Introduction Nowadays we see all over the internet, in newspapers and magazines what society considers as the ideal feminine image. The beauty stands for women imply big breasts, big buttocks, and a small waist. To slim down your waist and to get firmer buttocks you can use diets and physical exercises, but when it comes to increasing the size of the breasts, there are no methods that can help you achieve this aside from a plastic surgery intervention. Many women have deep emotional complexes and low self-esteem levels because they have small breasts. This is not unnatural because big, round breasts are one of the most important symbols of femininity. The plastic surgery intervention that can increase the size of the breasts is called breast augmentation. Many patients note that their lives improved for the better after a breast augmentation surgery. Why do women want to have bigger breasts? In some cases, the reason is as simple as the underdevelopment of the mammary gland. The patient has small breasts because they didn’t develop accordingly and proportionately with the rest of the anatomy. Small breasts are not a characteristic of petite women; tall women can experience this issue too and even in women who are overweight. Aside from this, we have the patients who had moderately sized breasts but after multiple pregnancies or with aging, the mammary gland tissue was lost, and now they are confronted with a mammary atrophy. Women want big breasts to feel more feminine, better in their own skin, and to avoid having difficulties in finding clothing that will look good on them. What can the breast augmentation surgery do for you? The breast augmentation procedure can be performed in three ways. First, we have the augmentation with implants that requires the use of implants to be inserted into a pocket created in the breasts. Then, an increase in the size of the breasts can be done with the help of fat transfer to the breasts. This procedure implies that the patient has an excess of adipose tissue in other areas of the body that can be harvested, processed and then re-injected in the breasts. The third option for breast augmentation is a combination of the two procedures. Breast implants and fat transfer can be used in combination to achieve superior aesthetic results. This method is especially recommended for patients with a thin mammary gland tissue that won’t be enough to cover the implants properly. To avoid rippling of the implants or visibility of the implants’ edges, the plastic surgeon might recommend fat transfer. It is important to mention that breast augmentation surgery can also correct visible asymmetries between the breasts, can improve the dimensions of the bust, and can also be used as a reconstructive method for women who underwent oncological interventions to treat breast cancer. Breast augmentation with implants When considering bigger breasts, breast implant surgery is the first choice that comes to mind. We have two types of implants that differ in contents; the soft shell being made out of the same material. We have implants filled with saline solution and implants filled with cohesive silicone gel. Each of them have advantages and disadvantages, and the patient should be fully aware of them before making a decision towards one or the other type. The implants can also differ in shape (either round or anatomical). The round implants have the benefit of not presenting a risk for rotation after being inserted into the breasts. They are the most popular choice, and they keep their shape whatever the position of the body might be. However, it is important to know that while anatomically shaped implants offer a more natural aspect of the bust, they determine a deformation of the shape of the breasts if they rotate. The surface of the implant can be textured or smooth. Your plastic surgeon will tell you from his experience which ones are the most recommended for your particular case. The volume of the implants also differs depending on the necessities and desires of the patient. In modern days we work with a series of measurements that allow the patient to make a choice that will offer the most natural aspect of the breasts. Generally speaking, the support base of the implant is decided upon taking into consideration the dimension of the thorax. However, not all patients aim to achieve a natural result after the breast augmentation procedure. Some desire upper pole fullness that makes the breasts very round. Make sure to tell your plastic surgeon exactly how you want your breasts to look like after surgery to avoid unsatisfactory results. When it comes to inserting breast implants, there are multiple choices. Mammary implants can be placed behind or in front of the pectoral muscle or in a position between what we call the dual plane. Placing the breast implant under the pectoral muscle is often used as it presents the lowest risk of developing a complication called the capsular contracture, interfering less with the mammogram and offering a better cosmetic result. However, positioning the implant over the pectoral muscle or under the mammary gland is less painful and comes with other benefits such as shorter recovery time. To place the implants, the plastic surgeon will need to make incisions. The incisions used for breast augmentation can be of three types: periareolar, transaxillary and inframammary. The first and the last one are more commonly used. The inframammary incision is made in the fold under the breasts, so it is well hidden. Moreover, it offers a good visibility for the plastic surgeon to place the implants, making it a preference of plastic surgeons. For a periareolar incision, the plastic surgeon will introduce the implant using an incision around the areolas’ edges. The scar is also well hidden due to the color of the areola. However, it is important to keep in mind that any imperfection that can occur in the evolution of the scar can make it become very visible. When this incision is preferred, there is also an increased risk of nipple insensitivity after the surgery. This side effect can be temporary and in rare cases even permanent. Breast augmentation surgery is performed under general anesthesia and can last between one and three hours. The patient is required to spend the night in the hospital under the supervision of medical staff. Breast augmentation with fat transfer The intervention has three steps when increasing the volume of the breasts via fat transfer. First of all, the plastic surgeon will perform liposuction on the donor areas to collect the fat needed. Once extracted, the fat goes through a complex purification process. The pure fat is re-injected into the breasts in multiple layers using small syringes. The augmentation that can be offered by the fat transfer to the breasts is not as impressive as what can be achieved when using breast implants. Moreover, the result is less predictable. The fat transfer to the breasts is conditioned by the amount of fat we can extract from other areas. Aside from this, even if we collect enough fat, there is a certain percentage (up to 40%) of fat that will be reabsorbed by the body after the intervention. In other words, your breasts might be big after the procedure but may decrease a few months after. The augmentation using autologous fat transfer provides natural results, and by using it we avoid all risks related to breast implant surgery, which is why many women prefer it. The recovery period is also shorter. Conclusion Recent studies show that the vast majority of patients undergoing breast augmentation in the last few years noticed a significant improvement in their quality of life after the intervention. Many of them believe they made the right choice, even after considering the potential complications, and would do it again if necessary. Having small breasts or breasts that are not proportionate to your anatomy can be a struggle and a source of deep emotional issues. Correcting this imperfection might make you feel better about yourself, give you a boost of self-esteem, and even improve your life in more ways than one. To make sure you achieve the best possible results, choose a board-certified plastic surgeon who is experienced in performing this type of intervention. He will be able to advise you on which the optimal treatment plan for your particular case is, what are the right implants to choose, and how to prepare for the intervention to ensure you have a fast recovery.