brand logo

In 2018, breast augmentation was the most common cosmetic surgical procedure performed in the United States. It was the most commonly performed cosmetic surgical procedure in women ages 18 to 34 years. Silicone gel-filled implants are the most commonly used in the United States, followed by saline-filled implants. The most common approach to placement of implants is through an incision in the inframammary fold. The majority of implants are placed subglandularly, under the breast tissue but on top of the pectoralis muscle. Postoperative complications include lumps, asymmetry, leakage or deflation, capsular contracture, changes or loss of nipple and areolar sensation, seroma, hematoma, changes in breast shape, and infection. Long-term complications include infection, implant rupture, capsular contracture, and breast implant-associated anaplastic large cell lymphoma. Any patient who has undergone breast augmentation who presents with a breast lump or mass should be referred to a breast unit for evaluation. Lumps can indicate implant rupture, capsular contracture, seroma, hematoma, breast cancer, or infection. Studies have shown no association between silicone-filled breast implants and connective tissue disorders. Breast reconstruction after mastectomy frequently involves placement of implants. Autologous reconstruction remains another option. Various implants are approved by the Food and Drug Administration for buttock and calf augmentation.

Case 4. Heather is a 31-year-old woman who underwent breast augmentation 1 week ago. She comes to your office today reporting tender breasts and redness on the right breast. She has scheduled a follow-up appointment with the plastic surgeon in a few days, but wants to know if these symptoms are normal.

Breast Augmentation

In 2018, breast augmentation was the most common cosmetic surgical procedure performed in the United States.1 It was the most commonly performed cosmetic surgical procedure in women ages 18 to 34 years.

The Food and Drug Administration (FDA) has approved saline-filled and silicone gel-filled implants for breast augmentation and reconstruction, and to correct developmental defects.133 Implants also are approved to correct or improve the result of a previous surgery. Silicone gel-filled implants are the most commonly used in the United States, followed by saline-filled implants.1

The outer surface of an implant can be textured or smooth. Although there is limited comparison data, a Cochrane study of breast reconstruction showed that textured silicone implants were associated with worse outcomes compared with smooth implants.134 However, studies using the FDA registry of breast implants found that textured implants were associated with fewer complications, including capsular contractions.135,136,137 In addition, textured implants have been associated with a lower risk of implant movement and rotation compared with smooth implants.136,137 Textured silicone implants are the most commonly used breast implants globally.137

Already a subscriber?  Log In

Subscribe

From $335
  • Immediate, unlimited access to all FP Essentials content
  • 60 CME credits/year
  • AAFP app access
  • Print delivery available
Subscribe

Edition Access

$59
  • Immediate, unlimited access to this edition's content
  • 5 CME credits
  • AAFP app access
  • Print delivery available
Interested in AAFP membership? Learn more  Learn More

Continue Reading

Copyright © 2020 by the American Academy of Family Physicians.

This content is owned by the AAFP. A person viewing it online may make one printout of the material and may use that printout only for his or her personal, non-commercial reference. This material may not otherwise be downloaded, copied, printed, stored, transmitted or reproduced in any medium, whether now known or later invented, except as authorized in writing by the AAFP.  See permissions for copyright questions and/or permission requests.