Medically reviewed by David Bogue, MD, board-certified plastic surgeon | Last reviewed August 2026
Breast augmentation starts with a simple question: what do you want your breasts to look like? Dr. Bogue asks what you like, what you don’t like, and what you would change. Some women want a subtle, natural enhancement, while others prefer more fullness, projection, and a rounder look. The goal is not to create the same breast for every patient—it is to understand the look you want and determine how best to achieve it.
Dr. Bogue has performed thousands of breast implant procedures and brings that experience to every first-time breast augmentation consultation. He has also served for years as a physician advisor within the breast implant industry, providing clinical feedback on new and emerging implant technologies. Just as importantly, patients frequently state that he listens carefully, explains their options clearly, and never makes them feel rushed. He uses that combination of experience, judgment, and patient input to help you choose the implant and surgical plan that best fits the result you want.
"Dr. Bogue did my breast augmentation. I'm very happy with the results, everything came out perfectly. When you go in for your consultation he takes the time to explain everything with you and help you choose what you want and answer any questions you have without feeling rushed."
RH Glow
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Visualize Your Breast Augmentation with 3D Simulation
Choosing the right implant is about more than volume. Dr. Bogue uses Mentor breast implants, which are available in multiple volumes, widths, and projections; silicone options also vary in gel cohesivity. These differences, together with your existing breast tissue and body proportions, determine how an implant will look on you. Dr. Bogue uses the Arbrea 3D Simulator and Mentor sizing system during consultation to help you compare options and communicate the look you want.
You can also use myArbrea at home to create a 3D simulation using your own photos and share it with Dr. Bogue before your consultation. The simulation is a planning tool rather than a guarantee of an exact surgical result, but it can make the conversation about implant size and shape much more useful.
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Breast Augmentation FAQs
How Do I Choose the Right Breast Implant Size?
Choosing the right implant involves more than picking a number of cc’s. Dr. Bogue uses a biodimensional approach, selecting implants that fit the dimensions of your breasts and body rather than simply choosing a volume. This helps avoid problems that can occur when an implant is too large or too small for the breast.
Your starting breast size, the size you would like to be, and the look you want all matter. Some patients want a subtle, natural change, while others prefer more upper-breast fullness, projection, and a more obviously augmented appearance. Cup size can be a useful starting point, but because bra sizing varies considerably, the desired look is often more helpful than a specific cup-size number.
During your consultation, Dr. Bogue uses the Arbrea 3D Simulator and Mentor sizing system to let you compare different options and better visualize how a change in implant size may affect your appearance.
What Is the Difference Between Silicone and Saline Breast Implants?
Both saline and silicone implants have a silicone outer shell, but they feel and behave differently. Saline implants typically feel more like an implant, while silicone gel implants are softer and tend to feel more like natural breast tissue. Saline implants also tend to ripple more and are heavier, while silicone implants are generally lighter and are preferred by most patients for their softer, more natural feel.
Modern highly cohesive silicone gel implants, sometimes called “gummy bear” implants, are designed to hold their shape particularly well. Their cohesive gel helps minimize rippling and limits movement of the gel if the implant shell ruptures.
Rupture is another important difference. When a saline implant ruptures, it deflates and the saline is absorbed by your body, so the change is usually obvious. A silicone implant may continue to look and feel normal after rupture, which is why ultrasound or MRI may be needed to detect a rupture and silicone implants require ongoing monitoring.
Dr. Bogue discusses these tradeoffs with you so the choice reflects the look, feel, and long-term considerations that matter most to you.
Should Breast Implants Be Placed Above or Below the Muscle?
The best implant position depends on your breast tissue, the type of implant you choose, your lifestyle, and the look you want. Dr. Bogue uses both approaches, but he does not believe that every patient should automatically have an implant placed beneath the muscle.
Dual-plane, or partially submuscular, placement can be particularly useful when you have very little natural breast tissue or when a saline implant is being used because the muscle provides additional implant coverage. The tradeoff is that contraction of the pectoralis muscle can cause visible implant movement, sometimes called animation deformity, and over time muscle forces can contribute to the implants moving toward the sides. Patients with submuscular implants are also generally advised to limit heavy pectoralis exercises.
For many patients, Dr. Bogue prefers subfascial placement, in which the implant is placed above the pectoralis muscle but beneath its fascial covering rather than in the traditional subglandular plane. This works particularly well with modern cohesive silicone implants, including BOOST and “gummy bear” implants. Because the implant is not being moved by the chest muscle, you can exercise normally without worrying about visible implant movement or muscle-related displacement, and recovery is typically faster. Dr. Bogue also favors this plane because of its favorable capsular contracture profile.
Do I Need a Breast Lift With My Augmentation?
“To lift or not to lift” is one of the most common questions in breast augmentation, and the answer usually requires an examination. If your breasts have little or no sagging, an implant alone is often enough. This is the case for the majority of first-time augmentation patients.
If you have significant breast ptosis, or sagging, adding a breast lift can help reposition your breast tissue so it sits properly over the implant and creates a better overall shape.
There are also borderline cases. Sometimes an implant with enough volume and projection can provide enough fullness to avoid a lift, while in other cases trying to accomplish too much with a larger implant can lead to a less attractive or less stable result. Dr. Bogue will examine your breasts, discuss the look you want, and explain whether augmentation alone or augmentation with a lift is the better choice for you.
Which Incision Will I Have, And How Will the Scar Heal?
Dr. Bogue most commonly uses either an inframammary fold incision or a periareolar incision for breast augmentation. The choice depends on your breast size and shape, the size of your areola, the implant being used, and where the scar can be placed most discreetly.
An inframammary incision is placed in the fold beneath the breast. It is usually well hidden, although it can be more visible in women with smaller breasts. It provides direct access to the implant space without requiring dissection around the nipple or through the breast skin.
A periareolar incision is placed along the border between the areola and the surrounding breast skin, where the color change can help camouflage the scar. It requires an areola large enough to safely perform the incision and careful dissection to protect the nipple and surrounding breast skin.
Scar care after surgery is important, and both types of scars typically fade and become less noticeable with time. Dr. Bogue prefers these approaches over transaxillary incisions because the scars are easily hidden in a bathing suit and can usually be reused later if an implant ever needs to be replaced or removed.
How Long Is Recovery After Breast Augmentation?
Breast augmentation is generally well tolerated, and most patients are surprised by how manageable the recovery is. Discomfort is usually mild to moderate and is most noticeable during the first few days. Prescription pain medication is typically needed only briefly, and recovery can be somewhat faster when the implant is placed over the muscle compared with under the muscle.
For the first two weeks, you should keep activity very light and avoid exercise and heavy lifting. At about two weeks, you can usually resume cardio and light lifting and return to full arm range of motion. A supportive or compression bra is typically worn around the clock for six weeks.
By about six weeks, most patients can return to unrestricted exercise and normal activity. Your breasts will continue to settle and soften over the following several months as swelling decreases and the implants move into their final position.
Are Breast Implants Safe?
Breast implant safety is an important part of every augmentation consultation. Dr. Bogue considers modern breast implants to be safe medical devices when they are used appropriately, but breast implants are not lifetime devices and they do require informed consent, long-term follow-up, and an understanding of their potential risks. The FDA now requires breast implant manufacturers to provide a boxed warning and patient decision checklist so that you can review these issues before surgery.
Silicone implants have been studied extensively. In 1992, the FDA placed silicone gel implants under a moratorium while additional safety information was collected, and silicone gel implants were approved again for cosmetic breast augmentation in 2006. Current FDA information states that it has not detected an association between silicone gel-filled breast implants and connective-tissue disease, breast cancer, or reproductive problems. Some women with implants do report systemic symptoms—often called breast implant illness—such as fatigue, joint or muscle pain, rashes, or “brain fog.” These symptoms are real concerns for the women experiencing them, but their cause and the degree to which they are related to breast implants remain unclear, and research is ongoing.
One established implant-related risk is BIA-ALCL, a rare lymphoma that develops in the fluid or capsule around a breast implant. The FDA has found that the risk is higher with textured implants than with smooth implants. In 2019, Allergan recalled its BIOCELL textured implants after the FDA identified an increased risk associated with those devices.
Silicone implant rupture also requires long-term monitoring because most ruptures are silent and may not be detectable by appearance or examination alone. The FDA recommends that women without symptoms have an ultrasound or MRI beginning 5–6 years after silicone implant placement and every 2–3 years thereafter. A rupture can sometimes cause local problems such as changes in breast shape, lumps, discomfort, swelling, or other changes around the implant.
Dr. Bogue discusses these risks with you in detail so that you can make an informed decision. If concerns about silicone remain important to you, saline implants are also an option and have the advantage that a rupture usually becomes obvious when the implant deflates.
For additional information about breast implant safety, risks, and current FDA recommendations, visit the FDA’s breast implant safety resources.
How Long Do Breast Implants Last?
Breast implants are not lifetime devices, but that does not mean they automatically need to be replaced every 10 years. There is no fixed expiration date. Some women need revision surgery earlier because of rupture, capsular contracture, implant movement, or a change in the appearance of the breast, while others may keep the same implants much longer. The FDA emphasizes that the longer you have implants, the greater the chance that you will eventually need another operation.
If your breasts still look and feel good and your implants are intact, replacement is not necessarily required just because a certain number of years has passed. With silicone implants, however, ongoing ultrasound or MRI monitoring remains important because rupture can be silent.
Dr. Bogue reviews the condition of your implants, changes in your breast tissue, and your goals over time to help you decide when replacement, revision, or removal makes sense.
What About Breastfeeding and Mammograms?
Breast augmentation does not prevent you from breastfeeding, and many women with implants are able to breastfeed successfully. However, breast surgery can affect milk production in some women. If having children and breastfeeding in the future are important to you, Dr. Bogue will discuss this when planning your surgery and choosing the incision.
You should also continue your normal mammogram and breast cancer screening schedule after breast augmentation. Mammograms are safe with breast implants, although additional views are usually taken to see as much breast tissue as possible. Be sure to tell the imaging center that you have implants when scheduling your mammogram.
How Much Does Breast Augmentation Cost?
The cost of breast augmentation varies depending on the surgical plan, the type of implants selected, and the complexity of your procedure. Your total fee includes the surgeon’s fee, anesthesia, operating-room costs, and the implants themselves.
After your consultation, our office will provide you with a detailed, individualized estimate based on the procedure you and Dr. Bogue have planned. This gives you a much more accurate cost than a standard price that may not reflect your particular surgery.
Breast Augmentation Before & After
Ready to Discuss Breast Augmentation?
If you’re considering breast augmentation, schedule a consultation with Dr. Bogue to discuss the look you want, your implant options, and the surgical approach that makes the most sense for you. Call 561-886-1000 or request a consultation online.