Breast augmentation continues to be among the most popular cosmetic surgery procedures in the United States, with 300,378 procedures performed in 2017. * That’s a 41 percent increase from 2000, so you know you’re in good company when you are thinking about getting breast enlargement surgery.

If you’ve been researching breast enhancement, you may be feeling confused or overwhelmed by the sheer number of different options out there – from implant material to size and more. Here’s a breakdown of the most significant choices you’ll have to make, so you can head into your surgery forearmed with the knowledge you need.

1. Surgeon

It’s no exaggeration to say choosing a competent, experienced and board-certified cosmetic surgeon is the most essential decision to make in your journey toward better breasts. You will need to do your homework to find the doctor who is the best partner for you. You should be prepared to have in-person consultations with multiple different doctors to select someone whose personality, aesthetic vision and skill level are a good fit. Your goal should be to find someone who not only has many years of experience in breast enlargement surgery, but also has been able to provide consistently excellent surgical outcomes.

2. Size

Once you’ve chosen the right surgeon, your work is far from over – you still have several other decisions to make. Breast implant size is one of the major factors that contribute to the successful outcome of a breast augmentation procedure.

The first thing to know about breast implant size is that it’s not measured in terms of bra cups, but in cubic centimeters. When thinking about size, two major factors come into play: your body type and how natural you want your results to look. In the early days of breast augmentation surgery, many women intentionally chose larger implants; however, most plastic surgeons today will caution you against going too big.

A knowledgeable cosmetic surgeon should be able to educate you on how each breast implant size will alter your physique, including how much your skin will need to stretch to accommodate them. During your consultation, ask to view various before-and-after photos of previous augmentation patients with a similar body frame as yours.

3. Saline vs. Silicone

Another essential decision regarding implants is the choice between saline vs. silicone implants. Saline implants feature a sterile saltwater solution much like the natural fluid that comprises much of your body. Your surgeon will fill your saline implants after placing them into your chest, which is convenient because it allows more precision and control. Additionally, the incision for saline implants is slightly smaller than the one required to place silicone implants.
Silicone implants are made with a viscous gel that is designed to closely mimic human fat. As a result, many women say silicone looks and feels more like natural breast tissue. Unlike saline implants, silicone breast implants are fully filled before placement. Silicone implants also tend to be somewhat more expensive than saline.

When you are weighing the pros and cons of saline vs. silicone breast implants, you may be wondering if there is a difference regarding durability or safety. While both types of implants have received FDA approval, ** many women choose to get saline implants because if they do leak, your body will harmlessly absorb the saltwater filling. If silicone implants rupture, it is often difficult to detect, so the FDA recommends regular breast exams, MRIs or mammograms.

4. Surgical Incision and Implant Placement

You and your surgeon also need to decide among three spots for the placement of your incision: under your arms, around your nipples or underneath your breasts. All three of these locations are designed to keep incisions as inconspicuous as possible, so the decision about where to place the incisions for your procedure will depend on both your personal preference and your anatomy.

You will also need to choose whether you want the doctor to place your implants over or under your chest muscles.Breast Enlargement Surgery Sub-muscular placement means your implants are partially beneath your pectoral muscles, while in sub-glandular placement, your implants will be between your chest muscles and your breast tissue. A qualified surgeon can help you decide which is best, depending on the type of implant material you choose and the results you hope to achieve.

Smooth vs Textured

Breast implants come in two different textures: textured or smooth. The textured surface is rough like fine sandpaper, which provides greater traction. Meanwhile, the smooth surface is a consistently slippery cover on all sides, which allows them to move inside the breast pocket without friction.

Smooth implants tend to be longer-lasting and less expensive. However, textured implants generally feel firmer. Also, the slight roughness causes the surface of the implants to adhere to the surrounding tissue around it, which keeps them in their initial positions. Textured implants were originally designed to minimize capsular contracture, which is a complication of breast enhancement that causes hard and sometimes painful scar tissue to form around the implant. Evidence of this benefit remains medically unproven, though.

6. Implant Shape

There are two different breast implant shapes: round or teardrop. Your surgeon can help you choose between these based on which shape fits your body best, as well as which type will provide you with the most natural-looking results.

Because round implants have a consistent shape throughout, you won’t have to worry about them rotating out of place and becoming asymmetrical in the future. However, teardrop-shaped implants are more anatomically correct because they are more in line with the natural shape of your breasts – they are fuller in the lower half, and have less volume in the upper. Teardrop implants are often an excellent choice for women who have less existing natural breast tissue. Teardrop implants also tend to feel slightly firmer, so if you want your results to feel soft, you may want to opt for round implants instead.

Are You a Candidate for Breast Augmentation?

To determine whether breast enhancement surgery is right for you, you’ll need to schedule a consultation with a skilled cosmetic surgeon such as Dr. Michael Kulick. Over more than 20 years in his San Francisco practice, Dr. Kulick has earned a reputation as one of the most well-respected and in-demand cosmetic surgeons in the Bay Area. Having received board certification from the American Board of Plastic Surgery, Dr. Kulick has provided many women with naturally beautiful-looking breast augmentation results. Make your appointment today by calling 415-956-2550 or reaching out online.

* Source: American Society of Plastic Surgeons, March 2017

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*** Source:, June 2018

Dr Michael KulickDr. Michael Kulick, MD is a leading board certified plastic surgeon in San Francisco, California. During an initial consultation, he’ll examine your individual anatomy, discuss all your options, and create a unique treatment plan along with any other necessary procedures. If you’d like to learn more about the benefits of plastic surgery and are looking for a qualified cosmetic surgeon, use this online form to request a consultation with Dr. Kulick or call 415-956-2550.