The Breast Augmentation Guide: A Complete Guide to Breast Augmentation

Introduction of Charlotte’s Top Breast Augmentation Surgeons

At Charlotte Plastic Surgery, we’ve performed tens of thousands of breast augmentation procedures, which means we’ve met with tens of thousands of women like you. We understand that finding accurate, honest information is sometimes the most challenging part of the process. Learning if this decision is right for you can sometimes be overwhelming.

That said, we thought you might appreciate some straight talk from our board-certified plastic surgeons with the most up-to-date resources and our best tips, tricks, and recommendations for a stress-free experience. Together, we’ll walk you through everything you need to know—no confusing terminology, no sales pitch, and no pressure. We look forward to helping you bloom. Here is a great guide to breast augmentation.

Breast Augmentation Common Misconceptions

Here are some common myths busted about breast augmentation surgery.

  • Breast Implants must be replaced every ten years. This is FALSE. If you’re not having problems with your implants, you don’t need to replace them.
  • The most common reason for an implant exchange is when a patient decides to modify their size, either up or down.
    Saline implants are safer than silicone. This is FALSE. In the early 1990s, silicone implants were removed from the market due to safety concerns, but the data gathered through a 14-year study has proven these implants to be safe.* They’re the most tested medical device on the market.
  • You can lose nipple sensation after surgery. This is TRUE. You can lose nipple sensation temporarily due to stretching of the nerve, but for most patients, sensation returns between 6 to 8 months after surgery.
  • Having breast augmentation will fix a sagging breast. This is FALSE. Adding an implant to a sagging breast creates a larger sagging breast. A breast lift, with or without implants, is the only way to bring the breast back to where it used to be.
  • You can’t breastfeed after implants. This is FALSE. In most cases, breast augmentation surgery does not damage the glandular tissue where your milk ducts reside.
  • Bigger isn’t always better. This is TRUE. Remember, you’re modifying your breast size for many years to come, so we encourage you to think about how you’ll feel regarding your implant size as your lifestyle and body change. Your surgeon will help you determine the best fit for your body type and use tools like the VECTRA to help you visualize that outcome.

Most Frequently Asked Questions About Breast Implant Surgery

How long do breast implants last?

Our patients always want to know if they are getting results that will last a lifetime. Breast implants are not necessarily lifetime devices, but they can sometimes be. Earlier iterations of implants were prone to failure, and that’s where the recommendation to have them checked every ten years came from.

But that was back in the era of first- and second-generation implants. Now we’re into the fifth generation of breast implant technology, which has proven extremely safe and much less prone to rupture/failure.

We still recommend that patients return to their surgeons every few years to make sure the implants are, in fact, “okay,” and that no signs of rupture are detected. This is especially true following any bodily injury you might sustain in a car accident.

Assuming there are no symptoms and these regular check-ups go smoothly, however, women with implants have little to worry about, and there is a high potential for their implants to last a lifetime. So feel confident when asking the question, how long do breast implants last, that your breast implants can last with attention and taking care of yourself.

Will I be able to breastfeed with implants?

Many moms or moms-to-be want to know how implants will impact their ability to nurse.

The first thing to note here is that not every woman can breastfeed, and no “test” can be done to determine whether or not a first-time mother will be able to breastfeed, so the occurrence of breastfeeding problems may have nothing to do with implants.

That said, it is improbable that getting implants will impact a woman’s breastfeeding ability. In fact, in a recent clinical study with over 4500 women who gave birth to over 5500 children after primary breast augmentation, 80 percent with silicone implants and 75.9 percent with saline implants were able to breastfeed their infants without complications.

And the rate of women in the study with lactation complications was comparable to reports in the general population of women who breastfeed, indicating that implants play no significant role in the woman’s lactation ability.

Will my breasts look fake?

We spend a lot of time talking to patients about their goals and the look they’re trying to achieve. There are certainly patients who want a more “fake” or “augmented” look, and there are ways we can give patients that look, although it’s certainly not routine for our practice. And frankly, we find that women want this look—the Baywatch look—less and less.

As top breast plastic surgeons at Charlotte Plastic Surgery, we strive for natural results that are subtle and elegant and that provide the patient with plausible deniability. To help us meet the goals of our patients, we utilize VECTRA 3D simulation technology, which allows the patient to “try on” implants in their form. The simulation is more than 90 percent accurate and has dramatically reduced the rate of breast surgery revision due to patient implant size dissatisfaction.

Will I ever need additional surgery on my breasts?

Related to the breast implant life expectancy question, many women want to know how likely it is that they will need follow-up procedures.

The answer is potentially yes, but not everyone does. Additional surgeries may occur for various reasons, including but not limited to capsular contracture, implant rupture, to take advantage of newer implant technology, or to change the implant’s size and/or shape. There are many variables, making it tough to give a simple answer on this one. It just depends on the patient.breast lift techniques

What can I do to ensure my breast implant surgery goes as smoothly as possible?

The first thing you should do is make sure you work with a reputable breast plastic surgeon—someone who will take the time to walk you through the various issues related to pre-op preparations, post-op recovery, and ongoing breast care.

Once you find a plastic surgeon near you, make sure you spend time consulting with them and setting clear expectations. Guarantee that you and your surgeon are on the same page about the desired results.

Here at Charlotte Plastic Surgery, we emphasize consistent communication with patients. We always want to spend some time getting to know you before the procedure, ensuring we have a shared goal and a clear understanding of the outcome.

During your consultation, we invite you to ask any additional questions not addressed here. We are always happy to provide clarity. Connect with Charlotte Plastic Surgery today to learn more about what you can expect from breast augmentation.

Do Breast Implants Cause Cancer?

There has never been a study that has shown that breast implants cause breast cancer. However, there has been evidence of ALCL (anaplastic large cell lymphoma – entirely unrelated to breast cancer) occurring in a tiny group of women with textured implants. Thankfully, these incidents are pretty rare and completely treatable.

Given that most women choose smooth, round breast implants, this isn’t a risk that our patients typically have to worry about. And even for that subset of women who decide on textured implants, early detection ensures that the condition is easily cured.

“Researchers don’t know, definitively, why ALCL is associated with textured implants,” one report says. “Some top breast augmentation surgeons theorize that the rough surface of a textured implant may trigger an immune system response that spurs the disease. Others point to infections around the implant as possible culprits.” Again, the data underscores this condition’s occurrence is highly uncommon.

Does Having Implants Change the Way I Care for My Breasts?

According to top breast plastic surgeons, the short answer to the question is yes, getting implants does change the way you care for your breasts. When patients have breast implants, they will have additional breast studies done. For example, in addition to their regular self-exams and potential breast exams with their OBGYN, they will need to revisit their plastic surgeon every few years to rule out any indications of rupture or capsular contracture. Also, when receiving mammograms, patients will have additional displacement views called Eklund views where the implant is moved back.

It’s important to note that these additional screenings aren’t because the risk of breast cancer is higher, but just because, with any surgical procedure—including breast augmentation—regular follow-up with a doctor is prudent. Having additional examinations can be a hidden benefit of breast augmentation, as it ensures more consistent care and increases the odds that it is detected early if cancer is present.

There are some practical considerations for women with breast implants. For example, when scheduling a routine mammogram, it’s wise to let your doctor know that you have implants and to ensure you have a technologist who has experience performing mammograms for women with implants. Remind them that you have implants when you arrive for your appointment.

Implants can make it a little harder for doctors to get the needed images, so women with implants may get a few extra pictures taken (usually two additional photos of each breast).

One final note about mammograms: Some women have asked our top breast plastic surgeons if mammograms can cause breast implants to rupture. In previous generations, there was a small risk of this; thanks to advances in implant technology, it’s not much of a concern anymore.

Is breast augmentation surgery right for you?

Here’s how to know if you’re a candidate:

  • You’re healthy, not pregnant, and your breasts are fully developed
  • You are bothered by the feeling that your breasts are too small or lack volume
  • You feel you’ve lost breast shape and volume after pregnancy/weight loss/aging
  • You’re unhappy with the upper part of your breast looking empty
  • Your breasts are not the same size or shape

Why Choose Breast Augmentation Surgery?

Women choose to undergo breast augmentation surgery for many reasons. Often, women notice their breasts have lost shape and volume after childbirth, weight loss, or natural aging of the breast.

How do I know if I need a breast lift?

If you also feel your breasts are sagging onto your ribcage and your nipples point downwards, you may need a breast lift. One way to tell is by looking in the mirror—if your nipples are lower than the crease under your breast, you may need excess skin removed to get the perkiness and shape you’re looking for.

Do I Need a Breast Lift or Breast Augmentation?

In many ways, the question comes down to volume and shape—two important ways to evaluate the health and appearance of your breasts.

  • Are you satisfied with your current breast volume? And is your primary concern that your breasts aren’t in the right place? If so, that probably means you need a lift.
  • Meanwhile, if your breasts aren’t quite in the right place and you wish they were a little bigger, you’re a better candidate for augmentation and a lift.
  • Lastly, if you like the shape of your breasts but have lost volume, you probably want a breast augmentation. This is an especially common option for moms who have lost volume due to breastfeeding. (Ask us more about our Mommy Makeover procedure options!)

Whether or not you have sufficient volume in your breasts is somewhat subjective, though meeting with a plastic surgeon may help you determine whether your breasts are where you want them to be.

But what about breast placement? As a general rule of thumb, an attractive breast has the nipple at the apex of the breast mound, just as the breast peaks. It’s also crucial to determine where the nipple is in relation to the breast fold. If the nipple is above the fold, you rarely need a lift.

Meanwhile, if the nipple is below the breast fold, that usually means you need a lift to restore your breast to the proper shape—whether or not you receive an augmentation.

We also feel it is important to distinguish the difference between a Breast Reduction and a Brest Lift. Listen to one of our top breast plastic surgeons explain more:

Saline Breast Implants: Weighing your options


  • Saline breast implants require a smaller incision
  • They typically cost less than Silicone breast implants
  • There are more variations in size because you can adjust the volume of saline inside the implant
  • Because they go flat, it’s easy to detect a rupture
  • The filler is salt water (saline) and can be safely absorbed by the body if a rupture occurs


  • They tend to look and feel firmer and, therefore, can sometimes look and feel less natural than silicone breast implants.
  • They can cause rippling and jiggling due to the “water balloon” nature of the device.
  • Unless you have a lot of natural breast tissue, they may require an under-the-muscle placement; otherwise, they may be more “visible,” and it will look more obvious that you have implants.

FUN FACT: Saline breast implants were introduced in 1965 as an alternative to silicone implants. They have the same outer shell as silicone implants but are filled with saline (or saltwater) solution.

There are several types of breast implants. Let’s weigh your options.

Silicone Breast Implants: Weighing your options


  • Silicone breast implants appear and feel softer and more natural than saline breast implants.
  • There are more profile options than saline, meaning you can choose the amount of upper pole fullness (cleavage) that you want.
  • They are less likely to ripple than saline implants.
  • They are more easily used above the muscle (sub-glandular) due to their soft nature.


  • It can be harder to detect an implant rupture since the gel is cohesive (sticks to itself) and often remains inside the implant shell and breast pocket.
  • They require a slightly longer incision.
  • They cost more than saline (usually by $1,000 to $3,000)

FUN FACT: The terms gummy bear, cohesive gel, form stable, memory gel, and responsive gel are all marketing terms with no true scientific definition. They refer to the nature of the silicone to retain its shape when the implant is cut in half or ruptured.

Breast Implant Shape: Round or Anatomical

For many years, round breast implants were the only option for patients to choose. However, today, patients can also select a shaped or anatomical breast implant with a teardrop contour (smaller at the top and fuller at the bottom).

A patient might choose an anatomical implant if:

  • She does not want much fullness at the top of the breast
  • She has a very petite build, not a lot of breast tissue, and wants a teardrop-shaped breast
  • She has a breast deformity or defect that may benefit from the contours of a shaped device

A shaped implant will not project much at the top of the breast, so those women looking for more fullness at the top of the breast or cleavage will benefit more from a round implant.

Interestingly, numerous studies have been performed where breast augmentation plastic surgeons could not tell whether a patient had a round or an anatomic implant placed, likely because a round implant becomes tear-dropped when a woman is standing upright.

Breast Implant Surface: Smooth or Textured

Breast implants can have a smooth or textured surface, similar to sandpaper. It was initially thought that adding texture to breast implants would reduce the risk of capsular contracture (where scar tissue forms around the implant). However, this has not been entirely clinically proven. The texture does, however, help the breast implant to stick to the surrounding tissue and prevents it from moving or rotating (a benefit for teardrop-shaped implants since round implants look the same no matter how they are rotated inside the pocket).

A patient might choose a textured implant if she chooses a teardrop or anatomic-shaped breast implant.

Breast Implant Placement: submuscular or sub-glandular (also known as “under the muscle” or “over the muscle”)

Breast Implants can be placed either under the pectoralis muscle or on top of the muscle beneath the breast tissue. Which position is best for you may depend on various factors.

SUBMUSCULAR — under the muscle placement has the advantage of providing you more tissue over the implants. You may consider this placement if:

You have a small amount of natural breast tissue and require more coverage over the implant to make it appear less visible
You’re choosing a saline implant

With submuscular placement, you may have less rippling as more tissue covers the breast implant.

The downside to this placement is that breast implants under the muscle have a potential to “animate,” which means they may move or distort during flexing of the pectoralis muscle (so, if you’re an athlete or competitive bodybuilder, you may want to avoid this option). It can also be a more uncomfortable recovery and might require you to take an extra day or two.

SUB-GLANDULAR — You may consider over the muscle placement if you have ample natural breast tissue. You’re choosing a silicone breast implant.

Since silicone implants are softer and don’t require as much tissue coverage to look natural, many patients opt for this placement when choosing silicone implants. With sub-glandular placement, there is no muscle distortion or implant animation, and recovery tends to be less painful and shorter. But if you have ample breast tissue to cover the implant, this is still a good option for those who desire saline.

The downsides to this placement are that there’s a greater chance of rippling, and if using a saline device, there’s the potential that it will be more visible/obvious in the upper part of the breast.

PRO TIP: If breast implants are placed in a sub-glandular or submuscular position, it’s important to let your technician know when having a mammogram or breast ultrasound. This will allow them to take special imaging views that increase your chances of detecting breast cancer. Also, with newer radiology techniques, mammography and ultrasound are very accurate and can easily see inside the breast, no matter how your breast implant is placed.

Visualizing your result: Vectra 3D Imaging Technology

Do you spend much of your time thinking about what you’ll look like after your surgery? Do you wish you could “try on” your new breast implants before surgery? Well, now you can.

The Vectra 3D imaging device uses ultra-high-resolution cameras to analyze your breasts and torso and then turns those images into a 3D avatar. Through highly advanced computer software, you can then “try on” different shapes, styles, and size implants onto your torso to see how they would look on your body.

The Vectra is extremely accurate—an independent study here at Charlotte Plastic Surgery found the Vectra simulation to be more than 90% accurate compared to patients’ actual post-surgical outcomes.

Preparing for Your Breast Augmentation Consultation

Now that you have a better idea of your breast augmentation options, it’s time to sit down with a board-certified breast augmentation plastic surgeon to find out if surgery is right for you. Since there’s no “one size fits all” approach to surgery, it’s important to come to your breast augmentation consultation equipped with the tools to make the best decision for you. Our expert recommendations are:

  • Write Down Your Questions – You’ll be discussing a lot of information with your surgeon, so don’t risk forgetting something.
  • Write down your goals and concerns to make sure everything gets discussed.
  • Think about your Recovery – You might be restricted from heavy lifting for a few weeks and need a ride home from surgery. Find a trusted friend or family member who can help you through your breast augmentation recovery.
  • Consider Financing – CareCredit offers 12 months of financing with zero-interest for qualifying patients. Apply at to see what you are eligible for and calculate your monthly payments.
  • Find Breast Augmentation Before & After Photos to Review – Give your surgeon a better idea of the look you’re going for by bringing in photos you’ve found online, in magazines, or on our website
  • Look at your Calendar – breast augmentation surgeons are usually booked out several weeks for surgery, so be prepared with multiple timeframes that might work for your schedule over a period of many weeks.

Other Recommended Breast Augmentation Resources

  • FDA
  • ABMS.ORG – Verify your surgeon’s credentials by visiting the American Board of Medical Specialties website, and understand why board certification is vital to a safe and satisfactory experience.
  • SURGERY.ORG – Read descriptions of surgical procedures and find qualified surgeons near you.
  • REALSELF.COM – Find a community of real patients telling stories about their surgical journeys and showing their actual before and after photos.

Want to learn more about breast augmentation surgeries? Please watch our new Guide to All Things Breast Augmentation Surgery Video: