More and more women are seeking help from plastic surgery to get the breasts they always wanted as it is the only way to achieve effective and long-lasting results. The breast augmentation procedure can be performed with implants (silicone gel or saline solution) or using the patient’s own fat that is transferred from donor areas to the breasts. The procedure is among the most frequently performed in the world and has a high satisfaction rate; however, there are also patients who are not completely happy with the results of their breast augmentation. What is breast augmentation? Most of the time, breast augmentation is associated with implants as it is a more popular choice for patients. During the procedure, implants are inserted into the patient’s breasts, either under the mammary gland or under the pectoral muscle. The implants are placed in a pocket created there, and the surgical approach can require incisions either around the areola (peri-areolar), in the fold under the breasts (inframammary) or in the armpits (trans-axillary). The incision points and placement of the implants are chosen accordingly with the patient’s anatomy and the desired results after the surgery. In some cases, the correction of ptosis can be performed at the same time, and it is called a breast lift with implants. Breast augmentation is a safe procedure when performed by a board-certified, experienced plastic surgeon in an accredited facility. This means that it entails few complications and potential risks, and some of them can even be prevented with a rigorous pre-operative preparation and post-operative follow-up. But it is a surgery nevertheless, and unsatisfactory results can happen due to certain factors. What can go wrong during a breast augmentation? The breast augmentation starts with the pre-operative consultation. This is the time when the patient chooses together with the plastic surgeon the type, size, and shape of implants to be used and discuss the details of the procedure. The plastic surgeon needs to present all the information related to the surgery in clear terms so the patient can understand what to expect and what are the consequences. The patient’s responsibility is to explain to the plastic surgeon in clear and concise terms what she desires to achieve with this procedure. Bringing a picture to the meeting to illustrate what you want can be helpful; however, you need to be prepared to explain exactly what shape and size of breasts you would like. The plastic surgeon will suggest implants and surgical methods that should deliver you the expected results. But if the patient- plastic surgeon communication is not open and efficient, the patient might end up disappointed with the results of the breast augmentation. Aside from the communication aspect that can lead to unsatisfactory results in terms of the aesthetic result, size and shape of the breasts, the patient can also experience complications from the surgery that can cause dissatisfaction with the final result such as capsular contracture, infection, and bad scarring. When to assess the results after augmentation The augmentation is, of course, visible immediately after the procedure, but this doesn’t mean that your breasts will retain their look moments after the surgery. During the following weeks and months, the bruising and swelling will disappear, and the breasts will settle in a lower position on the chest. Their consistency might also change, and they might become softer when the edema is gone. Assessing the results of the augmentation a week after the surgery is not a good idea, not even when it comes to the size and shape of the breasts as it will change during the months to come. You can properly evaluate your new breasts three to six months after the surgery. The scarring process is complete after nine months to a year after the intervention, so a first proper evaluation of the final result can take place one year after. Reasons for dissatisfaction with the results of breast augmentation There are different reasons why people are not happy with their breast augmentation. Most of them can be avoided if you choose a plastic surgeon you can trust and talk to openly, and also if you choose a surgeon that is experienced in performing this type of intervention. Some common reasons for dissatisfaction with the results of breast augmentation include: – Breasts are too big – Breasts are not big enough – Visible asymmetry – Bad scarring – Breasts are not the shape that you wanted (round versus tear-shaped), among other things. What to do if you are not happy with the results After waiting for the results of your surgery to be final, you can take the next step to correct the issues you are not happy with. In many cases, a revision surgery can be performed a year after the initial procedure. During this intervention, you can remove and/or replace the implants with ones that are more suitable for your body type, and the plastic surgeon can also correct a potential asymmetry by using different sizes for the implants. If you are not happy with the results, the first thing you can do is contact your plastic surgeon and discuss this aspect with him and also get a second opinion from another board-certified, experienced plastic surgeon. Conclusion The breast augmentation procedure is very popular all over the world as it is the only effective method to increase the size of the breasts practically overnight and with permanent results. Despite its high satisfaction rate, there are still patients who, due to different reasons, might not be happy with the results of their breast augmentation. To ensure you avoid unsatisfactory results, you should choose a board-certified plastic surgeon who performs this procedure routinely and communicate openly with him regarding your lifestyle, dreams, and expectations from the procedure. Keeping the communication line opened with the plastic surgeon at all times can help you avoid severe complications and also allow you to achieve the results you desire.