In 2017, there were over 300,000 breast augmentation procedures performed in the United States, making breast augmentation the most popular plastic surgery procedure in America. While breast augmentation surgery have advanced greatly over the past 50 years, it is more important than ever to do your research before moving forward with surgery. Below is a look at the evolution of breast augmentation surgery and the steps you can take to ensure that you are satisfied with your results.

“The evolution of the modern breast implant began with a 2-component prosthetic device manufactured with a less permeable silicone elastomer shell filled with a stable filling material, consisting of either saline solution or silicone gel…Since that time, both silicone gel and saline-filled implants have undergone several technical alterations and improvements.”

– Allen Gabriel, MD and G. Patrick Maxwell, MD, Clinics in Plastic Surgery

The evolution of breast augmentation in Boston

Breast augmentation surgery has undergone a gradual transformation since silicone implants were introduced in the 1960s. The first breast augmentation procedure was performed in 1962 – the same year that Frank Gerow and Thomas Cronin invented the silicone breast implant. The first two decades of breast augmentation surgery were marred by ruptured implants and other safety concerns as researchers continued their pursuit of the most “lifelike” implants. Today’s breast augmentation surgeries are faster, safer, and designed to minimize scarring while maximizing softness and natural fullness.

Factors to consider when exploring breast augmentation surgery

Breast augmentation surgery can be a life-changing procedure for many women. Higher self-esteem, improved body image, and greater confidence are just a few of the positive effects many women experience after breast augmentation surgery. And while these positive effects are impressive, it is important to proceed with caution before undergoing surgery. Joshua Greenwald, MD, outlines “The Four S’s” patients should consider when exploring breast augmentation surgery:

Saline vs. Silicone

While most patients receive silicone implants, there are certain situations that may call for saline implants. For instance, patients on a limited budget or those who are seeking a very small incision may opt for saline implants. You should discuss weigh the options of saline and silicone with your surgeon to determine which type of implant is the best for your specific situation.

Surgical Incision

Advances in surgical techniques have enabled surgeons to greatly minimize the appearance of surgical scars. While surgeons vary in terms of the surgical techniques they use, there are three general approaches used by the majority of plastic surgeons:

  • Periareolar: An incision is made around the around the outer edges of the areola
  • Transaxillary: The incision is made under the armpit
  • Inframammary: The incision is made under the breast fold


Selecting implants that are the right size for your physique is important. Many of today’s patients are seeking a more natural look, highlighting the need for patients to be able to envision the results. Surgeons and their staff can help patients visualize results by providing them with a “sizing session” to ensure that patients choose implants that are the best size for their anatomy and aesthetic desires.

“Whether patients find their surgeon online or through a referral, they should feel a connection with the doctor as well as the entire practice staff but most importantly, patients must be confident of the surgeon’s ability to deliver their desired results.”

– Joshua Greenwald, MD, American Society of Plastic Surgeons (ASPS)


Your selection of a skilled plastic surgeon is the fourth and most important factor to consider before pursuing breast augmentation surgery. Make sure the surgeon you choose possesses the proper credentials and certifications. Additionally, you should carefully review before and after photos of the surgeon’s surgical results.

What questions should you ask during your consultation?

A thorough consultation is the cornerstone of a positive surgical experience. Before you arrive at your consultation, make sure that you are prepared with a list of questions and concerns you may have about the procedure. As you finalize your list of questions to ask prospective surgeons, make sure you include the following:

1) “Approximately how many procedures have you performed?”

There is no substitute for experience when selecting an aesthetic plastic surgeon to perform your surgery. Ideally, the surgeon you choose should be highly experienced and should possess a healthy portfolio of impressive results. Ask to see before and after photos of patients who are similar to you in terms of anatomy.

2) “Are you a board-certified aesthetic plastic surgeon?”

The surgeon you choose to perform your procedure should be a board certified aesthetic plastic surgeon with years of experience in the field. Ask your surgeon about his or her educational background and why you should seek their services as opposed to another surgeon in the Boston area. You may also wish to ask whether the surgeon has completed any relevant research on breast augmentation surgery or in the field of aesthetic plastic surgery.

3) “What can I do to prepare for breast augmentation surgery?”

As a prospective patient, there are some important steps you can take to help produce the surgical results you are seeking. The single most important step you can take to prepare for surgery is to follow the instructions your surgeon provides. Additionally, make sure you have transportation to and from the surgical facility and avoid alcohol and smoking in the days and weeks prior to your surgery.

The key to ensuring your satisfaction with breast augmentation surgery

Breast augmentation surgery remains the most sought after plastic surgery procedure in the United States. Selecting an accomplished aesthetic plastic surgeon to perform your surgery is the key to ensuring your satisfaction with the procedure.