Breast augmentation is one of the most popular cosmetic surgeries in the world. Women between the ages of 18 and 35 are the largest group seeking this procedure, often motivated by a desire for enhanced confidence and body image. But before you book your consultation, there are several things most surgeons won’t immediately tell you about breast augmentation. If you’re thinking about getting this surgery, understanding these lesser-discussed points can make all the difference in making an informed decision.

Not All Implants Are Created Equal

Different Types of Implants

When you walk into your consultation with Mr Reza Nassab in Manchester or Cheshire, you’ll quickly find out that breast implants aren’t one-size-fits-all. You’ll be faced with options: silicone, saline, or gummy bear implants. Each comes with its own advantages and potential downsides. Silicone implants tend to feel more natural, while saline implants are more adjustable during surgery although they are not commonly used in the UK. Gummy bear implants are newer and maintain their shape better, but they can feel a bit firmer. These are also called cohesive gel implants and the most common silicone implant that we use now.

Patients are often surprised by how different each type of implant feels and looks. Many surgeons might gloss over this, but the choice can affect how natural the implants feel inside your body.

Shape and Placement Matter

Beyond the material, implants come in different shapes. Round implants can provide more upper pole fullness, but teardrop-shaped implants often give a more natural slope. The final look also depends on whether the implant is placed above or below the muscle.

Most people assume the bigger, the better, but size has to be proportional to your body shape. A too-large implant can stretch the skin and lead to future sagging, which I cannot not emphasise enough. The excess tension on the wound can also increase the risk of hypertrophic or raised scars.

For example, one patient, Emma, 29, said:

“I chose tear drop initially because I heard they look more like natural. But when I tried on the implants during my consultation, I was surprised by how different the types felt and I liked the round shape instead.”

Long-Term Maintenance: A Reality Check

Implants Aren’t Forever

You might be under the impression that breast augmentation is a one-and-done procedure, but the reality is that implants have a limited lifespan. They may last 10 to 15 years, but eventually, many women will need revision surgery, either due to complications or the natural wear-and-tear on the implants.

Capsular contracture (when scar tissue tightens around the implant) is one of the most common complications, and it can happen years after the initial surgery. Revision surgeries can be expensive, and this long-term maintenance is something every patient should be aware of.

Routine Monitoring Is Essential

If you have silicone implants, regular MRI scans are recommended to ensure the implants haven’t ruptured. However, this is an additional cost that often isn’t mentioned upfront. While rupture rates have decreased with advancements in implant technology, it’s still a risk to keep in mind. We recommend scans every 5 years or so to check the implants for rupture.

The Recovery Process Can Be Tougher Than Expected

Pain and Discomfort

Every surgery has a recovery period, and breast augmentation is no exception. Some surgeons may downplay the recovery experience, leading patients to think it will be smooth sailing after a week or two. In reality, you’ll likely feel significant discomfort for the first few days, with tightness or pressure in the chest area that can make everyday tasks, like lifting your arms, difficult. Some patients may recovery very quickly following their procedure. I find that over the muscle patients recover more quickly than those that have implants under the muscle.

Natalia Zoppa’s Experience:

“I woke up, the recovery was okay. It wasn’t as bad as I thought. Obviously, it was painful. I would say maybe like a seven out of ten, but that was only for about a couple of days.  And every single day that went by, I was just. I felt so much better.”

Scarring: Not Always What You Expect

One aspect of breast augmentation that’s often understated is scarring. Depending on where the incision is made—whether in the crease under the breast (inframammary), around the nipple (periareolar), or under the arm (transaxillary)—you’ll likely have some form of scarring. With proper care, scars can fade over time, but they won’t completely disappear, so it’s important to understand that scars are permanent. In the UK, most surgeons will use an inframammary incision or cut under the fold of the breast.

Perfection Is Not Guaranteed

Symmetry and Aesthetic Limitations

Many women go into a boob job expecting flawless results, but it’s important to understand that achieving perfect symmetry is nearly impossible. Your natural breast shape, tissue, and skin elasticity all play a role in the final outcome. While augmentation can significantly improve the appearance of your breasts, some level of asymmetry will always be present. I often find many patients do not realise they have asymmetry until I point it out during their consultation.

It’s also important to manage expectations when it comes to volume. Going too large can stretch the skin and lead to sagging over time, particularly after significant weight changes or pregnancy. We will try to match your aesthetic goals, not every body type can achieve the same results.

Revision Surgeries Are Common

Breast augmentation isn’t always a one-time surgery. Some women opt for revision surgeries to correct complications or enhance their original results. One patient, Sarah, 34, said:

“I didn’t expect to need a revision, but three years after my first surgery, I decided to go smaller. I had capsular contracture and wanted a more natural look. My surgeon never mentioned this possibility in my initial consultation.”

Emotional and Psychological Impact

It’s Not a Cure-All for Confidence

While breast augmentation can certainly boost confidence, it’s important to have realistic expectations about how much it will improve your self-esteem. Surgery alone won’t fix deep-rooted body image issues. If you’re already struggling with self-confidence, consider whether surgery will genuinely address those concerns or if more internal work is needed.

It’s not uncommon for patients to feel a sense of emotional letdown after surgery, especially if the results don’t match their high expectations. The emotional rollercoaster of pre-op nerves, post-op recovery, and adjusting to a new body can be more intense than expected.

Surgery as a Stressful Event

From making decisions about implant type, size, and placement to worrying about complications, the stress leading up to breast augmentation can be significant. Make sure you’re mentally prepared for not just the surgery, but the recovery process and potential emotional side effects.

Breastfeeding and Sensation Changes

Breastfeeding May Be Affected

If you plan to have children in the future, you may want to consider how breast augmentation could affect your ability to breastfeed. Though most women can still breastfeed after the surgery, those having uplifts (with scars around the nipple) are at higher risk of not being able to breast feed. This is because the incision may damage milk ducts and nerve pathways critical for breastfeeding.

Sensation Changes

Change in nipple sensation will occur to some degree in most patients. Some women experience numbness or heightened sensitivity, which can be temporary or permanent. This is something many women aren’t fully prepared for post-surgery.

Cost: More Than Just the Initial Price Tag

The True Financial Commitment

A boob job isn’t cheap, but the costs extend beyond the surgery itself. You’ll also need to budget for anaesthesia, operating room fees, post-op medications, and follow-up appointments.

Additionally, the cost of future revision surgeries and ongoing monitoring (such as MRI scans for silicone implants) can add up over time. Make sure to factor these into your long-term financial plan.

The Social Stigma Around Breast Enlargement

Facing Judgment

Although cosmetic surgery is becoming more accepted, there’s still a stigma around breast augmentation. Some women report feeling judged by friends, family, or even strangers for choosing to undergo surgery. It’s important to be prepared for how others may react—and how you feel about disclosing your decision to them.

Conclusion: Making an Informed Decision

Breast augmentation can be life-changing, but it’s crucial to go into it with your eyes wide open. Surgeons may not always tell you everything upfront, so it’s up to you to ask the right questions, do your research, and weigh the risks and benefits. Remember, this is a long-term commitment, both physically and financially.

By understanding these key points, you can make a more informed decision and feel empowered throughout your journey. Whether or not you decide to move forward with surgery, the most important thing is making a choice that feels right for you and your body. You can book your consultation with Mr Nassab to find out more and address any concerns you may have.