Throughout history, breasts have always been associated with femininity and sex appeal. And over the years, women have tried various techniques to enhance their curves. Back in 1885, Austrian-German surgeon Vincenz Czerny made the first recorded attempt at breast augmentation using a patient's own adipose (or fatty) tissue. Shortly after, Czech surgeon Robert Gersuny tried to orchestrate enlargement with paraffin injections. In the early to mid-1900s, scientists experimented with a number of exotic substances (from ground rubber to ox cartilage and polymers) in an effort to upsize women's chests. The results of most of these attempts were, not surprisingly, disastrous.

Then, in 1961 Houston plastic surgeons Thomas Cronin and Franks Gerow introduced the first silicone breast implant--a major breakthrough that set the stage for the modern era of breast augmentation. Although the Food and Drug Administration (FDA) restricted the use of silicone implants in the United States for 13 years (during which time, most women opted for saline), the FDA revoked the silicone ban in 2006. That same year, breast augmentation was America's most popular cosmetic surgery, with 329,000 reported cases, according to the American Society of Plastic Surgeons (ASPS).

Procedure and Recovery
Also known as breast enlargement or mammoplasty, breast augmentation generally involves the insertion of saline- or silicone-gel-filled implants via incisions in the armpit, the areolar border (around the nipple), or the inframammary fold (under the breast). The implants may be placed underneath or over the pectoralis muscles, and generally incision scars fade within a few months but do not completely disappear. In an effort to provide a scarless version of the surgery, some surgeons offer the transumbilical (TUBA) technique, in which an incision is made in the belly button. However, this technique can only be used to insert saline implants and may make placement and/or removal more difficult.

Breast augmentation surgeries are usually performed under general anesthesia, so patients should plan to have someone drive them home from the surgery and take care of them for the 24 to 48 hours afterward. Most likely, the surgeon will prescribe pain medication, and it's important that patients take their medications exactly as prescribed. Recovery time varies depending on the patient: Some women experience minimal pain post-op and may be able to return to work within the week, if their jobs aren't labor-intensive, while others may require several weeks of downtime. In general, surgeons advise against physical exercise for at least two weeks after surgery.

Risks and Rewards
According to an FDA study, an estimated 87 percent of patients indicated being satisfied with their breast implants seven years after their procedures. However, the surgery comes with some risks. According to a study by implant manufacturer INAMED, 7 percent of breast-augmentation patients reported some degree of capsular contracture (a hardening of the tissue surrounding the implants) one year post-op, while 4 percent experienced leakage or deflation. As with any surgery, there's also some chance of infection, swelling, pain, or complications associated with anesthesia.

Plus, there's always the possibility that you won't like the results. In these cases, patients might opt for revision surgery to change the size or shape of their implants. According to a recent FDA study, there is an average 20 percent reoperation rate for breast augmentation three years post-op. However, a 2004 report published in Plastic Reconstructive Surgery suggests that when the right implants are selected and suitable techniques are used, reoperation rates may be as low as 3 percent after seven years.

15 Questions to Ask Your Doctor
When choosing a cosmetic surgeon, it's important to find a doctor who's both experienced in breast augmentation and willing discuss your concerns with you. During your consultation, you should ask for a detailed summary of the procedure and the results you can expect. Remember to be as specific as possible about the size and shape you'd like to achieve. All too often, a patient may say that she wants to be a certain cup size, but her understanding of that size and the surgeon's may be quite different.

In addition, be sure to ask the following questions.

1. How many of breast augmentations do you perform each year?
2. How many years have you spent performing breast augmentation?
3. Are you board certified, and if so, with which board(s)?
4. In which states are you licensed to practice surgery?
5. What are the risks and complications associated with breast augmentation?
6. How many additional operations can I expect as a result of this procedure over my lifetime?
7. What are my options if I'm dissatisfied with the outcome of my surgery?
8. If I'm unhappy with the results, is it possible to "reverse" my breast augmentation? If so, what results can I expect?
9. Does breast augmentation have any functional repercussions?
10. How can I expect my breasts to look over time?
11. What alternate procedures or products are available if I choose not to have breast augmentation?
12. Do you have before-and-after photos I can look at, and which of those results are reasonable for me to expect?
13. What's the most common complication you encounter with breast augmentation?
14. What's your reoperation rate, and what's the most common type of reoperation you perform?
15. Do you believe I'm an informed patient with realistic expectations who would be a good candidate for breast augmentation?

Breast Augmentation Financing Options
According to the ASPS, the average U.S. surgeon's fees for breast augmentation was $3,600 in 2006; however, this doesn't include fees related to anesthesia, operating-room facilities, or other related expenses. Since the procedure is considered elective (except in cases of breast reconstruction), it's not usually covered by insurance. If your policy doesn't cover the costs, take a realistic look at your finances to determine what you can afford. Also keep in mind that there may be other options available. Financial institutions, such as Capital One, offer health-care loans specifically designed for cosmetic surgery patients.