I guess you could say I have a thing about breasts. As a child of the ’90s, the decade that brought us Pamela Anderson’s slo-mo run and the Spice Girls’ cleavage-centric group sets, I grew with a hyper valuation of full busts. Maybe especially because I didn’t always have them.
So when I was 22–with my natural A-cup clearly not cutting it—I got breast implants, as did 399,439 other Americans that year. I carefully selected a board-certified surgeon and came out a full B-cup (more Bündchen than Baywatch), feeling like a balanced version of my natural body. I had a smooth recovery, and my chest 2.0 quickly became a part of me.
Now, at 35, my breasts were sitting lower and looser—thank you, breastfeeding and gravity. But one thing hadn’t changed: If you opt to get an augmentation, it will most likely not be your only surgery (see Chrissy Teigen). My first implants were guaranteed to last 10 years—at the 14-year mark, I was haunted by the thought of waking up with one breast deflated like a popped balloon.
With my WFH status secure, I started considering a second procedure (Google searches for “plastic surgery” are at a five-year high, so I wasn’t alone). I read countless articles, stared down pages of RealSelf before and afters, and asked my most in-the-know friends for referrals. It all led me to Lawrence Koplin, M.D., FACS, a Beverly Hills surgeon, who told me everything I needed to know. More on that below, along with other real life intel after a decade-plus with implants.
1. Implants don’t last forever.
Say it with me. The manufacturer-guaranteed life span varies by the type and maker. My first set—Mentor saline implants—came with a 10-year warranty, while Sientra backs theirs for 20. But even with a warranty, you may end up going under again sooner. A 2011 FDA study found that one in five patients needed a revision procedure by the 10-year mark. That said, your implants may also last much longer than their warranty. “We don’t feel someone should come in for a revision procedure just to have their implants exchanged,” says Koplin. So if you’re considering a second surgery because you’re worried your implants may break (as I’d been), don’t.
2. Know what can—and can’t—be achieved.
It’s an implant (that’s it). “Breast augmentation makes what the person has larger and fuller. It doesn’t have the ability to change the shape of the breast,” says Koplin. Augmentation or revision by a good surgeon can address minor types of asymmetry and sagging (my main gripes), and mine gave my chest the reboot it needed. But if you’ve had multiple pregnancies or weight fluctuations and are after significant reshaping or tightening, then a lift is the way to go.
3. Your options have changed.
“Not all breast implants are the same,” says Sientra’s VP of marketing, Lisa Rosas. There are two types of breast implants: saline and silicone gel. Saline-filled implants raise fewer concerns—in the case of a rupture, the salt water is easily absorbed by your body. Silicone-filled implants look and feel more natural but can lead to hardening or lumps if the gel leaks out (the medical consensus is that no greater health risks are associated). Regular MRI screenings may be recommended to detect potential silicone ruptures, and those get pricey fast.
A decade ago that’s where your options ended, but now there are highly cohesive silicone gel (a.k.a. gummy bear) implants—and they’re gaining in popularity for a reason. Because of the super thick filling, they’re less likely to rupture or leak (imagine cutting a gummy bear in half). They’re also better at retaining their shape, and they help minimize visible wrinkling, which is top of mind for thinner women like me. “In addition to an unrivaled safety profile and an unmatched 20-year warranty, Sientra implants are also the highest rated silicone gel breast implant brand in the U.S., according to realself.com,” says Rosas. For all the reasons above, this time around I went with Sientra Highly Cohesive Gel implants, and yes, they’re noticeably softer.
4. Aesthetic preferences have changed too.
“B is the new C,” Koplin says. “Most women don’t want giant balloon implants anymore.” As a rule of thumb, 200cc of filling is about one cup size—so a 400cc implant would take you from A to C. In reality, the outcome varies by patient depending on your height, the width of your torso, and even the shape of your ribs. I was terrified of going too big and brought in multiple “after” pictures. (Pro tip: Look for results from patients similar in age and shape to you.) We discussed needing 250 to 305cc to get the look I wanted, and Koplin “tried on” various sizes during the surgery to see how they sat IRL. Ultimately he selected 305cc—a number that would have sounded like a lot to me but ended up being just right.
5. Implants have their risks, so do your research.
Breast implants have been FDA-approved for almost 50 years, but the risks are still there. Over 10% of patients reportedly experience capsular contraction, a hardening of the breast caused by shrinking scar tissue around the implant. It’s possible to develop an infection, which could happen days, years, or even decades after the procedure. The presence of the implant can also compromise the early detection of breast cancer. And the general anesthesia required for the surgery comes with its own complications. Last, there are rare and unverified—but still possible—relationships to systematic issues, commonly referred to as Breast Implant Illness. A good doctor won’t gloss over this stuff.
6. Be prepared for downtime.
Post-surgery you’ll need a solid care partner to pick you up, help you get in and out of bed, and just about everything else (after my revision I was fully out of commission for three days). By day four I was able to get back to work online but had to take frequent breaks to rest, and by week two I was able to get through a typical day’s grind. If you’re into working on your fitness (raises hand), expect to be limited to light walking for the first week, then easing into lower body exercises in week two, followed by light arm exercises in week three. After four weeks most swelling had subsided, and after six weeks I felt pretty much normal. While this may seem like a good time to diet, it’s not—your body needs extra calories to fuel its healing.
7. They don’t come cheap.
So start saving now. Prices vary by doctor, location, and the specifics of your procedure, and RealSelf reports than an average breast augmentation clocks in between $6,000 and $7,000. If you’re after a revision procedure, it’s even more—averaging $8,075, according to RealSelf (although mine was pricier).
Getting breast implants is a big decision, and one you’ll have to continue dealing with for decades to come. You’ve probably guessed that I’m super happy with the results of my second surgery—and I am. But with everything I know now, would I have gotten breast implants in the first place? TBH, I’m not sure.