I want to address the top ten most commonly asked questions that my patients have about breast augmentation that were not already addressed in the preceding videos.
“What are the most common risks/complications?”
All surgical procedures carry risk — and it is important to discuss them calmly and factually.
The most common, and typically manageable, issues include:
-Implant malposition – This is when the implant migrates downward or to the side.
-Capsular contracture – This is when the natural scar tissue sac that forms around the implant becomes thickened and hard, making the breast feel firmer
-Infection – very rare, usually treated with antibiotics
-Rippling – Due to the implant characteristics, but more visible when your tissue is very thin. The breast tissue does not cause rippling, but it makes it easier to see it.
-Rupture – no breast implant will last forever. Eventually they will need to be replaced
Compared to all other breast implants, Motiva breast implants have the lowest rate of capsule contracture, rippling, infection, and rupture.
Compared to all other surgical methods of breast augmentation, Preservé has the lowest rate of complications.
“How long do implants last—will I need another surgery?”
No mechanical device will last forever.
However, based upon data submitted to the FDA, the generation 5 implants (Natrelle, Mentor, Sientra) have reported ten year rupture rates of 10% and higher.
Motiva rupture rate is 0.5% at five years. Longer term data will be available when the 10 year study, currently entering year 8, is completed. This data is similar to data reported elsewhere in other countries.
Replacement of a ruptured implant is usually a simple procedure,
Motiva implants will last far longer than competitive breast implants.
“Can I breastfeed / what about pregnancy later?”
Breast augmentation should have no effect upon the ability to breast feed.
“Will implants affect mammograms or breast cancer detection?”
With today’s multimodality methods of breast imaging (digital mammography, high resolution ultrasound and MRI), breast augmentation surgery should not affect the ability to detect breast cancer.
“Breast implant illness (BII) / BIA-ALCL—how real is the risk?”
This is a very emotional and controversial topic.
In my own practice, I have had only a few women complain of symptoms that they believed were caused by their breast implants.
While we know that approximately 94% of women with symptoms that they believe are due to their breast implants get relief of symptoms upon removal of the breast implants, there is no scientific evidence that ties breast implants to any specific disease.
In 2025, there have been some studies published in peer reviewed scientific journals that suggest that the symptoms may be psychologic in nature.
The “nocebo effect” is the belief that a foreign object in your body is making you ill and upon its removal you feel better.
I refer those interested to my website which cites these specific articles which you can read and then make your own informed decision based upon the scientific data presented.
“Will I lose nipple sensation (or will sensation change)?”
With traditional methods of breast augmentation, the risk for permanent nipple sensation loss is probably around a few percent.
Published data for the Preservé procedure cites a zero percent risk of loss of nipple sensation.
This is because there is no cutting of the breast tissue during the performance of the Preservé procedure.
“How do you prevent rippling / visible edges?”
Rippling is caused by the breast implant itself. The amount of rippling is determined by the characteristics of the gel, the outer implant shell and how they interact with each other.
If you have thin tissues, rippling may be more easily seen. Thin tissue does not cause rippling.
You cannot change your tissues.
The best way to prevent rippling is by not overstretching the breast with an oversized implant and by using an implant with a low risk of rippling.
I have found the Motiva Ergonomix and Motiva Round to have the least risk for rippling over any other implant, with the Motiva Round being the absolute lowest.
“What if I don’t like my result—what revision options exist?”
The answer to this is to first ask what is the issue with the breast?
There are many potential reasons for dissatisfaction – size, contour, capsule contracture, malposition of the implant, rippling, etc.
The options for resolution will depend upon what the specific issues are and how they can be addressed.
Fortunately, most, but not all, issues can be improved with revision surgery.
The best way to treat a revision is to not need one in the first place.
By following the process for implant size selection, and using Motiva implants which have the lowest rate of device related complications, and the Preservé method of implant placement which has the lowest rate of technique related complications, you are ensuring that you will have the lowest possible risk for revision of your breast implant surgery.
“Can I combine this with other procedures (mommy makeover, lift, lipo)?”
Many patients combine breast implant surgery with a lift, tummy tuck, labiaplasty, liposuction and other procedures when indicated and safe to do so.
When the length of the surgery is extended, the surgeon must ensure that you are in good physical condition for such a procedure.
“How do I choose a surgeon / what credentials matter?”
The best advice I can offer to answer this question is to take your time and do your research.
Look at the surgeon’s website, the quality and quantity of before and after cases.
Make sure that the surgeon’s “style” of breast enhancement aligns with that of your own.
Read the information about the procedure on their website and determine how much useful information they are providing.
I would strongly recommend selecting a surgeon who is certified by the American Board of plastic surgery.
This should be on the surgeons website.
You can also verify this information by going to the boards website www.abplasticsurgery.org
Social media can also be a useful tool as well.
Is the surgeon doing posts for entertainment or for education?
Do their posts provide you with a sense that the surgeon is truly experienced and has the necessary technical expertise to ensure that you achieve your goals safely and with an exceptional experience?
Look at the surgeon’s reviews. No surgeon is perfect and no surgeon makes 100% of their patients happy all the time. If this surgeon has a multitude of only 5 star reviews, beware.
Research the surgeon’s name alone, not the practice. Occasionally you may find some disconcerting information about the surgeon that does not appear on google and other practice review sites.
Are you getting a sense that this surgeon is current and up to date with technology?
Do you feel that this surgeon is credible?
Is breast augmentation a specialty of the surgeon?
Is the surgeon a recognized leader in the field?
When you call the surgeon’s office, are the staff truly knowledgeable about the procedure you are interested in?
Does the surgeon make any effort to truly educate you or are they just providing you with basic, standard language information that anyone can find on the internet?
When you met with the surgeon, did he/she:
-spend adequate time with you?
-make an effort to understand your needs, motivations and goals?
-use the most current technology to assess and make recommendations for surgery?
-answer all your questions?
-offer to be available should you have additional questions?
-was the coordinator friendly and receptive?
-were you offered a tour of the facility?
-do you think that the surgeon and coordinator had your best interests at heart?
-do not “shop for the cheapest price” – cheap may become expensive later on.
What does your gut truly tell you???
And here is a bonus question:
Do I need to replace my implants every ten years?
This is a complete myth! There is no science behind this. The vast majority of breast implants last beyond ten years. Motiva has the lowest rupture rate at 0.5%, so it will be many years before you need to replace them.
I recommend getting an ultrasound six years after surgery, then every 3 years to check your implants.
As long as they are intact and you are happy, leave them alone
In the next video I want to discuss what women say and do not say about the impact of breast augmentation on their lives.
