R.J. Ignelzi, Contributor

Tired of not filling out swimsuits and T-shirts to her satisfaction, 32-year-old Kristin Brackemyre decided it was time to get some serious breasts. But before that could happen, she knew she had to do some serious homework.

She and her lawyer boyfriend researched breast-augmentation surgery as if they were preparing a case for trial. After three years of contemplation and scrutiny, Brackemyre got saline breast implants in August from Dr. Joseph Grzeskiewicz at La Jolla Cosmetic Surgery Centre in California. Today, she wears a C-cup bra and describes her surgery and her new figure as 'amazing'.

"I feel so much better about putting on clothes, wearing bras and just the fact that I now need a bra," she says. "They (her new breasts) just make me feel better about myself."

Plastic surgeons wish all breast augmentation patients would be such diligent consumers. "We want the patient to be happy, healthy and well. We like educated patients, because an educated patient is the key to a happy patient," says Dr. Marek Dobke, head of the plastic surgery division at the University of California San Diego Medical Centre.

Things to consider before having breast augmentation

Plastic surgeons, along with the U.S. Food and Drug Administration (FDA) and the American Society of Plastic Surgeons, offer some critical things to consider before having breast augmentation:

Not all surgeons are the same.

Technically, almost any kind of surgeon can perform breast-implant surgery. However, for the safest experience and most satisfactory results, make sure your surgeon is board certified in plastic surgery.

The surgical facility needs to meet certain qualifications.

Although some augmentations are performed in a hospital with an overnight stay, most are performed as an outpatient in a hospital operating room, surgery centre or surgical suite in a surgeon's office.

The surgical facility should be professional, clean and efficient.

Breast augmentation comes with risks, including a chance of rupture.

Silicone implant makers report a one to two per cent rupture rate in the first three years, similar to that of saline implants. After 12 years, the rate rises to 15 per cent. The older the implant, the more likely it is to rupture. Some of the causes of rupture include damage during implantation or other surgical procedures, trauma or other excessive force to the chest or the compression of the breast during mammography.

There can be changes in nipple and breast sensation.

Some women report that their nipples become oversensitive, undersensitive or even numb. Some women also experience small patches of numbness near the incisions. Often, the symptoms disappear over time, but they can be permanent in some patients, according to the American Society of Plastic Surgeons.

Implants may affect your ability to breastfeed.

Women who have the periareolar (around the nipple) incision are less likely to successfully breast-feed as compared with other incision sites. If breastfeeding is something that you want to be a part of your future, discuss this with your surgeon.

There's a chance you may need more than one operation.

According to studies cited by the FDA, about 20 per cent to 25 per cent of women who got breast augmentation (silicone and saline implants were studied together) had additional surgeries during the first five years after implantation because of hardening of the breasts, shifting of the implants, sagging and ruptures. One of the most common causes for re-operation is capsular contracture, which occurs when the scar tissue or capsule that normally forms around the implant tightens and squeezes the implant. However, other surgeons note that for some fortunate women, one augmentation is all they will ever need.

Routine mammograms to screen for breast cancer will be more difficult with breast implants.

Be sure to go to a radiology centre where technicians are experienced in the special techniques required to get a reliable X-ray of a breast with an implant. Additional views will be required. For some women with implants, ultrasound examinations may be of benefit to detect breast lumps or to evaluate the implant.

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