Patients come in all shapes and sizes, and at Popp Cosmetic Surgery we’re happy to help them make sure that they’re in a body that suits them not just aesthetically, but functionally as well. When choosing between the most popular options for breast augmentation, it’s not just the size that counts.
There are two major types of breast augmentation patients can choose from: implants and fat transfer. These categories can be further specialized, ensuring that each patient gets a custom cup that fits their journey.
According to the International Society of Aesthetic Plastic Surgeons’ (ISAPS)report, there were 3.9 million breast procedures performed in 2024 alone. Breast augmentation was the third most common cosmetic procedure for women.
Types of Breast Augmentation
The two primary breast augmentation options areimplants and fat transfer.Learning more about the variations that exist within these two categories helps you find the perfect option for you.
Implants
- Saline implants are filled with a sterile saltwater solution, which is well tolerated and useful to the body. If you have ever had an IV placed in one of the veins of your hand or arm (such as prior to surgery), the clear solution that is running into that vein is saline. This offers peace of mind, especially to those who live or work in very physically demanding or high-impact environments. When a saline implant ruptures, it poses no threat to you. The body will absorb it just as if it were going into a vein, and your breast goes flat like a flat tire.
- Another common type of breast implant is made of silicone gel. These are a bit higher maintenance and may require routine care to monitor for possible degradation and rupture. Many people feel they are more natural feeling than saline, which is true if your natural breast tissue is minimal, as in an “A” cup. What you feel after breast implants is a combination of your breast tissue on top of the implant. If you are a large “B” cup or greater, the feel of the breast after surgery is mostly your natural breast tissue with the implant below.
- Form stable or gummy bear implants are made from a thicker, firmer silicone. They maintain their shape even if they break, but placing them requires a longer incision.
- Round implants are meant to look round all over. They don’t change shape even when rotated out of place.
- Textured implants are filled with silicone or saline but have a rougher, irregular outer surface. These are rarely used as they are associated more frequently with a type of lymphoma.
Fat Transfer
Fat transfer or lipo-augmentation moves fat from one part of the body to another. The fat is usually sourced from the patient’s abdomen, back, or thighs.
This method is typically used for small increases in size.
What Type of Breast Augmentation is Best?
The best option for you depends on factors such as your body type, goals, and lifestyle. However, there are a few benefits of each to consider.
The results from implants depend on which type you use. Traditional silicone gel is the most popular, however the FDA requires an MRI or Ultrasound every 2 years to determine whether the implants have ruptured. Saline is more affordable, requires a smaller incision, and there is no FDA mandate for an MRI or Ultrasound. When a saline implant ruptures the body absorbs it without issues, and as mentioned previously, the breast goes flat like a flat tire.
Fat grafting eliminates any foreign substances as the fat is from your own body and looks natural. However, if the patient is slim, there may be very little fat to move to the breasts, thus only giving a small cup size increase.
How to Prepare
The breast augmentation surgery process starts with a consultation. The surgeon will talk with you to help you find the best option.
They’ll discuss your overall health. Tell them if you’ve had any surgeries or a personal or family history of breast cancer.
You’ll receive instructions for how best to prepare for breast augmentation surgery.
It is imperative that you are honest about smoking habits, your use of drugs or medications, and about your plans for post-operative recovery. Miscommunications about your health can lead to harder-to-control bleeding, which can be very dangerous. These issues can also impact how your procedure heals, leaving you with sub-optimal results.
Prepare to take time off work while you recover. Have a friend or family member ready to drive you home after the procedure. Set up a comfortable area in your home to recover in.
How Breast Augmentation Works
During the procedure, you’ll be put under general anesthesia delivered through an IV. It will help relax you. It’ll also ensure you don’t feel any pain.
Fat transfer is one of the simplest breast augmentation options. The surgeon extracts fat from one area of the body and inserts it into the breasts.
Implants require an incision, but there are several types.
An inframammary incision is made in the fold beneath the breast. It’s the most common because it offers good access and a well-hidden scar.
A peri-areolar incision is made in the lower edge of the areola. It provides the surgeon proper access while hiding the scar, but it can also affect breastfeeding and nipple sensation.
A trans axillary incision is in the crease of the armpit. It avoids scars on the breast but also requires a specialized technique and makes revision surgery more complex.
The implant can go under your breast tissue and in front of the muscle or behind your chest muscle (pectoralis major muscle).
When the procedure is complete, the surgeon will close the surgical site with sutures. They may also place drainage tubes, and you may be observed in an aftercare room for an hour until you can go home.
What Day is the Hardest After Breast Augmentation?
Breast augmentation recovery is relatively simple, but the first two to three days are the most difficult. This is the time when you’ll feel the most pain or irritation.
Follow any aftercare instructions you’re given. Avoid heavy lifting or active sports for a few weeks.
Potential Risks
Serious complications with breast augmentation are rare. The most common side effects include:
- Redness
- Sensitivity
- Bruising
- Bleeding
- Swelling
Regardless of thetypes of breast augmentation you choose, you could develop an infection or have trouble healing. You could also develop a hematoma (blood clot) around the surgery site.
There are also complicationsthat could develop over time. They include:
- Scar tissue/Capsular Contraction
- Rippling
- Sagging
- Synmastia
- Seroma
- Rupture or deflation
- BIA-ALCL cancer
- Inability to breastfeed
- BII (Breast Implant Illness)
The signs of these complications don’t always show up right away. Don’t wait to get help if they start to show up.
Serious symptoms that require immediate attention include:
- Fever
- Abnormal discharge
- Ruptured stitches
- Increased breast enlargement with pain and pressure
- Indications of Breast Implant Illness (BII)
Frequently Asked Questions
What Do Patients Wish They Knew Before Getting Breast Implants?
Many patients don’t understand that implants don’t always last forever. They can last for 10 years or more, but you may need revisions or replacement surgeries. You’ll also need regular checkups. Remember with silicone you will need an MRI or Ultrasound every 2 years as they are the only tests currently available that can determine if a silicone implant has ruptured. Again, saline does not require these studies as you will know if your saline implant has ruptured (“flat tire”).
You should also be aware of the recovery time before you sign on to the procedure.
What is the 45-55 Rule for Breasts?
The 45-55 rule is a general guideline for breast augmentation. It says that 45% of the breast volume should go above the nipple and 55% should go below it. This rule helps create a more natural, teardrop appearance instead of a fully rounded one.
This rule is a guideline and not a requirement. Discuss with your surgeon what ratio you want.
Schedule Your Consultation Today
Dr. Jeffrey C. Popp MD is a board-certified cosmetic surgeon who has been practicing since 1983. He has more experience in the field of cosmetic surgery than any currently practicing physician in the region. His office provides patients with the latest, highest-quality cosmetic procedures backed by decades of education and compassionate hands-on care. The helpful staff can guide you to the best option for your physical and mental wellness.
Request a consultation today.
