The pros and cons of all aspects of each type of augmentation or reconstruction should be discussed with the plastic surgeon prior to selecting a procedure. If a patient does decide to proceed with breast implant surgery – either for augmentation or reconstruction purposes – the next step is to choose what type of implant is best suited for the individual. It is advisable that she consider the following factors before the breast implant procedure:

• Implant status. Whether the implant is or is not approved for use in the United States. If it is investigational, the patient will need to become part of a controlled clinical trial to receive the experimental implant.
  
  
• Size and shape. It is important to choose the correct size and shape (round or contoured) depending on the cosmetic result the patient hopes to achieve. Here, the plastic surgeon can offer advice and guidance.
  
  
• Surface of the implant. According to the Food and Drug Administration (FDA), a few studies have shown that textured surface implants, which were initially designed to reduce the risk of capsular contracture, show no such decrease in this complication compared to smooth-surfaced implants. Capsular contracture is scar tissue that develops and tightens or squeezes the implant.
  
  
• Implant palpability/visibility. The feel and look of the implant. Textured implants and larger implants may be easier to feel and see. The same is true when patients have less skin or tissue left to cover the implant.
  
  
• Implant placement. Implants are placed either under the chest muscle (submuscular) or under the breast glands (subglandular). The type of placement may influence the performance of mammograms, breastfeeding or breast self-examination.

Additional information should be considered as there are variations in the surgical incision site, although most surgeons will utilize the mastectomy scar for re-incision (for reconstruction). For breast augmentation surgery, implants may be inserted through an incision at the bottom crease of the breast, in the armpit, along the lower edge of the areola or the navel. The plastic surgeon who performs the breast augmentation or reconstruction surgery will recommend a particular method or implant depending on the individual needs of the patient.