Breast augmentation is a surgical procedure that uses implants to refine the shape and size of the breasts. Recently, the FDA has lifted the restriction on the use of silicone implants allowing patients the choice between silicone and saline breast augmentation.

Breast augmentation has seen a dramatic increase in popularity over the past three years, a testimony to the high satisfaction rate that most women give to the results.

A breast lift, technically called a mastopexy, is a surgical procedure which can help to restore a more youthful and natural shape to sagging breasts. Gravity, pregnancy, nursing, weight gain, loss of skin elasticity, and aging, can all lead to sagging and a loss of firmness.

A breast lift removes excess skin and tissue to reshape and firm the breasts, and it almost always involves repositioning the nipple-areola complex higher on the breast mound. Like an abdominoplasty, it produces a scar which can take one or more years to fade.

Modern surgical techniques, such as a vertical mastopexy, result in fewer and better scars than older techniques. I have switched to the vertical mastopexy technique for most patients for this reason. Recovery is surprisingly rapid, with resumption of reasonable activity in two or three days. The discomfort is very moderate, approximately equal to a sub-glandular breast augmentation (saline).

There is considerable controversy among surgeons over breast implants, particularly those related to decisions about size and shape. The size and shape are decisions that are mostly subjective and are governed by prevailing taste.

Adding to the confusion is the fact that nobody really agrees about what the appropriate size of the ideal breast actually is.

To resolve these issues in my office, we first perform detailed measurements and estimate a reasonable implant volume, based upon the tissue characteristics that we measure. This size becomes our starting point for the next step of our process.

To help our patients better visualize the suggested volume, we have them use \"sizer\" bras with different sized sizer implants to demonstrate the effects on them.

By standing in front of a mirror with these sizes in their own clothes, patients can more appropriately appreciate what is ideal for them. Within reason, we let our patients pick their own size implants. If the patient\'s choice differs dramatically from what the surgeon thinks the tissues will accept, we then try to compromise.

It is paternalistic of me to choose the \"correct\" implant size for a patient. What I think is the right size may have nothing to do with what women think is the right size. It is far more important to please the patient\'s body image than my sense of beauty.

By combining the bio-dimensional measurements with the patient trial sizes, we are now able to have uniformly happy patients and have greatly reduced implant size exchanges. Recovery time depends on the type of procedure and ranges from two days to one week.

The discomfort ranges from mild, when the implant is placed above the muscle, to moderate, when the implant is placed below the muscle.