Every breast augmentation patient needs to accept the remote possibility of needing a revision at some point in her life after the initial augmentation. Issues that tend to increase this risk are implant placement above the muscle, very large volume implants (because they are heavy), and under filling of saline implants. However, there are factors that are beyond the surgeon’s control and are unpredictable, such as unusually stretchy tissue or asymmetric chest walls that make symmetric breast augmentation impossible. Equally unpredictable are the effects of gravity, pregnancies, weight gain/loss and breastfeeding.