context: Women can get breast implants to make their breasts bigger and fuller. That can be done for reconstructive purposes, such as after mastectomy for breast cancer, or for cosmetic reasons. This article covers cosmetic breast augmentation only. It discusses the types of breast implants available, the procedures used, and possible complications. There are two basic types of breast implants: saline and silicone gel. Saline-filled implants are silicone shells filled with sterile salt water (saline). Some are pre-filled and others are filled during the implant operation. Silicone gel-filled implants are silicone shells filled with a plastic gel (silicone). Although many women say that silicone gel implants feel more like real breasts than saline, they pose more of a risk if they leak. Both saline and silicone come in different sizes and have either smooth or textured shells. Each has its own pros and cons, so it is a matter of preference. How much breast implants cost depends on the location, doctor, and type of implant used. Typically, the surgery ranges from $5,000 to $10,000. Because it is a cosmetic procedure, health insurance usually doesn't cover breast augmentation. Because breasts can continue to develop until a woman reaches her late teens or early 20s, the FDA requires that women be at least 18 years old to get breast augmentation with saline-filled implants and at least 22 years old to receive silicone implants. When picking your surgeon, look for one who has a lot of experience. You may be less likely to have complications later on if you choose a surgeon who has had at least five years of surgical training and at least two years' experience in plastic surgery. Before your breast implant procedure, you will meet with your surgeon for a medical evaluation. You can talk about what you want and get feedback from the doctor. Your surgeon may ask you to stop taking certain medications a few days or weeks before your surgery. You can get breast augmentation done as an outpatient procedure, or you may stay overnight in the hospital. The procedure takes one to two hours. You will likely be given general anesthesia, during which you will be "asleep" and pain-free. The surgeon will make a cut under your breasts, under your arms, or around your nipples, depending on your body, the type of implant, and how much enlargement is being done. The surgeon will put the breast implant into a pocket above or below your chest muscle. After the implant is in place, the surgeon will close the cuts with sutures or surgical tape. Your breasts will be covered with gauze after the surgery. You may have drainage tubes, which will be removed in a few days. You may need to wear a surgical bra as you heal. You'll need to take it easy for a few days after your breast augmentation surgery. For instance, you shouldn't do any heavy lifting for up to six weeks after getting your implants. Over-the-counter pain relievers such as acetaminophen may help relieve discomfort. Your doctor may also prescribe pain medication for you. You will probably have some swelling in the area where the surgery was done. Over time, the swelling should ease and the scars will fade. Although it is a cosmetic procedure, breast implant surgery can have risks, such as: Breast pain Changes in sensation in the nipple and breast Scar tissue forming and hardening in the area around the implant Scarring Bleeding Infection Problems with the size or shape of the implants (for example, the breasts may not be symmetrical) Associated Anaplastic Large- Cell Lymphoma or AALCL (rare, but may be linked to textured implants) It is also possible for implants to rupture and leak. If saline implants rupture, the saline will be safely absorbed by the body. A silicone leak may stay inside the implant shell or leak outside of the shell. When a saline implant ruptures, it will deflate. But silicone breast implants may cause no obvious symptoms when they rupture. This is called silent rupture. Breast implants are not designed to last a lifetime. You may need to have the implants replaced if you have complications or if the size and shape of your breasts change over time. Women who have silicone gel-filled implants will need to get an MRI scan three years after the implant surgery and then MRI scans about every two years to check for silent rupture. If your implants rupture, you will need to have them removed or replaced. Having breast implants can make it more difficult to get a mammogram, but special X-ray views can be done. There is a chance breast implants may make you more likely to get breast cancer. Breast implants also may make it harder for you to breastfeed. Cosmetic Surgery: Before-and- After Pictures