Breast augmentation doubts - what if I don't like my new breast implants?

Thanks for the question -

You're right to be cautious. Surgery - any surgery - is something that can never be completely undone. You should be sure about why you're doing it, you should be sure you've found a board certified plastic surgeon who can answer all of your questions and you have good communication with.

Smaller breast augmentation is more "reversible" than larger breast augmentation. The skin envelope stretches more to accommodate larger implants and a larger pocket must be created to hold larger implants.

Scars in any size breast augmentation are permanent, whether the implants are removed in the future or not.

Be sure you've had all of your questions answered by the surgeon that you're planning on doing the surgery and make sure you understand all the risks and benefits to breast augmentation. You should never be pressured by a surgeon to proceed with surgery.

Best of luck.

Steven Williams, MD

Patients considering Breast Augmentation have generally thought about the procedure for several years.  Most patients also have one or several friends or family members with whom they have consulted regarding their motivation for and experiences (positive or negative) with Breast Augmentation.  A multitude of websites, including RealSelf, are available as additonal resources to patients considering Breast Augmentation. By the time they enter the Plastic Surgeon's office for a formal consultation, most patients have already made the positive decision to have Breast Augmentation, and they are simply searching for the right doctor at that point.

If a patient comes to my office still uncertain about whether or not she wishes to have a Breast Augmentation, my duty is to inform her of the potential risks and benefits of the procedure.  However, my practice under this circumstance would be to advise the patient not to proceed with Breast Augmentation until she had no doubt it was the right procedure and the right time for her.

Although the implants can certainly be removed within days or weeks of a Breast Augmentation, with minimal residual effect on the breast other than the permanent scar from the incision used to place and remove them, it would be far better to NOT do the surgery in the face of doubt, or based on an impulsive choice by the patient.

The overwhelming majority of Breast Augmentation patients are extremely happy with their surgical results, because they have chosen to have breast implants for the right reasons for themselves.  Even so, it is not unusual for patients to "second-guess" their decision, while they adjust to their new appearance in the first few days or weeks after surgery.  These temporary misgivings about the decision to have Breast Augmentation are natural, but if a patient seriously doubts that she will be happy BEFORE the surgery, it is better to avoid the surgery entirely.

Or maybe you haven't made the decision.  Most women who come in for breast augmentation surgery have always disliked their small breasts and can't wait to have them enhanced.  With that, the removal rate for dissatisfaction with the implants is very low.  It sounds as if you have trepidation about whether you really want the procedure or not.  Rest assured that you can always have the implants removed if you don't like them.  Good luck!

When you get right down to it, nobody really needs aesthetic cosmetic surgery.

It is really a matter of whether or not an individual wants aesthetic cosmetic surgery. God makes us all (and all of our parts) in different shapes and sizes, and beauty is not merely in the eyes of the beholder, but also in the eyes of the beheld. That being said, aesthetic cosmetic surgery can have a positive, powerful and lasting impact on a person's life. You may be absolutely certain that you want to have a particular procedure performed, and I am continually amazed at how thoroughly many patients have educated themselves about specific procedures prior to their consultation.

In any case, the only way to truly decide whether or not to "have something done" is to get the best information available from a source with experience and appropriate credentials, whom you trust with your well-being. That information includes a thorough understanding of all options available and it should be provided by a baord certified plastic surgeon that understands your aesthetic sensibility and goals. This is what I do my best to provide for every individual that I meet in consultation.

My personal aesthetic sensibility is this: a good aesthetic cosmetic surgery result is a result that looks natural, not 'done'.

When considering breast augmentation surgery, be sure to look at many ,many before and after photos of work performed by the plastic surgeon you are considering.  Some plastic surgeons specialize in very large breast implants. My goal is to provide natural looking results from breast augmentation surgery.  A petite woman looking for extremely large implants would not be the ideal patient for my practice since my goal is always to provide a very natural looking result. You may wish to speak to several previous patients of your plastic surgeon so they can discuss their experience with you patient to patient.

You should feel very comfortable with your plastic surgeon and feel like he or she is listening to and understands your concerns and desires. You  should feel confident that all of your questions have been answered before proceeding with surgery.   You can and should ask questions about lawsuits, complications and reoperations. You also need to ask how many breast augmentation procedures a plastic surgeon performs annually.  Of course before proceeding with any surgery, you should go to the website of your state medical board and check out the background of your surgeon there.

A slight bit of nervousness before surgery may be normal but real fear or serious doubt should not be ignored. Take your time when considering plastic surgery and never let anyone make you feel rushed into making a decision.

Although breast implants can be removed , careful consideration about surgery and taking time to research is a far better option.

It is normal to be a bit skeptical or ambiguous about your feelings to have breast implants even after they are inserted.  This is common.  But, your questions and concerns shoudld be answered during your consultation including the size, shape, location, etc.. so that the majority of your concerns are alleviated.  If you are not happy with the implants placed at the time of your surgery, your implants can be removed.  If done soon after surgery, the tissues usually rebound to where they were before.  The longer you wait, the more likely the tissues will have a deflated appearance.

Prevention is the best medicine to prevent a bad choice. When considering a breast augmentation it is critical that you first find a Board Certified Plastic Surgeon who is a member of the American Society of Plastic Surgeons. Then you should have a personal face to face meeting with the surgeon. He or she should have ample time to discuss with you the procedure and possible complications in detail. You should spend time with your surgeon exploring the different approaches, trans axillary sub muscular, peri areolar sub muscular or sub mammary, infra mammary sub muscular or sub mammary. You should also discuss in detail the size and shape of the implant that will be used. You should see and feel the different implants, silicone gel filled or saline filled. The most important thing is that you feel comfortable with your choice of surgeon, the procedure, the implant and the size and location of your implant. When you are comfortable with these then you should choose a time that is good for you which doesn't put you under time pressure. When all these pre operative conditions are met, you almost always will find that your results will full fill your expectations and you will be delighted with your results.

You are experiencing a very normal part of the surgery decision process.  This procedure is purely elective.  You are chosing to have surgery when you are perfectly healthy.  You need to be certain this is the right decision.  This should not be a whim.  I am certain that all of the doctors responding have thousands of very happy patients with breast implants.  It is extremely rare for a patient to reverse their choice after surgery.  It is common however for patients to  feel different and even self conscious within the first few weeks.  This feeling passes.  I have recently had a patient who although she loved her new look, felt that people were treating her differently.  With alot of time (3-4 weeks) and careful counseling, the feeling passed and the patient is back for another procedure.

Make sure this decision is your choice.  Don't be influenced by a spouse, boyfriend or even a girl friend.  You have to live with the implants for the rest of your life.  Go back and talk to the doctor.  Talk to his nurse or someone in the office who has had implants.  If you are with a reliable board certified Plastic Surgeon, they should be willing to help you make the right decision for you.  It isn't about the money, it is about happy and satisfied patients.

Plastic surgery is not for everyone. Breast augmentation will change the way you look and most patients are very happy with the result. If you are not sure about surgery, that is ok. Take some more time to think about it. There is definitely no rush. Go back to your surgeon and try out samples of implants under your bra. See how you feel with them. If it feels "not normal" and uncomfortable, then you may not be ready for the procedure. Talk to your surgeon some more and see how you feel.

It is very rare for patients to want the implants removed soon after surgery. However, it is possible to remove them through the same incision and you are left with a small scar. In the vast majority, there is no change to your breast size and shape after removing the implants. This is especially true for younger patients and those with moderate sized implants. Good luck with your decision.

Please don't take surgery lightly. Plastic surgery is great and for the most part people are very happy with their results. However, it seems like you may need to think about it some more before you go ahead and have surgery. Having breast implants placed is not something you just try out with the intention of having them removed. Talk to other patients who have had the surgery so you can get a better idea of what them went through. If you are considering breast implants, have the surgeon's office lend you some sizers and walk around with them in your bra for a couple of hours. Try on some different clothes and see how you like the new fit.

I hope this is helpful.

David Shafer, MD
Shafer Plastic Surgery
New York City

Breast implants are certainly removable and most of the time there are no consequences from their removal. However, while most patients have an appropriate level of preop anxiety, it is usually about the safety, the anesthesia etc.

If you have a significant concern that you might not like your result, wait until you feel more comfortable with the process, and more comfortable with your doctor and that they have properly informed you as to what to expect postop. This is not emergency surgery, and you might want to wait until you are more at ease and feeling more positive about the potential change in your body.

While the overwhelming majority of women are very happy with their implants and do not want them removed, if you do have them removed, it is unlikely that your breasts will look like they did before surgery. Implants are a commitment, and you should carefully consider whether or not to have augmentation. That being said, breast augmentation is among the most common procedures women ask for, and most women are very, very happy with the results.

The short answer is that if you want your implants removed, the breasts will usually go back to their old shape, but of course you will have a short scar.

In practice, this is very rare.  Most patients are very happy with breast augmentation, even when the result is not entirely perfect.  You have to be a good candidate, and you need a good, experienced surgeon.

Breast implants will stretch the overlying tissues, and the more the stretch, the more likely you are to have loose skin after removal.  To some degree, with pressure there is even some shrinkage of the overlying tissues, and so your breast volume may seem less than before your surgery.  The scar resulting from your incision will be quite permanent, and often looks worst at 6 weeks following surgery.

It takes several weeks/months for breast size and shape to stabilize after surgery.  Your body's initial response to surgery and medications may make you feel uncertain about your decision to have augmentation, even though you made your decision with great care.  You may initially feel strange or conspicuously 'big' after your augmentation, and your new implants will be a preoccupation to you. By six weeks most people make it through the day without once thinking about their new breasts, you will be back to your exercise routine, and regrets about surgery would be most unusual.

Good luck with your decision!