1. It’s rare for insurance to cover breast surgery for cosmetic reasons.
Unless your insurance company thinks the surgery is medically necessary, it won't be covered, says Dr. Val. Womp womp. One sitch where breast implants are covered by insurance is when they're part of the breast reconstruction process after undergoing a mastectomy, she says. For breast reductions, Rady Rahban, MD, FACS, adds that insurance will sometimes pay if the breasts are so large they create symptoms of back pain, neck pain, or rashes under the breasts.
2. Beware of “less-invasive” breast augmentation procedures.
While it might be tempting to opt for a procedure like fat grafting to achieve your desired look, the results from fat grafting are harder to predict than the ones from a traditional boob job. “Thirty to 50 percent of the fat will not survive. It is also not possible to know which fat will and will not survive, which may alter your results," explains Melissa Doft, MD, FACS.
3. Find out what kind of incision your doctor wants to use.
According to the American Society of Plastic Surgeons, there are four main types of incisions used during breast augmentations: transaxillary, inframmary, areolar, and trans-umbilical breast augmentation (TUBA). Basically, those terms mean you'll have an incision in either your armpit, the crease under your breast, your areola, or, in some cases, your stomach. The crease under your breast and your areola are the two most common places for incisions.
Some factors to keep in mind: If you have very small areola, that might make areola incision more difficult, says Dr. Doft. Scarring is also something to consider talking to your doctor about when discussing what type of incision they'll use. Dr. Norman Rowe, MD, says that for some women who want to go topless, they’d prefer to use the areola incision method, while others want to use the underarm incision so they can wear tank tops freely.
4. Look into your doctor’s social media presence.
It’s not uncommon for patients to find doctors via social media like Instagram and Snapchat. These platforms, when used appropriately, can be a good indicator of the kind of doctor you’re getting, says Dr. Rahban. You can get a sense of the doctor’s personality and the kinds of surgeries they do, “But when a doctor utilizes it as an entertainer or for shock factor, it tells a lot about [their] professionalism.” Meaning, popularity is more important to them than patient care.
Just keep in mind that the results you see on a doctor's feed aren't always indicative of what your results will be, adds Dr. Val. She recommends taking a look at results on body types that are similar to yours to get a more realistic idea of what a doctor can do.
5. DON'T SIZE UP TOO MUCH.
“The most important thing with breast augmentation is to make sure that the implant you select is conservative and not too large for the size of your anatomy," says Dr. Rabhan. He estimates that 30 percent of the errors made in breast augmentation come down to incorrect size selection.
It’s a red flag if your doc doesn’t advise you on the maximum size you can reach safely, without medical complications. Having an implant that's too big for your body can cause your breast tissue and surrounding muscle to become thinner, which is hard to reverse, explains Dr. Val.
6. Some implants may affect your health.
Certain types of breast implants are associated with a kind of cancer called ALCL (anaplastic large cell lymphoma). “At this point, they are unsure as to what causes it but believe it is somehow related to the texturing of the implant surface,” explains Dr. Rahban. That's because it's more commonly found in women who have textured implants.
The good news: Removing the implant along with any scar tissue around it usually cures it. It's not a deadly form of cancer and most patients don't even need chemotherapy, says Dr. Khuthaila.
7. There are lots of implant types.
You have a choice of different kinds of implant materials. There’s saline, silicone, “gummy bear” (aka cohesive gel), and autologous fat, explains Dr. Rowe. For the latter, you’ll need around two to three pounds of your own fat to inject into the chest, and patients often need touch-ups to achieve symmetry. With saline, the implant ripples more—meaning there are sometimes visible wrinkles under your skin—and some patients think that it feels heavier. Silicone tends to feel more natural, hold its shape, and ripple less. Dr. Doft says the majority of her patients choose silicone.
8. Your first breast surgery probably won’t be your last.
Implants don't last forever. According to Dr. Val, most need to be changed out within 12 years. Factors like weight gain, weight loss, breastfeeding, and gravity can change the way your breasts look, she explains. The implant could also begin to leak over time or a “scar shell” could develop around it, warping the shape and causing a need for new implants.
Keep in mind that you might need a revision surgery within 12 years. Dr. Val recommends budgeting accordingly so that you're prepared if something goes wrong with your implants down the road.
9. Breast implants will cost you around $3,947.
This average total, according to the 2019 statistics from the American Society of Plastic Surgeons, is based on the surgeon’s fee only and does not include the cost of anesthesia, facilities, and materials (stitches, bandages, drapes, etc.). The price will also depend on your doctor, patient needs, and the surgery location.
The cost of reduction, though, varies greatly from patient to patient, is about $5,475, according to 2019 statistics from the American Society of Plastic Surgeons. A reduction procedure typically takes three to four times longer than an augmentation, and the cost reflects that.
10. You won't need that much PTO.
Generally, patients will only have to take five to seven days off work for a breast augmentation and about the same for a reduction. After five to seven days of rest, you’ll be in good enough shape to head back to the office as long as your job doesn’t require manual labor. Pain medications are so effective these days that patients are able to go back to their normal routine pretty quickly, says Dr. Val.
11. When you're all healed, they should feel squishy.
If your implants are properly placed, you shouldn't be able to feel them through the skin. It's a total myth that breasts with implants feel unnatural, says Dr. Val. As long as your doctor takes into account how much breast tissue and skin elasticity you have and places your implants properly, they should feel really natural when you touch them.
You’ll be more likely to notice there’s an implant in a woman who began with little breast tissue than a woman who had more breast tissue, adds Adam R. Kolker, MD. Smaller implants and those that are placed below the muscle are harder to detect.
12. You can try on different boob sizes.
Using “sizers,” a bead-filled neoprene sack, you can stuff your bra to give you an idea of the size you might like. Some offices will also let you put implants in your bra and look in the mirror to get a better idea of what they'd look like under clothes, says Dr. Val.
13. You can’t go from small to huge all at once.
If you’re starting with a small A cup, don’t expect to go up to a DD cup in one procedure. Your body and skin need time to adjust to drastic changes, so a surgeon will likely suggest going up only a couple cup sizes at first, then increasing the implant size over the course of a few years.
You have to consider what's best for your anatomy too, says Dr. Val. As she mentioned earlier, choosing an implant that's too large for your body can cause your skin and muscle to permanently stretch out.
14. Breast augmentations or reductions could affect your ability to breastfeed.
"By making incisions on the breast we're interrupting or changing the anatomy. We're decreasing the amount of breast tissue that can actually produce milk," explains Dr. Val. That said, there's a pretty good chance that you'll still be able to breastfeed with implants. As long as you have an incision that's far from the nipple your milk ducts and glands shouldn't be affected, says Dr. Khuthaila.
15. You might temporarily lose feeling in your nipples.
Basically, the nerves in your nipples can get stretched and might be stunned for a few weeks after surgery, says Dr. Khuthaila. But don't freak. This effect is totally temporary in most cases. Losing feeling in your nipples permanently is pretty rare. Dr. Khuthaila says she's never seen it in any of her patients and she's operated on thousands.
16. Not all “plastic surgeons” are board-certified.
You definitely don't want to rush into finding a doctor to perform your surgery since, unforch, not all of them are trustworthy. Dr. Val suggests meeting with more than one surgeon so you can find one you feel comfortable with. You can ask to see their surgery results on patients with similar body types to yours and even ask to talk to former patients if you want.
In terms of credentials, make sure the surgeon is certified from the American Board of Plastic Surgery. Be wary of other “boards” that are not legitimate. To check, you can head to the American Board of Plastic Surgery website and search the doctor's name, says Michael K. Obeng, MD, FACS.
Your doctor should also be a member of the American Society of Plastic Surgeons and American Society for Aesthetic Plastic Surgery, both of which have a very high standard of criteria and education maintenance.
17. What you see when you wake up isn't what you end up with.
Right after your surgery you're going to have swelling and bruising, so it's not an accurate idea of what your boobs are really going to look like, explains Dr. Val. Your implants will need time (about four to six weeks) to settle into their natural position.
18. You can get an areola reduction during your procedure.
This is also called a mastopexy. Oftentimes women who get a reduction will also have an areola reduction so the areola is proportional to the new size of the breast. The area around the nipple is very forgiving with scarring.
19. Implants won't affect breast cancer screenings.
The idea that having implants makes it harder to get an accurate breast cancer screening is a total myth, says Dr. Khuthaila. Radiologists and technicians know how to maneuver the implant out of the way during a mammogram.
20. Exercise is restricted after surgery.
Since your body is healing, you'll want to avoid all types of exercise for four to six weeks after your surgery, says Dr. Khuthaila. If you're hesitant about exactly when and how to start back up with your typical workout routine, talk to your doctor.
21. You'll need someone to help you in the days after surgery.
If you live alone, you'll definitely want to have a family member or friend come stay with you after your procedure. "You're going to be sore, you did just have surgery, and with the medications onboard you might feel a little fuzzy so just having somebody around to help you with getting food and helping you walk to the bathroom is advisable," Dr. Val explains. You can also hire a nurse to say with you.
22. There can be psychological effects.
A lot of times, the motivation to get breast surgery has a psychological component. People want to feel better in their bodies and have more confidence, whether that's thanks to a breast aug or a breast reduction. So after surgery, some patients notice an improvement in their mood and mindset, says Dr. Val.
That said, there can be negative psychological effects too. Some women, especially those who have breast reductions, have trouble looking down and getting used to seeing something different, she adds.
23. You don't have to wait until after you have kids.
If you've heard that waiting to get a breast augmentation until after you have kids makes the implants feel more comfortable, that's a total myth, says Dr. Khuthaila. You can get breast implants whenever you want to, regardless of whether you've had kids.
24. You might need a breast lift, too.
Sadly, going up a couple of cup sizes won't automatically make your chest perkier. So if you're looking to counteract gravity, Dr. Khuthaila recommends adding a breast lift to your augmentation. Doctors can do the two procedures at once to help you achieve your desired look.
25. You could experience Breast Implant Illness.
While doctors still don't understand exactly why it happens, increasing evidence shows that breast implants make some women sick. Experts use the term Breast Implant Illness to describe a wide variety of symptoms, like fatigue and hair loss, that appear after getting implants.
Since Breast Implant Illness is a fairly new concept, Dr. Khuthaila recommends staying up to date on the latest findings. You can talk to your doctor if you have concerns about it.
26. Augmented breasts will affect your posture.
The weight difference between equal volumes of saline, silicone, and breast tissue is slim to none, so a natural C cup and an augmented C cup are very similar in weight, says Dr. Kolker. If you choose an implant size proportional to your frame, you will see little effect on your posture. However, if you choose large implants, you will feel the effects on your body.
27. You can easily have them removed.
Chrissy Teigen made headlines this summer when she decided to get her implants removed saying, "They’ve been great to me for many years, but I’m just over it. I’d like to be able to zip a dress in my size, lay on my belly with pure comfort! No biggie! So don’t worry about me!"
If you feel the same in a few years, you can easily have them removed, says Dr. Khuthaila. Your boobs might look a little deflated, but that can be fixed with reshaping or a lift.
28. Your boobs don't need to meet a size requirement for a reduction.
This is all based on personal preference. Think of boob size in terms of a scale from small to large. Based on breast size before the procedure and desired breast size afterward, there are a huge range of results. You can even choose to get a reduction and an implant to replace some of the volume you’ve lost over time.
29. Your boobs can grow back after a reduction.
Dr. Kolker explains that if the procedure is done after pregnancy and your weight stays consistent, your breast size is unlikely to change.
30. Ask yourself the following questions before going through with the surgery:
How much does my current situation bother me?
Why do I want this procedure?
How excited am I to go through with this?
Can I handle the time off from work and exercise?
How much am I willing to expose myself to certain risks?
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