This is a procedure that increases the breast size by inserting a medical implant from under the breast (inframammary), through the armpit (transaxillary), or around the nipple (periareolar). The implant then sits either between the breast tissue and the muscle (subglandular), or partially under the chest muscle (subpectoral). There is no one, best or most “natural” place to put the implant, as different bodies and goals will require different methods. If our implant is placed under the chest muscle (subpectoral), some ways of moving our arms can squeeze the implant. Surgeons do recommend that if we plan on taking estrogen, we do so for a few years, in order to know how much breast tissue we can make on our own. Breasts have a primary growth spurt for many years of being on estrogen, then continue to change in shape throughout the lifetime. Implants are most often made of a silicone shell with salt water inside, which can be absorbed into the body without harm if there is a rupture of the implant. Recently, implants that are filled with silicone gel all the way through (referred to as “gummy bears” by some) were approved by the FDA. These are different than an older generation of implants filled with liquid silicone, which could cause health problems if leakage into the body occurred. It is possible to lose sensation in the nipple and breast that we previously enjoyed.