Breast Augmentation is one of the most gratifying cosmetic procedures offered by plastic surgeons today, and in fact, studies show a 95% satisfaction rate with this surgery which is one the highest rates among all procedures. A large number of patients have breast augmentation when they are in their younger years where they are just joining the work force, are in school or otherwise find it difficult to fund surgery. It may still make sense to have this surgery both because of the high satisfaction rate and because the beneficial effects of the surgery are so long lasting. Breast implants provide for a permanent size that never changes during a patient’s life time. Implants also affect shape, and make the breast appear natural and youthful, even when patients are in their older years. Breast implants also allow for greater ease in the wearing of different styles of clothing. In a way, breast augmentation surgery might be considered a worthwhile investment.

Breast implant surgery is generally performed under anesthesia and so support personnel are required to provide the safest and most pleasant experience. Staffing for surgery involves not only the physician performing the procedure but also an anesthesiologist and nursing staff, as well as other operating room personnel. The surgery must also be performed in an accredited surgery center and all materials and procedures must comply with the best standards and practices. Despite the high cost for providing this high level of medical care, competition has made breast augmentation surgery affordable for almost every patient. One factor has put an upward pressure on the cost of breast augmentation surgery.

Breast Implant Cost

In the 1980’s, there were two types of implants available: saline and silicone filled breast implants. The cost of the implants was so low that they represented approximately 4% of the total cost of the surgery and so breast augmentation prices remained low. More recently, breast implant manufacturers have brought different types of breast implants to the market and at higher prices. Most significantly, “gummy bear implants” were introduced and these breast implants have a thicker silicone gel fill than previous gel breast implants. When gummy bear implants are used, they drive implant cost to account for 30% of the total cost of surgery.

Higher Cost But are they Better?

The breast implant manufacturers state in their sales literature that gummy bear implants support the upper part of the breast more than saline implants and more than their other silicone gel breast implants. They also state that it is more difficult to “feel” the implant and that therefore the results of breast augmentation surgery are more natural with the gummy bear implants. These claims have not been confirmed yet by independent scientific study.

As mentioned above, breast implants are quite durable when one considers that they move with the patient’s movements and appear totally natural and part of the patient’s natural anatomy for many years. Patients, in consultation are encouraged to feel the different types of implants, to “try on” the implants in a specially designed bra and also to look at breast implants before and after photos.

One issue that might affect a patient’s shape with gummy implants is that, with time, and as normal breast tissue is lost, the more solid shape of these implants may become more noticeable. Gummy bear implants are relatively new and although they are FDA approved, it may take some years of actual patient experience to determine what the long term effects are on the shape of the breast as compared with the current saline and silicone gel alternatives.

Fat Transfer Breast Augmentation

Recent innovations in the field of liposuction and fat transfer have made the use of fat an alternative to enlarge the breast. Benefits of the use of fat are that no foreign object (i.e. a breast implant) is required. The greatest negatives regarding the use of fat to enlarge the breast are the degree to which the breast can be enlarged, which is a fraction of one cup size and that multiple treatments may be required. The average increase in cup size when patients opt for breast implants to enlarge the breast is between one to two cup sizes. Additionally, with time the fat that has been transferred may be lost, whereas breast implant volume never changes, with the exception of the occurrence of a deflation which is uncommon. Thus, for now fat transfer breast augmentation is probably not the best option for patients seeking breast augmentation but technological advancement may change that.

Breast Lift with Implants

Some patients may develop loosening of their breasts, especially after childbirth and with breast feeding and this can cause the breast to droop. The other issue with drooping is that, at the same time, there is a loss of tissue in the upper part of the breast and so the breast can appear less full.

Patients who develop drooping of their breast and also note loss of fullness in the upper part of the breast usually require a breast augmentation with a breast lift. Since this surgery takes at least twice as long to perform, the cost is more. There may be alternatives and so it is important to discuss these with your plastic surgeon.

Dr. Newman is a board certified plastic surgeon.