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Breast augmentation is one of the most common surgical procedures performed in the United States. Based on your goals and appearance, you plastic surgeon can confirm whether a breast augmentation, breast lift, or both would best achieve the results you are looking for. Breast implants are placed above or below the chest muscle, and can be used to shape or enlarge the breasts. Your plastic surgeon can advise you on the type of implant to use, and where the incisions and implant are placed.


Breast implants are filled with either saline or silicone gel. Over 60% of our bodies are made up of saline, or saltwater solution. So, if a saline implant ruptures, the implant rapidly deflates and your body easily reabsorbs the saline solution. Silicone implants are filled with a cohesive silicone gel that helps these implants maintain their shape and have a more natural feel than saline implants. Silicone implants were reapproved by the FDA in November 2006 in patients 22 years of age or older. The shells of both saline and silicone implants are made from an elastomer consisting of polydimethylsiloxane, which is made more durable or vulcanized at room temperature. These implants can be smooth or textured.


Breast implants can be positioned above or below the chest or pectoralis muscle. In general, implants are placed under the pectoralis muscle if the patient has only a modest amount of tissue thickness above the nipple. This can look more natural and may reduce the formation of breast implant scar tissue also known as capaular contracture. Patients who are extremely athletic, or have more pre-existing breast tissue may chose to have their breast implants positioned above the pectoral muscle.


The 3 most common incision locations for breast implant patients are:

  1. under the breast
  2. under the areola (the pigmented circle that surrounds the nipple)
  3. in the armpit.

An incision under the breast, or the inframammary fold (IMF), is an excellent option for any patient except those who also require a breast lift. Incisions under the areola are an excellent option for any patient undergoing a breast lift, or who has moderate to large-sized areolas. The incision is placed along the lower curve of the areola and can be well concealed between the color change occurring at the areola - breast skin interface. The armpit, or transaxillary approach, uses a short scar concealed in the armpit. We typically reserve this approach for patients who have not had previous breast augmentation, do not require a breast lift and want a saline implant.


Browse a photo gallery of Washington University Physician patients' before and after photos of Breast Augmentation Procedures.

More information about a simultaneous Breast Augmentation and Lift.

More information about corrective breast lift procedures.

To learn more details about breast augmentation surgery, review photos, or learn when we are having a free seminar please visit us online at

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