Breast enlargement, also known as augmentation mammoplasty, is a cosmetic surgery that enhances the upper body contour of a woman who is unhappy with her small breast size. This is perhaps the cosmetic procedure that the public is most familiar with. Breast enlargement is done by having an implant placed through an incision, under the breast tissue or under the muscle. The incision can be made under the breast, around the nipple or under the arm. A breast implant is composed of an outer silicone shell filled with saline (the use of silicone gel implants are now restricted). The outer surface may be smooth or textured, and implants come in various shapes to meet the individual woman’s needs. When the implant is placed under the actual muscle of the breast, there is a lower chance of contracture (contraction of the tissue surrounding the implant), and mammography is more reliable. There is also less risk of visible or palpable implant edges. The down side is that there are some people who believe the implant has a more natural appearance when placed above the muscle, under the breast tissue. The shape of augmented breasts depends on the implant. Implants can be round or teardrop-shaped (anatomical). The choice depends on the look the female wants to achieve. Anatomical implants produce a gentle slope, resulting in a fuller upper area, whereas round implants create a round curve in the upper part of the breast. Another factor to consider prior to surgery is breast width, which determines the amount of “cleavage” between breasts and the outer curves. Realistic expectations are important. Some women often think of breast size in terms of bra cup size. If a size “A” wanted to be a size “C”, there still has to be adequate existing breast tissue coverage: otherwise there could be visible or palpable implant edges and other possible risks. This is a major procedure, and someone undergoing breast augmentation absolutely needs someone to drive her home and stay with you for 24 hours after surgery. There will be pain the first few days, but normal pain pills should take care of this as the body adjusts to the new implants. Wear a bra at all times (except when showering) during the first 2 weeks after surgery. Avoid heavy lifting and avoid even moderate exercise for at least the first week, and then only moderate exercise. During recovery, the breasts will be somewhat swollen. Within a few weeks, the actual shape and size will be evident, and the full success of the procedure will come abundantly clear.