As with any sort of surgery there are always risks involved. The two most common risks for breast implant surgery are bleeding and infection. In general, the risk of bleeding is very low, and if it does happen, it will typically happen within the first 24 hours. Infection on the other hand, can take up to one to two weeks to before it will show itself. However, we take every possible precaution such as; using sterile equipment, sterile gowns, gloves, masks and many other safety precautions. The risk of infection is typically anywhere from two to three percent. So yes, there are risks and they can happen but they are very rare. One other risk that needs to be mentioned is the risk of using anesthesia. So yes, it can happen, but it’s exceedingly rare.
There are cases where some patients are wanting a very unnatural or obviously augmented look. This can be created by placing the implant over the muscle, as it allows you to really define the sharp edges of the implant, which in turn will create a very obviously implanted look. Aside from that, the advantages of going over the muscle can come in terms of the fact that you are preserving the strength of the pectoralis muscle. Some patients who are athletes or weight lifters, may want to ensure that they are maintaining 100% of their power and strength, therefore if the breast implant is placed over the muscle it allows them to maintain their ability to bench press at their highest weight. Furthermore, there are some patients which due to their anatomy, it is required to place the implant over the muscle. For example, if they had a previous breast augmentation where the breast implants was placed under the muscle that left significant scarring or if they had a severe capsular contraction, it would be recommended that they switch the location of the implant. Another benefit to having the breast implant placed about the muscle is that it can offer a more defined round shape if the patient’s breast has tissue that takes on a different shape.
Please call the office between 8:30AM and 4:30PM during the workweek to make arrangements for me to see you one week after your surgery. Please call for appointments for follow up visits at six weeks, six months, and twelve months. The reason for this extended care is because it takes six months to one year for complete healing to occur. There are no charges for any of your aftercare office visits. It would be my pleasure to see you at any time to answer any questions about your breast surgery or any other cosmetic surgery you read or hear about. Finally, please mention me to you family and friends when they bring up the topic of cosmetic surgery or therapeutic injections. It has been my pleasure helping you through this cosmetic surgery experience!
Post-operative patient surveys about mental health and quality-of-life, reported improved physical health, physical appearance, social life, self-confidence, self-esteem, and satisfactory sexual functioning. Furthermore, the women reported long-term satisfaction with their breast implant outcomes; some despite having suffered medical complications that required surgical revision, either corrective or aesthetic. Likewise, in Denmark, 8 per cent of breast augmentation patients had a pre-operative history of psychiatric hospitalization.[3][4][5][6][7][8][9][10][11]
Fat transfer breast augmentation has a few important limitations. First, fat transfer is typically limited to approximately one cup size increase in breast size. Second, the transferred fat may be absorbed again by the body. Third, it is more expensive because of the extra time involved in harvesting and processing donor fat as well as possible need for a special vacuum bra device. This option is best reserved for women who desire a modest increase in size without using an implant.
In the early 1990s, the national health ministries of the listed countries reviewed the pertinent studies for causal links among silicone-gel breast implants and systemic and auto-immune diseases. The collective conclusion is that there is no evidence establishing a causal connection between the implantation of silicone breast implants and either type of disease. The Danish study Long-term Health Status of Danish Women with Silicone Breast Implants (2004) reported that women who had breast implants for an average of 19 years were no more likely to report an excessive number of rheumatic disease symptoms than would the women of the control group.[26] The follow-up study Mortality Rates Among Augmentation Mammoplasty Patients: An Update (2006) reported a decreased standardized mortality ratio and an increased risk of lung cancer death among breast implant patients, than among patients for other types of plastic surgery; the mortality rate differences were attributed to tobacco smoking.[27] The study Mortality Among Canadian Women with Cosmetic Breast Implants (2006), about some 25,000 women with breast implants, reported a 43 per cent lower rate of breast cancer among them than among the general populace, and a lower-than-average risk of cancer.[28]

Since experienced surgeons are aware of these issues with saline breast implants and their need for eventual replacement, they opt to place them under the chest muscle. The chest muscle works as an extra layer of tissue over the implant, which makes for a smoother transition from the chest wall to the implant. The finished product is a more seamless transition versus a more visible and abrupt change when the implant is not placed below the pectoral muscle. As for gel breast implants, they can also be safely placed below the pretorial muscle if that is a viable option for the patient since replacement and wrinkling is less common with this type of implant.
The ARTOURA™ Breast Tissue Expander or CONTOUR PROFILE® Breast Tissue Expander can be utilized for breast reconstruction after mastectomy, correction of an underdeveloped breast, scar revision, and tissue defect procedures. The expander is intended for temporary subcutaneous or submuscular implantation and is not intended for use beyond six months. Do not use the ARTOURA Tissue Expander nor CONTOUR PROFILE® Tissue Expander in patients where an MRI may be needed. The device could be moved by the MRI causing pain or displacement, potentially resulting in a revision surgery. The incidence of extrusion of the expander has been shown to increase when the expander has been placed in injured areas. 

A breast lift involves both repositioning the nipple higher on the chest wall and reshaping the breast.  A breast reduction does the same but also removes breast tissue to make the breasts smaller.  If you are considering a breast reduction with lift or breast lift alone, I would recommend an in-person consultation with a plastic surgeon to allow for a thorough physical examination and a detailed discussion regarding your options to determine the best treatment plan for you.  Best of luck!
Silicone gel implants were approved by the U.S. Food and Drug Administration for cosmetic breast augmentation in November 2006. The move ended a 14-year moratorium during which silicone gel implants were available in the U.S. only for breast reconstruction, for women who already had these implants and needed a replacement for medical reasons and for use in ongoing clinical trials.
Does the nipple/areola sit below the crease underneath my breast? One trait cosmetic surgeons frequently look for when evaluating a breast lift candidate is the position of the nipple/areola in relation to the inframammary fold, or crease beneath the breast. Try this test: slide a plain sheet of paper underneath your breast (no bra) so it sits against the breast crease. When looking in the mirror, do your nipples sit below the top edge of the paper? If so, this is a good indication that you have enough sagging to warrant a breast lift.

A great question that comes up often.  A breast reduction will both reduce the breast size and improve the shape of the breast while lifting it.  During this surgery, breast tissue is removed while preserving the tissue around the nipple.  The breast is then shaped and nipple placed in a higher, more ideal position.  This is essentially the breast lift component of this surgery.  With the reduction, we are accomplishing both. Hope this helps. 
Tell your doctor if you have received any other botulinum toxin product in the last 4 months; have received injections of botulinum toxin such as Myobloc®, Dysport®, or Xeomin® in the past (tell your doctor exactly which product you received); have recently received an antibiotic by injection; take muscle relaxants; take an allergy or cold medicine; take a sleep medicine; take aspirin-like products or blood thinners.
Dr. Jacono is a dual board certified plastic surgeon who is one of a very small group of doctors whom have achieved certification in Facial Plastic and Reconstructive Surgery as well as Head and Neck Surgery. He has performed thousands of primary and revision rhinoplasty procedures and he is considered one of the best rhinoplasty surgeons in the world.
These placements vary from shallow (subglandular) to deep (complete submuscular). The right placement for your breast implants is based on your anatomy as well as your goals and expectations. You should express your desires to your surgeon, but make sure to take his or her expert opinion into account. Improper implant placement can create complications such as breast augmentation double bubble, wrinkles and rippling.
The plastic surgical emplacement of breast implant devices, either for breast reconstruction or for aesthetic purpose, presents the same health risks common to surgery, such as adverse reaction to anesthesia, hematoma (post-operative bleeding), late hematoma (post-operative bleeding after 6 months or more),[21] seroma (fluid accumulation), incision-site breakdown (wound infection). Complications specific to breast augmentation include breast pain, altered sensation, impeded breast-feeding function, visible wrinkling, asymmetry, thinning of the breast tissue, and symmastia, the “bread loafing” of the bust that interrupts the natural plane between the breasts. Specific treatments for the complications of indwelling breast implants—capsular contracture and capsular rupture—are periodic MRI monitoring and physical examinations. Furthermore, complications and re-operations related to the implantation surgery, and to tissue expanders (implant place-holders during surgery) can cause unfavorable scarring in approximately 6–7 per cent of the patients. [22][23][24] Statistically, 20 per cent of women who underwent cosmetic implantation, and 50 per cent of women who underwent breast reconstruction implantation, required their explantation at the 10-year mark.[25]
We strongly recommend you choose an implant type with your surgeon, who will be able to match the right type to accomplish your desired results. All available implants are considered good, safe choices. However, this article will explain the pros and cons of each of the three main types of breast implants so you can get an idea of what might be the best fit for you.
For my patients, I also provide a post-operative packet. This includes arnica and other ointments, gauze and tape, an ice pack, and nasal decongestant spray. If your surgeon does not provide these items to you before or after your surgery, they are all helpful during the healing process. I encourage my patients to get anti-nausea medication for the first few days following surgery as well.
Implants come in various sizes, and your surgeon will guide you on choosing the right size to help you achieve the look you desire. In addition, your surgeon will help you decide whether you want a more natural, teardrop shape or a more rounded look. Implants also come with either smooth our textured shell surfaces, and your surgeon will help you decide which is best for you.
Do not receive BOTOX® Cosmetic if you: are allergic to any of the ingredients in BOTOX® Cosmetic (see Medication Guide for ingredients); had an allergic reaction to any other botulinum toxin product such as Myobloc® (rimabotulinumtoxinB), Dysport® (abobotulinumtoxinA), or Xeomin® (incobotulinumtoxinA); have a skin infection at the planned injection site.
Fat transfer breast augmentation has a few important limitations. First, fat transfer is typically limited to approximately one cup size increase in breast size. Second, the transferred fat may be absorbed again by the body. Third, it is more expensive because of the extra time involved in harvesting and processing donor fat as well as possible need for a special vacuum bra device. This option is best reserved for women who desire a modest increase in size without using an implant.

The surgical scars of a breast augmentation mammoplasty develop approximately at 6-weeks post-operative, and fade within months. Depending upon the daily-life physical activities required of the woman, the breast augmentation patient usually resumes her normal life at 1-week post-operative. Moreover, women whose breast implants were emplaced beneath the chest muscles (submuscular placement) usually have a longer, slightly more painful convalescence, because of the healing of the incisions to the chest muscles. Usually, she does not exercise or engage in strenuous physical activities for approximately 6 weeks. During the initial post-operative recovery, the woman is encouraged to regularly exercise (flex and move) her arm to alleviate pain and discomfort; if required, analgesic indwelling medication catheters can alleviate pain[80][81] Moreover, significantly improved patient recovery has resulted from refined breast-device implantation techniques (submuscular, subglandular) that allow 95 per cent of women to resume their normal lives at 24-hours post-procedure, without bandages, fluid drains, pain pumps, catheters, medical support brassières, or narcotic pain medication.[82][83][84][85]
Adam R. Kolker, MD, explains: Although silicone breasts feel similar to real breasts, they are still man-made and don’t feel like natural breast tissue. 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 to begin with. Smaller implants and those that are placed below the muscle are harder to detect.
Drink only liquids for the first few hours after surgery. Advance slowly to small, light meals. If you experience  nausea or vomiting more than two times, please call me so I can prescribe something to reduce this.  Excessive vomiting and retching can result in bleeding beneath the breast and/or around the implant (if  breast enlargement was done) that will require more surgery.
Breast implants have gotten a bad reputation from the past and the fact that they had been known to rupture. The modern-day breast implants are very well made, and it’s almost impossible to cause them to rupture. This doesn’t mean that it can never happen, but it’s exceedingly rare. The rippling and wrinkling however, is a more difficult problem to address. This tends to me more common in the saline implants than with the silicone implants due to the filling. The saline implant is just water which is less dense then the silicone gel. The gel is denser and more closely resembles the actual breast tissue. Even when if the implant is placed below the muscle, it only covers about a half to two-thirds of the implant. Therefore, along the sides or underneath the implant you may see some wrinkling or rippling, however, depending on the size of implant used it may not even be noticeable. The larger the implant used the more visible any wrinkling or rippling could become. Typically, silicone implants are recommended because the risk of any wrinkling or rippling is lower and the implant feels more natural.
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