BA surgery stands for breast augmentation, a procedure that increases breast size using either implants or fat transfer. It is one of the most commonly performed cosmetic surgeries in the United States, though it’s also done for reconstruction after mastectomy or to correct developmental asymmetry. The average surgeon’s fee runs about $4,875 for implant-based augmentation and $5,719 for fat grafting, with total costs running higher once anesthesia, facility fees, and follow-up care are factored in.
Why People Get Breast Augmentation
Most people pursue BA surgery electively to change the size or shape of their breasts. But cosmetic preference isn’t the only reason. Some patients have breasts that developed unevenly, and others experience significant volume loss after pregnancy or breastfeeding. Breast augmentation is also a key part of reconstruction for people who’ve had a mastectomy due to cancer.
Implant Types: Saline vs. Silicone
The two main implant options are saline and silicone, and the choice affects how the result looks, feels, and holds up over time.
Saline implants are filled with sterile salt water. They’re inserted empty and then filled once they’re in position, which allows for a smaller incision. They’re available to anyone 18 and older. If a saline implant ruptures, the salt water is safely absorbed by your body, making a leak immediately obvious because the breast visibly deflates.
Silicone implants are pre-filled with a silicone gel that most people find closer in feel to natural breast tissue. They’re approved for augmentation starting at age 22. A silicone rupture is harder to detect because the gel tends to stay in place rather than leaking out, which is why the FDA recommends periodic imaging to check implant integrity.
Textured implants, which have a roughened outer shell, have largely fallen out of favor. They carry the highest risk of a rare type of lymphoma called BIA-ALCL. Some textured implants are no longer available in the U.S. as a result.
Fat Transfer as an Alternative
For people who want a modest size increase without implants, fat grafting is an option. The surgeon removes fat from another area of the body through liposuction, processes it, and reinjects it into the breasts. Each breast typically receives 200 to 300 milliliters of fat per session. Results measured at six months have been shown to remain stable over five years, with an average increase in breast circumference of about 24%. The tradeoff is that fat transfer produces a subtler change than implants, and not all of the transferred fat survives in its new location.
Incision and Placement Options
Surgeons use one of several incision sites depending on the implant type, the patient’s anatomy, and the desired outcome. The most common is the inframammary incision, made in the natural crease beneath the breast where the scar is well hidden. A periareolar incision runs along the border of the areola, blending with the color change in the skin. A transaxillary incision is placed in the armpit, keeping the breast itself scar-free. In rare cases, a transumbilical approach allows the implant to be inserted through the navel, though this only works with saline implants.
Beyond the incision, the implant can be placed either above or below the chest muscle. Submuscular placement (under the muscle) provides more tissue coverage over the implant, which can look more natural in people with less existing breast tissue. Subglandular placement (above the muscle) tends to involve a shorter recovery and can work well for people who already have moderate breast volume.
Preparing for Surgery
Preparation starts at least four weeks before the procedure. You’ll need to stop all nicotine products, including cigarettes, vapes, patches, and marijuana. Nicotine constricts blood vessels and significantly impairs healing. You’ll also need to discontinue aspirin, ibuprofen, vitamin E, garlic supplements, green tea extracts, and St. John’s wort, all of which can increase bleeding risk. Some surgeons also ask patients to pause oral contraceptives and estrogen supplements.
What Recovery Looks Like
The first few days after surgery carry a risk of bleeding into the tissue pockets around the implants, so activity is kept to a minimum during that window. Most people take about one to two weeks off work depending on how physical their job is. You’ll wear a supportive surgical garment during the initial healing phase. Swelling and tenderness are normal and gradually subside over several weeks.
High-impact exercise, heavy lifting, and vigorous upper-body movement are typically off-limits for four to six weeks. Your surgeon will set a specific timeline based on how your healing progresses. Final results can take three to six months to fully settle as swelling resolves and implants drop into their natural position.
Risks and Complications
Capsular contracture is the most common long-term complication. It happens when the scar tissue that naturally forms around an implant tightens and hardens, squeezing the implant and sometimes causing pain or visible distortion. This occurs in roughly 15 to 30% of implant-based breast reconstruction patients, though rates are lower in cosmetic augmentation. Mild cases may only cause firmness, while severe cases can change the breast’s shape and require revision surgery.
Other complications include symmastia, where the implant pockets merge across the midline of the chest, causing the breasts to lose their natural separation. Double-bubble deformity creates two visible folds across the lower breast where the implant edge and the natural breast crease don’t align. Visible rippling, where the edges of the implant show through the skin, is more common in thin patients and with saline implants.
BIA-ALCL is a rare but serious risk. The FDA has received 1,380 reports of this implant-associated lymphoma worldwide, with 64 reported deaths as of mid-2024. Textured implants account for 73% of all reported cases. When caught early, BIA-ALCL is highly treatable, usually by removing the implant and surrounding scar tissue.
How Long Implants Last
Breast implants are not lifetime devices. The average lifespan, measured as the time between insertion and rupture or removal, is about 9.3 years. Some implants last significantly longer, but reoperation rates climb over time. One large study tracking the latest generation of implants found a 24% reoperation rate at 10 years for primary augmentation patients. Common reasons for replacement include capsular contracture, rupture, implant shifting, and simply wanting a different size.
Planning for at least one replacement surgery over the course of your life is realistic if you get implants in your 20s or 30s.
Effect on Mammograms
Breast implants don’t increase cancer risk, but they do make screening mammograms harder to read. Implants are opaque on imaging and can obscure anywhere from 22% to 83% of the surrounding breast tissue. To work around this, radiologists use a technique called implant displacement, where the implant is pushed back against the chest wall and the breast tissue is pulled forward for additional views. This allows more tissue to be visualized and compressed clearly. If you have implants, let the imaging center know when you schedule your mammogram so they can allocate time for the extra views.