Breast augmentation is a procedure whereby plastic surgeons can increase the size of a patient's breast by inserting saline or silicone implants. Augmentation may be a good option for a patient who has lost breast volume as a result of weight loss or breast cancer surgery, or who is otherwise displeased with the size and shape of her breasts.

BREAST IMPLANTS:
There are many styles, shapes, and materials from which to choose when it comes to selecting breast implants. Both silicone and saline implants are used extensively worldwide, and both have been approved by the Food and Drug Administration for use in the United States. A substance known as silicone elastomer composes the outer casing of both types of implants. Saline implants are flooded during surgery with a sterile saline solution. Silicone implants are filled with a "cohesive" silicone gel that doctors and patients agree is more natural to the touch. The FDA ban on silicone implants was recently lifted.

SURGICAL PLACEMENT TECHNIQUES:
Implants are surgically placed either above, partially under or completely under the muscles of the chest wall.The four breast augmentation surgical techniques are based on the location of the incision:

• Inframammary (under the breast) - This is the most widely-used breast augmentation technique. The implant is inserted into the crease where the breast and the chest come together, and placed over the pectoral muscles.
• Transaxillary. This technique employs an incision under the arm to reduce scarring.The breast implant is inserted via the armpit and usually placed under the chest wall muscles.
• With the transumbilical technique, the implant is inserted via the bellybutton and adjusted into place on top of the chest wall muscles. No incisions are made in the area of the breasts. Though the scar-free nature of this approach appeals to patients, surgeons generally choose not to perform it due to the increased risk of trauma to the body.
• Periareolar (along the areola). An incision is made along the outside of the nipple (with the function of minimizing scarring) and the implant is introduced directly into the breast.Surgeons can place the implants in a variety of locations around the chest muscles.
  

CANDIDATES FOR BREAST AUGMENTATION
Good candidates for breast augmentation will be healthy, and have good self esteem and realistic expectations about the surgery. Certain medical conditions (such as heart problems) may make a patient ineligible, as might smoking. Those who cannot demonstrate healthy and realistic expectations for the surgery may be denied it. Their doctors will follow up by discussing other available options.

SELECTING THE RIGHT PLASTIC SURGEON
Several items should be considered when selecting a breast augmentation surgeon. It is best to select a breast and body plastic surgeon that is board certified by the American Board of Plastic Surgery. The additional specialized training in plastic and reconstructive surgery that these professionals possess is a definite benefit. The cosmetic surgeon you select should also have an excellent bedside manner and address all of your questions honestly as well as provide patient testimonials and photos of his or her previous work.