Breast plastic surgery: implants, lifts and reductions

The types of breast surgery

Breast surgery isn’t one operation. Each type solves a different problem, and many people end up combining two. Here’s the whole category side by side, with how often each was done in the US in 2025 and what surgeons charge on average.

Counts are national estimates from the American Society of Plastic Surgeons (ASPS) 2025 statistics; the augmentation figure includes implant revisions, and the reconstruction figure comes from insurance claims. Fees are ASPS’s latest published averages and cover the surgeon only: anesthesia, the operating room and other costs come on top. For how breast surgery compares with face and body procedures, see the overview of plastic surgery types.

Breast augmentation

Augmentation increases breast size, restores volume lost after pregnancy or weight loss, or evens out breasts of different sizes. It’s done in two ways:

What patients ask for is changing. In ASPS’s 2025 survey, 36% of member surgeons said patients had moved toward smaller implants and 12% toward larger ones, while 52% saw no change. Implants of 300 to 400 cc were the size surgeons used most, followed by 200 to 300 cc.

Augmentation alone doesn’t fix sagging. ASPS notes it “does not correct severely drooping breasts” and points to a lift for that, with or without implants.

Breast lift, with or without implants

A breast lift (mastopexy) removes stretched skin and moves the nipple and breast tissue higher. ASPS lists the usual signs it’s the right operation: nipples that sit below the breast crease when unsupported, nipples and areolas that point downward, stretched skin and enlarged areolas, or one breast lower than the other. ASPS names pregnancy, breastfeeding, weight changes, aging, gravity and heredity as causes.

ASPS says a lift “does not significantly change the size of your breasts or round out the upper part of your breast.” It suggests a lift combined with augmentation if you want fuller breasts, or a lift combined with reduction if you want smaller ones. Some surgeons are seeing more of them. “I’m seeing more breast lifts with augmentation, too,” Chicago plastic surgeon Sara Dickie, MD, told ASPS for its 2025 report. Ask how the combined operation changes your scars and recovery.

Breast reduction, and when insurance pays

A breast reduction removes skin and breast tissue, then reshapes and lifts what’s left. ASPS describes the typical candidate as someone whose breast size limits physical activity or causes back, neck and shoulder pain, grooves from bra straps or skin irritation under the breast crease.

Because it treats physical symptoms, insurance sometimes pays for a reduction, but plans set strict rules. Aetna’s policy, last reviewed in March 2026, shows the kind of rules insurers set; other plans’ criteria differ:

The weight rule can clash with the result you want: a surgeon may judge that a smaller reduction suits your frame better than the minimum your insurer requires. Ask your surgeon and your plan how they handle that before you’re scheduled, and if a claim is denied, ask exactly which criterion wasn’t met.

Implant removal (explant)

Implant removal takes out implants from an augmentation or reconstruction, and often the capsule of scar tissue the body forms around them. ASPS says people choose it for capsular contracture (hardening of the breast), pain, a leak or rupture seen on imaging, or simply because they no longer want implants. Others exchange them for a different size at the same time. Removals among augmentation patients held steady in 2025 at 45,773, which ASPS reads as evidence that the shift to smaller implants isn’t driven by people taking theirs out.

Ask your surgeon how your breasts are likely to look once the implants are out, and whether a lift in the same operation makes sense for you. The FDA notes that some patients with systemic symptoms report they went away after their implants were removed without replacement; it hasn’t established that removal helps everyone. If you’re having implants removed because of symptoms, say so at the consultation and ask whether the surgeon plans to remove the capsule too.

Male breast reduction (gynecomastia surgery)

Gynecomastia surgery removes enlarged breast tissue, excess fat or both from a man’s chest. ASPS says good candidates are men whose condition can’t be corrected with other medical treatment, whose breast development has stabilized and who are at a relatively stable, normal weight. It adds that teenagers may benefit, though they may need another operation later if breast development continues.

ASPS also looks at the cause: if gynecomastia comes from a medication, steroids, other drugs or weight gain, it warns that the results only last if you stay off that substance and keep your weight stable. Insurance may not help: Aetna’s policy, for example, classifies gynecomastia surgery as cosmetic for every indication. Male breast reductions fell 8% in 2025, to 23,318.

Breast reconstruction after cancer

Reconstruction rebuilds one or both breasts after a mastectomy, using implants (often after a temporary tissue expander stretches the skin) or a flap of your own tissue; ASPS’s 2025 report names a flap from the lower belly as the most common. ASPS counted 159,140 breast reconstruction procedures in 2025, including revisions. Federal law requires most health plans that cover mastectomies (some church and government plans are exempt) to cover all stages of reconstruction and surgery on the other breast to make them match. The reconstructive surgery guide covers the options in more depth.

Saline vs silicone implants

Both types have a silicone outer shell; the difference is the filling. The table below summarizes the FDA’s implant pages. The choice affects feel, the minimum age, and how you’ll find out if one breaks.

The FDA approves both types for reconstruction at any age. For one risk, texture matters more than filling: the FDA says the lymphoma described below occurs more often with textured implants. Ask which implant, by brand, model and surface, your surgeon plans to use, and keep the patient device card you’re given afterward.

What the FDA requires you to be told

Since October 2021, implants can only be sold to surgeons and facilities that go through the manufacturer’s FDA-required Patient Decision Checklist with patients before surgery. You initial each item and sign at the end, and your surgeon signs it too. The labeling also carries a boxed warning, which says:

BIA-ALCL in numbers. As of June 30, 2024, the FDA had received reports of 1,380 cases and 64 deaths worldwide. Of the cases, 73% involved textured implants and 3% smooth (most of those had prior or unknown implant histories; the rest didn’t say). The median time from the most recent implant to diagnosis was 8 years. The FDA lists the main symptoms as persistent swelling, a lump or pain around the implant, which can appear years after surgery; if you notice them, it says to talk to your doctor about further evaluation. Allergan’s BIOCELL textured implants were recalled in 2019. The FDA has also received reports of squamous cell carcinoma and other lymphomas in the scar capsule around implants. It doesn’t recommend removing implants in people without symptoms.

Breast implant illness. The FDA acknowledges symptoms such as fatigue, memory loss, rash, “brain fog” and joint pain may be associated with breast implants, and says their causes are poorly understood. The FDA notes these symptoms may not meet the diagnostic criteria for any disease.

Other common problems. The FDA’s checklist lists capsular contracture (scar tissue tightening around the implant), rupture, wrinkling, visible implant edges, shifting and repeat operations. The checklist also warns that implants can interfere with mammograms and breast exams, and tells patients to let the mammography technician know they have them. For how breast surgery compares with other procedures on safety, see the riskiest types of plastic surgery.

Timing after pregnancy and breastfeeding

Surgeons quoted by ASPS advise waiting, because breasts keep changing after a baby. In an ASPS article from June 2026, one member surgeon said breast surgery should wait until “a woman is certain her breasts have stopped changing,” noting that after stopping breastfeeding it can take four to six months for breasts to settle. Another said she prefers to wait at least three months after weaning, and a minimum of six months after giving birth for most procedures, ideally nine to 12 months or once you’re back at your usual weight.

If you plan more children, ask your surgeon how a later pregnancy could affect the result; one of the surgeons in the same article says a mommy makeover in particular requires “the completion of childbearing.” And if you’d like to breastfeed in future, the FDA checklist warns that implants and breast surgery may interfere with it. Some parents combine breast surgery with a tummy tuck in a “mommy makeover”; the body contouring guide covers the body side of that.

Costs and insurance

The ASPS averages below are what surgeons charge. A full quote adds anesthesia, the hospital or surgical facility, medical tests, post-surgery garments and prescriptions, so expect the total to be well above these figures.

ASPS doesn’t currently publish an average for breast reduction, and its pages don’t say which year the other figures come from. Budget for the long term if you choose implants, too: the FDA warns that removal, replacement and screening scans may not be covered by insurance.

Recovery

Recovery depends on the operation and on how physical your job is. These are typical timelines from The Aesthetic Society and ASPS; your surgeon’s instructions take priority.

After a reduction, ASPS notes, swelling and bruising may hide the final result at first, so size and shape can keep changing after you’re back at work. Its recovery pages suggest asking your surgeon what to watch for at the incisions and in your general health, and when to come back for follow-up.

How to choose a surgeon

The bottom line

Get two or three consultations, bring this guide’s questions and our plastic surgery checklist with you, and ask each surgeon how long to wait after pregnancy or weight loss before you book.