A poorly performed breast augmentation can leave you feeling less attractive than you did before the operation. It can also require you to undergo one or more follow-up procedures to correct the problem.

The following are some examples of common complications that occur when your breast enlargement doesn’t go exactly as planned:

Rupturing – All breast implants are at risk to rupture. If a rupture occurs, it will leave your breasts looking misshapen and out of proportion with each other. If you have saline implants, the liquid will be absorbed by your body. If a silicone implant ruptures, the leak will be slower and your body will not absorb the gel. You will need to consult your cosmetic surgeon immediately if your implant ruptures, since it will require additional surgery.

Capsular Contraction – Sometimes scar tissue will form around the implant. If it starts to squeeze your implant, it will cause you a great deal of pain and can lead to infection and distorted breast shape.

Symmastia – If your implants are placed too close together, they may have a tendency to connect at the center of your chest. This makes it look like you have one connected breast.

Failed Cancer Screenings – A poorly inserted silicone implant can cause problems with mammography readings, which might impair your doctor’s ability to diagnose breast cancer at an early stage.

Bottoming Out – Implants that are poorly placed can sometimes shift downward in the breast tissue. This downward shifting can also be caused by an implant that is too large for your body. As a result, your nipples might point upwards. You will need surgery to correct this problem.

Loss of Sensation – Sometimes, loss of sensation in the nipples and breasts occurs after breast enlargement. Frequently, you will regain sensation after healing from the surgery. However, in badly botched augmentations, this loss of sensation may be permanent. This might also adversely affect breast feeding in the future.

It is important to discuss all of these risks and complications, along with your medical history, in great detail with your cosmetic surgeon before deciding whether or not to go ahead with breast implant surgery.

In the 1970s plastic surgeons wanted softer and more lifelike implants so breast implants were redesigned with thinner gel and thinner shells; these implants had a greater tendency to rupture and leak, or “bleed” silicone through the implant shell into the body cavity and complications such as capsular contracture were common. It was predominantly silicone implants that were designed in the 1970s that were involved in the class-action lawsuits against Dow-Corning and many other manufacturers in the early 1990s. One manufacturer did produce a model of pre-filled saline implants but has been reported to have had high failure rates following surgery.

In the mid 1980s, advances in manufacturing principles brought about elastomer-coated shells to decrease gel bleed, and were filled with thicker, more cohesive gel; these implants are sold under restricted conditions in the U.S. and Canada, but are widely used in other countries. Saline implant shells are made of silicone elastomer and the implants are filled with saline solution after the implant is placed in the body. Dr. Thomas Cronin and Dr. Frank Gerow, who were two Houston, Texas, plastic surgeons, developed the first silicone breast prosthesis with the Dow Corning Corporation back in 1961.

Saline-filled breast implants were first manufactured in France in 1964 and were introduced by Arion with the goal of being surgically placed using smaller incisions than they were then using. The first woman was implanted with silicone implants in 1962.

Since the early 1990s, a number of independent reviewers have examined studies concerning links between silicone gel breast implants and systemic diseases; the consensus of these reviews is that there is no clear evidence of a causal link between the implantation of silicone breast implants in breast plastic surgery and systemic disease; it’s always wondered who is funding these studies and that should clearly be stated. There is a general international consensus in the medical field that silicone implants in breast plastic surgery have not been shown to cause systemic illness, excluding the possibility that a small group of patients may become ill through (as yet) unknown mechanisms may prove difficult; this has been questioned by many women experiencing various health issues.

Extracapsular silicone has the potential to migrate to other parts of the body, but most clinical complications have appeared to be limited to the breast and axillae as inflammatory nodules (granulomas) and enlarged lymph glands in the armpit area called axillary lymphadenopathy it’s reported.

One study reported 30% of ruptures in asymptomatic patients are accurately detected by experienced plastic surgeons, compared to 86% detected by MRI. An intracapsular rupture can progress to outside of the capsule, called an extracapsular rupture, and it is generally agreed that both conditions indicate the need for removal of the implant. Manufacturers and doctors are required to inform women that implants are not permanent devices and that most recipients will probably need additional surgery to replace or remove their implants.

When breast implants are removed that have been implanted for a long period of time, a mastopexy is often performed to tighten up the loose skin: this is additional surgery usually done at the same time and at an additional expense. Studies of saline-filled breast implants approved by the FDA in May 2000 showed rupture and deflation rates of 3-5% at three years and 7-10% at five years for breast augmentation patients.

The age and design of the implant are important factors in rupture, but estimating rupture rates of contemporary devices has been difficult for a variety of reasons, mainly because implant designs have changed somewhat over time. Capsules of tightly-woven collagen fibers form as an immune response around a foreign body like breast implants, which tends to wall it off; capsular contracture happens when the capsule tightens and squeezes the implant.

Some doctors in specialties other than plastic surgery, like dermatologists, perform breast plastic surgery like breast augmentation; choose a plastic surgeon instead. If you decide to proceed, make sure you choose the best breast plastic surgeon based on your research; ask health professionals you know for referrals. Just a reminder that breast augmentation is usually considered an elective cosmetic breast plastic surgery.

Evaluation of these patients includes looking at the texture of their skin, to see if there are stretch marks, noting significant underlying damage to the skin’s ability to tighten . In addition, it’s important to look at the shape of the breast, the areolar size, the asymmetry of the breasts, and the age of the patient.

1. The truth about implants. Contrary to what you may think, the majority of plastic surgeons would choose silicone over saline for patients. This prevailing opinion is agreed upon by 9 out of 10 plastic surgeons.

Currently, the implant manufacturers are using gel that is even thicker. They call it “cohesive gel” because it is designed not to leak out in case of a disruption in the outer shell.

As the size of the implant increases, it becomes more difficult to disguise it. Women are selecting larger implants than ever before and they need to know that their body can only camouflage a certain size implant before it becomes obviously “un-real”. My consultation with every patient includes a discussion that specifically compares their body and breast type with the implant size that they choose.

2. “What happens to my breasts with age?” Breast tissues age just like other tissues of the body. The skin stretches out, the fibers that hold the internal tissues together weaken, the milk-producing gland tissue enlarges and shrinks with each menstrual cycle and pregnancy, and the fatty tissue varies with weight changes.

Insertion of a small or moderate breast implant behind these tissues will be accommodated well and will improve the shape of the breast in most cases; however, larger implants are also heavier, and they will produce a greater degree of stretch to the tissue, thereby causing it to weaken over time.

Brassiere sizing is not constant. Although the brassiere manufacturers set up a standard sizing system, they do not adhere to it. A 34C bra bought from Victoria’s Secret is much smaller than a 34C bought from Target. We are, however, accustomed to describing breast size in terms of bra size.

It is better to discuss your desires with a surgeon based on the look that you want rather than the bra size. Bring in photographs of topless models, ask to place sample implants inside a bra that gives you the look that you are hoping for, or visit websites that show examples of patients that have undergone breast augmentation.

3. “Is the surgeon peer reviewed?” Peer reviewed means that the surgeon has privileges to do breast augmentation at a hospital or surgical center where other surgeons also operate at. To obtain those privileges, the surgeon must submit an application that is reviewed by other qualified surgeons. These other surgeons have been selected to give privileges only to new surgeons that perform skilled surgery.

A board certified plastic surgeon can only be certified in America by the American Board of Plastic Surgery. Other boards exist that certify dermatologists, facial plastic surgeons, cosmetic surgeons, gynecologists etc. They are not truly plastic surgeons although they may perform plastic surgical procedures and may call themselves plastic surgeons.

“Should a non-plastic surgeon do my surgery?” If you decide to work with a non plastic surgeon, you should check up on the surgeon’s qualifications.

How many years has the surgeon been in practice? It is always reassuring to know that the surgeon has been practicing for some time, and that he performs a considerable amount of surgery. How many cases does the surgeon do per year? If the surgeon is using his own operating room, you must ask if it is certified by one of the accepted certifying agencies. These organizations maintain standards that ensure safety, quality and experience.

4. “Who puts me to sleep?” There are several methods used for administering anesthesia. If an anesthetist is supervised by an anesthesiologist (M.D.) on the premises, you have nothing to worry about. If the anesthetist is supervised by the surgeon or by an anesthesiologist that is not physically present, you should think twice about surgery performed in that location.

You want your surgeon to focus on your surgery and not to be distracted by the responsibility of the anesthesia. Some rural hospitals allow anesthetists to provide anesthesia without supervision. Personally, I would not allow an unsupervised anesthetist to give me anesthesia, unless it was a dire emergency.

Anesthesia is a drug induced mental state that allows surgeons to work without you experiencing pain. These drugs can and often have other effects. Some drugs may cause postoperative nausea and vomiting. Usually this will resolve in a day or two, although occasionally patients say that they remain mildly affected for up to two weeks after surgery.

Newer drugs and techniques are developed every year, usually because they do the job better and with fewer side effects. It is the sole job of the anesthesiologist to keep up with these drugs and techniques, so that your anesthesia goes as smoothly as possible.

5. “Why do prices vary?” The cost of the surgery is a combination of three charges. The first of the charges is the surgeon’s fee. The surgeon’s fee will include the operation and all of the office appointments. Do not underestimate the office appointments.

Most surgeons will allow you to return annually at no charge to check up on your implants and to examine your breast tissue. Take advantage of this benefit. If you go out of town for your surgery, you are giving up that benefit. The surgeon’s fee will also include the price of the implants. Some surgeons include medications while others ask you to fill a prescription. This can amount to $100-200.

The second charge is the operating room fee. Surgeons that use a surgical center or a hospital will tell you that fee, and you will usually pay it directly to the facility. Surgeons that use their office for the surgery will not usually describe this fee specifically; it will be part of the “inclusive fee”.

Food for thought: Surgeons that run their own operating room have been tempted to cut corners to save expenses. Again, be sure that the operating room has been certified.

The third charge is the anesthesia fee. Usually the same billing methods apply as for the operating room.

Why is the cheapest quote definitely not the best? There are some things that add cost to the surgery, which are well worth the extra expense. Yes, you can have a breast augmentation surgery without these things, but you will be sacrificing something. The sacrifice may be a safety feature or it may be a less optimal appearance of your breasts.

Allow me to give some examples. There are many types of implants. Silicone implants cost more than saline implants. Some implants have a separate saline and silicone compartment. Implants are shaped differently. These are for special situations. They are more expensive to produce and therefore they sell for a higher price.

Your surgeon should tell you about these special implants if he feels that they will be a better choice for your particular situation. Your surgeon should also tell you if your breasts will require additional work, such as a breast lift, to obtain the optimal result. This additional work will add more time to the surgical procedure and therefore the cost of the surgery will increase.

An anesthetist is not as costly as an anesthesiologist. Some surgeons cut costs in their own operating room by using anesthetists. Always consider the “what ifs”, because surgery is not without risk. Be comfortable that your surgeon is well trained and strives to have as few complications as possible. Complications do occur and will often lead to additional expenses.

If you go out of town for your surgery, you will have to travel again to treat a complication should it develop. Or you will have to go to another surgeon closer to home to treat the complication. It is the best policy to choose your surgeon wisely. Try to avoid shopping for the lowest price surgeon.

6. “Do I want to buy the extended warranty?” Did you know that all of the implant manufacturers have a warranty for their implants and that they sell an extended warranty for an additional fee? As I have said above, no medical devices including breast implants last forever. Breast implant manufacturers offer a very generous warranty.

They realize that their product is chosen as a lifestyle luxury. You will not see this type of warranty from any other type of medical device manufacturer. The breast implant manufacturers will replace the implants, if anything goes wrong with them, for your entire lifetime.

In addition, for several years after implantation they will also reimburse some of your expenses for the other costs of the second surgery. The extended warranty that can be purchased increases the amount of reimbursement and lengthens the period of time that the reimbursement is available to you. So how do you decide if it is worthwhile to buy the extended warranty?

Most consumer advocates will agree that extended warranties are generally not worth the expense, and merely serve to make greater profit for the seller. However, there are always certain situations that can make it worthwhile. I will tell you my personal opinion regarding the extended warranty for breast implants.

Most plastic surgeons want to have happy patients that will return to them in the future. If one of our patients has an implant problem, such as a leaky implant, also called a deflation, we will usually perform the second surgery, even if it is many years later, for a minimal fee. However, if another surgeon performed the first operation, the surgical fee for the second surgery can be higher than the original surgery.

Therefore, if you think that you may not be able to return to your original surgeon in the future, e.g. you have plans to move elsewhere, it may be prudent to purchase the extended warranty. Conversely, if you traveled a distance to an outside surgeon, you may want to consider purchasing the extended warranty.

Remember the warranty only applies if there is a problem with the implant. If in the future, you wish to change implants for a larger size, you will have to pay for the new implants.

7. “Do I like the surgeon?” Answer this question immediately after your consultation. You may have gone to the consultation because of a recommendation by a friend. Do not let that influence you. You should feel comfortable with the surgeon. You need to be able to openly discuss exactly what you want. You need to feel that you can ask as many questions as you desire. You should not feel as if you are on an assembly line or that the surgeon is too busy to give you adequate time and consideration.

Many surgeons are busy and often run late with their patient appointments. However, if the surgeon gives you all of the time that you want when you are in the initial consultation, you should be reassured that you will not be shortchanged at your following appointments.

If the surgeon treats all of the patients equally well, there will be other patients that need more time or have more questions for him than his schedule has allowed for. If he is running late because of spending extra time with another patient, you can be assured that he will give you extra time when you need it.

Do I like the surgeon’s staff? Many of your interactions will be with the other members of the staff. Be sure that they are friendly, knowledgeable and sincerely want to help you. The type of staff in a medical office also speaks volumes about the personality of the surgeon.

If you have made it this far, you must truly be interested in having a breast augmentation. Doing your homework will bring you to the day of surgery with a comforting feeling that the surgery will give you a new figure that will last you a lifetime.

Tubular Breasts

Tubular breasts are characterized by narrow bases, often high on the chest wall. The breasts, though narrow, sometimes have a significant amount of tissue, which extends forward, but, unable to support itself, shows a high degree of ptosis (sagging). In addition, these often have unusually large areola, which are distended outward by a protrusion of the breast tissue under the nipple.

Inexpert augmentation of this kind of breast can lead to a phenomenon known as double-bubble, or double-breast where the breast tissue sits visibly atop the implant, but a skilled cosmetic surgeon can correct this malformity by reshaping the breast using a donut mastopexy (breast lift), a reduction of the areola, and a reshaping of the breast tissue to give a more natural, pyramidic shape to the breast.

Downward Pointing Breasts

In many cases, downward pointing breasts may just be the result of ptosis of the breast, and can be corrected using a breast lift, with or without augmentation. However, in some women, downward pointing breasts are the result of a prominence of the upper chest wall. This women can achieve a good shape of the breast following augmentation if high profile implants are used that can sit in the midchest, under the prominent upper chest protrusion, balancing the breast and making it more natural in shape.

Divergent Breasts

Women with divergent breasts have a hard time achieving good cleavage in most outfits. The separation of the breasts can make them appear even smaller than they are, especially impacting their projection in front of the chest bone. For these women, breast augmentation can bring the breasts closer together and reposition the nipples, giving a more normal, appealing shape.

Breast Asymmetry

Many women have breasts that are uneven, with one significantly larger than the other. Breast augmentation can correct this disparity between breasts. In addition, a breast lift can be used to correct breasts that are positioned differently on the chest wall.

If you have breasts whose shape is far outside what is considered normal, and this causes you anxiety or self-consciousness, you do not have to suffer. Breast augmentation is not simply a cosmetic procedure, but can be a corrective for many developmental variations of the breast that are seen as aesthetic defects.

Schedule a Consultation to Create a Custom Breast Augmentation Procedure

The consultation is a crucial part of planning your breast augmentation surgery. During the pre-operative appointment, you will be presented with many options for customizing the procedure. Open communication with your doctor is the best way to create a custom breast augmentation procedure to meet your needs.

The surgeon will conduct a medical examination and describe what can realistically be achieved through breast augmentation surgery. You will need to establish a grounded understanding about the benefits, limitations and risks for the procedure. Through the guidance of your breast augmentation doctor, decisions about the incision, type of implant and placement will be made. Planning should be made with your physique and current breast size in mind.

Custom Breast Augmentation: Type of Implant

You have the option between silicone and saline breast implants. Saline implants have a silicone shell and are filled with a solution that matches your body chemistry. Silicone implants are filled with silicone gel.

In addition to breast implant material, there are differences in shape. For breast augmentation surgery, implants can be round, oval or anatomical. There is conflicting evidence regarding anatomical implants and whether they actually provide the most natural-looking results. Some implants are also inflatable, which allows for more control over symmetry.

The surface of your implants can be textured or smooth. Some surgeons hold firm that textured implants reduce the risk of capsular contracture. Capsular contracture occurs when scar tissue forms around the implant, hardening the breasts. Other breast augmentation doctors prefer smooth implants.

Create a Breast Augmentation Procedure to Meet Your Needs: Type of Incision

The location of the incision may rest on what your surgeon is comfortable with doing. If you have a preference, locate a cosmetic surgeon accordingly. Breast augmentation surgery can be performed under four different types of incisions, with no one method necessarily safer than the others.

The most common incisions for a breast augmentation procedure are in the crease of the breast or underneath the areola. Incisions can also be located in the armpit or through the navel. Breast augmentation surgery through the navel leaves virtually no scar. However, choosing an implant that is filled pre-operatively will lessen your options for the type of incision.

Custom Breast Augmentation Procedure: Sub Glandular Implant Placement

During breast augmentation surgery, the implants can be placed differently. Sub glandular placement is right behind the glands and in front of the pectoral muscle. Sub glandular placement may not be suitable for patients without enough breast tissue. However, women with larger breasts may find it adds a little lift.

Custom Breast Augmentation: Partial Sub Muscular Placement

Partial sub muscular placement is between the major and minor pectoral muscles. This can enhance cleavage and create a natural appearance. However, partial sub muscular breast augmentation is more complicated. Recovery may cause substantial discomfort.

Custom Breast Augmentation: Full Sub Muscular Placement

Full sub muscular is placement behind the muscle. Results for full sub muscular breast augmentation require the longest adjustment period. It can take several months before noticing the results.

However, many patients find the body’s adjustment to full sub muscular breast augmentation well worth the wait. Breasts usually look entirely natural. There is also a reduced risk for capsular contracture and rippling.

Locate a Qualified Surgeon and Create a Custom Breast Augmentation Procedure

An experienced breast augmentation doctor is essential for the proper guidance. A qualified surgeon is certified by and accredited organization, such as the American Board of Plastic Surgery. For more information about breast augmentation, or for help locating a doctor, visit DocShop.com.