Breast Augmentation

Breast Implants, Fat Transfer Breast Augmentation and Breast Lifts

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Breast augmentation surgery may be an option if you want to increase the size, shape, and fullness of your breasts. It may be combined with a breast lift if you want to correct sagging or drooping breasts. Duke’s board-certified plastic surgeons have extensive knowledge and skill performing breast augmentation, which includes autologous fat transfer or “fat grafting.” It uses fat from other parts of your body to increase breast size and gently lift the breasts. Our training and years of experience ensure you experience minimal scarring, a fast recovery, and the results you want.

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Frequently Asked Questions About Breast Augmentation

What is breast augmentation?
Breast augmentation is a surgical procedure that is performed to increase the size, shape, and fullness of breasts. It includes breast implants and fat transfer. Breast augmentation may be performed to correct changes in breast size following pregnancy, breastfeeding, weight loss, age, and gravity. Breast augmentation can also enhance your self-image and self-confidence. It may be combined with a breast lift to enhance the final result. Your plastic surgeon will recommend a combination of procedures after your initial surgical consultation.

What are breast implants?
Saline breast implants are filled with an elastic gel, while saline implants are filled with sterile salt water. Your plastic surgeon will make an incision under your breasts, arms, or around your nipple to insert the implant under your chest muscle or directly behind your breast tissue and over your chest muscle. These decisions are dependent on your breast anatomy, body and skin type, and how much enlargement you want.  The incision is closed with sutures.

What Is fat transfer breast augmentation?​​​​​​
Autologous fat transfer, also known as fat grafting, is an alternative to using breast implants for breast augmentation. Your plastic surgeon will use liposuction to remove fat from one part of your body, and then inject it into the breast. This is an option if you are looking for a small increase in breast size and a more natural-looking result. The process may require multiple sessions to increase breast size and there may be a limit to the breast size obtained. You will need to have an adequate supply of excess fat for the procedure, and it can take up to six months or more for your result to take final shape after the procedure.

What is a breast lift?
A breast lift re-contours your breast shape and is typically recommended for drooping or sagging breasts. During surgery, excess skin is removed, the remaining skin is tightened, and the breast mound is reshaped. The nipple is then repositioned higher on the chest wall. This procedure may be performed at the time of augmentation or in a separately scheduled procedure.

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Duke Health offers locations throughout the Triangle. Find one near you.

How much does breast augmentation cost?
While this is a very common question, it is best left to be addressed at your consultation. Breast augmentation is an elective procedure that is not covered by insurance. Costs can vary greatly because of the personalization involved. Your plastic surgeon will discuss which procedures they recommend, the timing, and the costs at your initial consultation.

How long does breast augmentation take?
The actual breast augmentation surgery takes about two to three hours, depending on the procedure. It is usually an outpatient procedure that takes place in modern surgical suites at our accredited surgical centers. It requires general anesthesia which is administered by our board-certified anesthesia team.

What should I expect after surgery?
You will need at least three days of rest following the procedure. You can return to work in about one week, but it will take several weeks, perhaps up to one month for the swelling and soreness to subside. As your body heals, it is common to feel tightness in your chest. It is also common to experience less sensation in your breasts and nipples immediately following surgery.

A supportive, post-surgical bra will help your breasts maintain position during recovery.

You should be able to return to all normal activities, including exercise and heavy lifting, about six weeks after surgery.

When is breast implant removal performed?
Breast Implant removal can be performed if you decide that you no longer want your implants, desire to have a smaller size again, or if you are having issues with your implants such as implant rupture, capsule contracture, pain or other symptoms.

Your surgeon will evaluate you to decide what treatment option is best for you/ That may include removing the implants through your original scar or new incision. Removing the capsule that surrounds the implants may be recommended depending on your situation.

Additional procedures such as replacing the implants, fat grafting or a breast lift may be performed to improve the appearance after removal. These may need to be done during a different surgery. That will be dependent on your needs.

Call for a Consultation

Consultation and Pre-Surgical Testing



When meeting for the first time, your plastic surgeon will discuss your reasons for pursuing breast augmentation, your desired outcome, and the expected results. We conduct a thorough medical history, including your family history, general health status, previous operations, and any medications you may be taking.  We examine your breasts and take measurements of their size, shape, the placement of your nipples and areolas. Photographs will be taken for your medical record. We complete the consultation with a personalized treatment recommendation. This will also include a discussion of potential risks and complications, costs, and recovery.

Pre-Surgical Testing


To ensure you are in optimal health for surgery, blood work will test your liver and kidney function and will determine if you have any infection, blood disorder, or anemia, that may have gone previously undetected.

A mammogram may be recommended to detect any underlying breast abnormalities.

Consistently Ranked Among the Nation’s Best Hospitals

Duke University Hospital is proud of our team and the exceptional care they provide. They are why we are once again recognized as the best hospital in North Carolina, and nationally ranked in 11 adult and 9 pediatric specialties by U.S. News & World Report for 2023–2024.

Why Choose Duke

The Comforts of a Private Practice
Our plastic surgeons combine the comforts you expect from a private practice with the advantages you gain from seeking experts at a large medical institution. Our clinics are conveniently located and offer free parking.

Personalized Treatment Recommendations
During the extensive consultation and careful evaluation, we take time to understand your breast anatomy, skin elasticity and body type. We recommend the implant, the approach, and the placement of the implant that meets your needs and also minimizes scarring, hastens recovery time, and does not interfere with routine breast imaging such as mammography. 

Other Body Contouring Options
If you are interested in other body contouring procedures, such as a tummy tuck or thigh lift, we discuss your reasons, your desired outcome, and your expected results.

Augmentation with Breast Reconstruction
When appropriate, breast augmentation may be combined with breast reconstruction following mastectomy.

This page was medically reviewed on 01/22/2020 by