic Surgery Fellowship at BIDMC. Dr. Lin was awarded the recipient of a “Mentoring Award,” by Harvard Medical School through a special nomination process which is sent out to all Harvard faculty members, house officers, fellows, and students. He has been a Boston “Top Doc” for several years in plastic surgery. Haute Beauty Expert Dr. Lin discusses the proper care, recovery, and results of breast augmentation surgery. 

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What is breast augmentation?

Breast augmentation is a surgery where implants (saline or silicone) are placed in the breast to enhance breast size, shape, and/or symmetry. A breast augmentation may help improve body image or help clothes fit better. Some people choose to have a breast augmentation for rejuvenation after childbearing or breastfeeding.

How is breast augmentation performed?

Breast augmentation is typically performed under general anesthesia. During a breast augmentation an incision is made on or near the breast (around the nipple pigmented area, in the fold of the breast, or from the armpit area) in order to create a space to insert a breast implant. Usually, the incision is located in the crease below the breast and is about 3-4 cm long, but other locations for the incision are possible in select patients.

Who is a good candidate?

A good candidate for breast augmentation is a patient whose primary goals are an improvement in the shape, size, and symmetry of their breasts. It is important that patients considering breast augmentation have given careful thought to their motivations and expectations for surgery. Patients must be a minimum of 18 years old to receive a breast augmentation for cosmetic purposes. The FDA has approved the use of silicone implants for breast augmentation in patients 22 years and older, though they may be used off-label in select younger patients.

Patients with body dysmorphic disorder or an unmanaged psychiatric condition are not good candidates for breast augmentation. Additionally, it is important that a patient is not experiencing external pressure to have a breast augmentation. A patient who is under peer, spousal, parental, or other pressure is not a good candidate for a breast augmentation. Additionally, patients with significant breast disease may not be good candidates for breast augmentation. Examples of significant breast disease include severe fibrocystic disease, ductal hyperplasia, and high-risk breast cancer. Patients must also be in sufficiently good health to undergo elective cosmetic surgery in order to have a breast augmentation.

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How do you prepare for surgery?

Patients interested in breast augmentation should prepare for surgery by first consulting with a board-certified plastic surgeon. Patients looking to have a breast augmentation should also consider the financial and time commitment needed to have and recover from surgery. The price of breast augmentation can vary based on the surgeon, geographic location, and other factors. According to 2020 data from the American Society of Plastic Surgeons, the average cost of a breast augmentation is $4,516-$6,000. This price does not include anesthesia, operating room facilities, or any other related expenses such as garments or prescription medications, so the total costs associated with breast augmentation are likely to be higher.

An understanding of the recovery process can help patients prepare for surgery. Most patients will go home on the day of surgery. Driving is allowed after the first post-operative visit, as long as patients are no longer taking prescribed pain medications. About three-seven days after surgery, or when it is not painful, patients may begin doing certain exercises designed to help the implant settle into the proper place on the chest. Two to four weeks after surgery, patients may resume light aerobic exercise. For the first six weeks after surgery, lifting and upper body exercises are strictly limited. After surgery, wearing a bra is optional, but a bra underwire or a push-up bra cannot be worn for 6 weeks after surgery. Altogether, the healing process takes about 6 weeks.

Additionally, as they prepare for breast augmentation, patients should identify a family member or other support person to help them through the process. For patients who smoke, quitting smoking several weeks before surgery is important for optimal healing.

What are the risks of the procedure?

Like any surgery, breast augmentation carries risks. Potential risks of breast augmentation include scarring, bleeding, bruising, infection, and dissatisfaction with the cosmetic result. There may also be a change in or loss of nipple sensation. Additionally, there are risks associated with the use of breast implants. The implants and the body interact with each other. Normally, the body forms a capsule of scar tissue around the implant. Occasionally, this capsule can distort the implant and cause a complication known as capsular contracture which sometimes requires another surgery to fix. Implants can also break. If an implant breaks, patients may or may not notice it immediately depending on the type of implant. Broken implants often need to be removed and replaced with surgery. Some patients have also experienced a constellation of symptoms such as fatigue and muscle aches after breast augmentation, referred to as breast implant illness. Finally, a rare, treatable type of lymphoma, called anaplastic large cell lymphoma, has been associated with certain breast implants that are no longer in use today. Any patient with symptoms or concerns after breast augmentation should consult with their plastic surgeon for guidance.

For patients who desire improved shape, size, or symmetry of their breasts, a breast augmentation may accomplish these goals. Any patient interested in breast augmentation should consult with a board-certified plastic surgeon to learn more about the process and their options. Board certification by the American Board of Plastic Surgery is an indication that the surgeon has undergone extensive training in plastic and reconstructive surgery.

References:

1. Breast Augmentation Cost | American Society of Plastic Surgeons. Accessed October 19, 2021. https://www.plasticsurgery.org/cosmetic-procedures/breast-augmentation/cost
2. Breast Implants: What Patients Need to Know | ASPS. Accessed October 19, 2021. https://www.plasticsurgery.org/patient-safety/breast-implant-safety
3. Janis, Jeffrey E., and John S. Silverton. Essentials of Plastic Surgery. Thieme, 2017.

Written in collaboration with Natalie Hassell and Samuel J. Lin, MD, FACS.