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Competing Interests: The author reports no conflicts of interest.

Background: Prospective long-term data on the occurrence of complications following breast augmentation are sparse and the reported frequencies differ substantially., Methods: The Danish Registry for Plastic Surgery of the Breast has prospectively registered preoperative, perioperative, and postoperative data for women undergoing breast augmentation in Denmark since 1999. From the Registry, the authors identified 5373 women with a primary cosmetic breast augmentation between 1999 and 2007. The authors calculated incidence proportions of adverse clinical outcomes within three time intervals (0 to 30 days, 0 to 3 years, and 0 to 5 years) after primary implantation. Outcomes of primary interest were capsular contracture, asymmetry/ displacement of the implant, hematoma, and infection., Results: During the entire follow-up period (mean, 3.8 years; range, 0.1 to 8.7 years), 16.7 percent of the women were registered with an adverse event and 4.8 percent of the women were registered with a surgery-requiring complication. The most common adverse events within 30 days were hematoma (1.1 percent) and infections (1.2 percent), whereas the most common adverse events within 5 years were change of tactile sense (8.7 percent) and asymmetry/ displacement of implant (5.2 percent). Within 5 years, 1.7 percent of the women had a record of severe capsular contracture. Displacement/asymmetry and capsular contracture were the most frequent indications for reoperation with removal or exchange of the implant., Conclusions: Population-based complication frequencies among women with cosmetic breast augmentation in a Danish nationwide implant registry were generally lower than those reported in other studies, although frequencies of complications increased with length of follow-up.

More than 3,000 participants from three large, multi-center, US clinical studies of silicone implants (Allergan, Santa Barbara, CA) were asked to rate their motivations for breast augmentation surgery prior to implantation. A 5-point scale was used to rate the level of importance, ranging from "not at all important" to "extremely important." Prior to implantation and 1 year after implant surgery, women also rated their level of satisfaction with various aspects of their breasts. This article reviews the data collection methods and current results of these studies, identifying the patient's motivation for breast augmentation surgery and reported post-operative satisfaction.

In the early 1990s, it was reported that silicone breast implants were possibly responsible for serious damage to women's health. In January 1992, the Food and Drug Administration issued a voluntary breast implant moratorium and, in April, issued a ban on the use of silicone gel-filled implants for cosmetic breast augmentation. Since that time, silicone gel-filled breast implants have been available to women only for select cases: women seeking breast reconstruction or revision of an existing breast implant, women who have had breast cancer surgery, a severe injury to the breast, a birth defect that affects the breast, or a medical condition causing a severe breast deformity. Since the ban on the use of silicone gel-filled breast implants for cosmetic breast augmentation, numerous scientific studies have been conducted. To ensure patient safety, the American Board of Plastic Surgery believes that these scientific studies and the Food and Drug Administration's scrutiny of silicone gel-filled breast implants have been appropriate and necessary.

Saline augmentation mammaplasty has dramatically increased in popularity over the past 5 years. Maximizing immediate and long-term results requires skilled perioperative nursing intervention.

The use of an expander/implant for augmentation mammaplasty allows for increased patient satisfaction in the postoperative period. Surgical time may be shortened as final volume determination is not an intraoperative concern, and secondary surgery for certain complications such as asymmetry, wrinkling, and capsular contracture can often be avoided.