Ask Dr. Berman: I Desperately Want Breast Implants

Q:I am 23 years old and desperate for breast implants! My boyfriend says I am crazy, but I know he will be happy when he sees the end result. Can you tell me what options are out there and reassure him that breast implants are completely safe?

A: To begin, breast implants are not completely safe, as no surgical procedure ever comes without risk (even getting your wisdom teeth out!)

That being said, who hasn't wanted their breasts to look a little perkier, a little bigger, a little something else? There's no need to be embarrassed if you've considered support that goes beyond a push-up bra. While implants are far from risk-free, they do offer a viable solution for women who are unhappy with their breasts, and they can counter the toll that time and motherhood may take on breasts.

If you are considering breast-implant surgery, make sure you know the facts first. There are two main types of breast implants: silicone and saline. Many women prefer the more natural shape and feel of silicone, but saline is considered safer. In fact, silicone implants were taken off the market in 1992 because of health and safety concerns. Then in 2006, the FDA approved two brands of silicone implants on the condition that the companies that make them continue to study their long-term safety; but critics still maintain that silicone implants pose a significant risk to women's health. The research on this is mixed, but it's safe to say that silicone implants do pose at least slightly more of a risk than saline implants in the event of a rupture. And since most implants will rupture over the course of a typical lifetime, saline seems the safer bet.

The main difference between the two during a rupture is that the breast deflates almost immediately after a saline implant ruptures (leaving no doubt as to what's happened), but a breast will maintain its shape after a silicone implant ruptures. This allows silicone to leak undetected into the body for an indefinite amount of time — and that leakage has been linked to an increased risk of fibromyalgia and other connective-tissue disorders. Regular MRI exams can check for ruptures and offer a protective measure, though.

After considering physical risks such as these, you should also consider the emotional toll of surgery. Even with your new breasts, you might not immediately be filled with confidence. Breast implants aren’t a way to “perfect” your body, and they certainly aren’t going to change the way you feel on the inside. Only you can do that, and real, lasting self-improvement such as that requires hard work, self-awareness, discipline, and sometimes even therapy. However, if you have carefully considered this decision and have realistic goals for the surgery (and if you are ready to take on the potential risks of surgery), then breast implants might be a good option for you.

In the end, it's like any other health decision: Weigh the risks against the benefits and make the decision that's best for you.

— Dr. Laura Berman

Read more Sex and Love Advice from Dr. Laura Berman.