A few years ago, the plastic surgery industry was rocked by concerns about breast implants causing disease, and we saw an increase in implant surgeries. Despite the negative press, breast augmentations remain a cornerstone of many plastic surgery practices. Once the leading cosmetic surgery, it has recently been overtaken by liposuction. However, implants appeal to a wide range of patients seeking enhancement for reasons such as post-pregnancy volume restoration or to improve proportions. What is driving these changes? Here’s a look at the popularity of breast implants today and the advancements in breast augmentation.
Featured experts
- Dr. Mark Jewell is a board-certified plastic surgeon based in Eugene, OR
- Dr. Kevin Rose is a board certified plastic surgeon based in Salt Lake City, UT
- Dr. Chet Mays is a board-certified plastic surgeon based in Louisville, KY
- Dr. Henry Mentz is a board certified plastic surgeon based in Houston
- Dr. Philippe A. Capraro is a board-certified plastic surgeon based in Denver
The popularity of breast implants
Breast augmentation has been a cornerstone of cosmetic surgery for decades, consistently ranking as the top cosmetic surgery procedure since 2006. According to American Society of Plastic Surgeons, 304,181 breast augmentations were performed in 2023 alone, a two percent increase over the previous year. This statistic highlights the enduring appeal of breast implants. Eugene, OR plastic surgeon Mark Jewell, MD notes, “Breast augmentation remains an extremely popular procedure. Patient preferences for a natural-looking result that is in harmony with other body features are the norm as opposed to oversized implants that are not natural. I think patients are less concerned about systemic symptoms associated with breast implants.”
“The usual reasons for breast augmentation haven’t really changed,” adds Louisville, KY plastic surgeon Chet Mays, MD. “Most patients want to plump up their breasts after having children or breastfeeding or losing weight.” However, Dr. Mace says the look patients want is a very natural aesthetic. In other words, while implants are still very popular, they should not look like implants. “Patients are opting for more natural breast fullness, which makes medium and lower profiles seem more popular than higher profiles.”
Salt Lake City, UT plastic surgeon Kevin Rose, MD adds that implants are also a popular choice for reconstruction patients, who also maintain a strong focus on achieving a natural appearance. “The market for breast implants is growing, due to increased awareness of body image and the growing need for reconstruction due to breast cancer. However, there is a clear trend towards more natural-looking results and smaller sizes, reflecting a wider societal shift away from a ‘bigger is better’ mentality.
Liposuction takes the lead
Breast augmentation’s long dominance as the most popular cosmetic surgery has recently been eclipsed by liposuction, which took the top spot worldwide in January 2023. This change in breast implant popularity is due to several factors. One factor is the growing concern about the link between breast implants and cancer, particularly BIA-ALCL (breast implant-associated anaplastic large cell lymphoma). Moreover, there was almost 47 percent global increase to patients seeking to have their breast implants removed from 2019 (with International Society of Aesthetic Plastic Surgery). This trend toward implanting or choosing smaller implants that better fit one’s frame and lifestyle reflects a changing perception of body aesthetics.
However, implants are still in demand, they just might be more undetectable. “I’ve seen a decline in the desire for larger implants in the last year, with more patients aiming for the ‘ballerina body’ or the ‘Pilates body,'” says Houston plastic surgeon Henry Mentz, MD. “We see many patients choosing to go up just a half or full cup size instead of multiple cup sizes.”
Advances in lifting and filling
Many patients today seek breast augmentation to restore volume lost after pregnancy or weight loss, or to achieve better body symmetry. Dr. Mentz suggests that the rise of GLP-1 drugs, such as Ozempic, may affect this trend. “Patients now want to support and adapt to a healthier, more active lifestyle. As a result, they choose more modest implants for a more athletic look.”
Dr. Mace also notes the growing popularity of combining breast augmentations with lifts, often incorporating fat to achieve the desired look with smaller implants. “I do a lot of complex breast augmentations, adding fat during the procedure to create fuller, more natural looking breasts. This approach allows for smaller implants, reducing tissue stress and leading to longer-term results.”
Dr. Jewell adds that placing implants in front of the pectoralis muscle, known as the retromaxillary-infrafascial approach, is gaining favor with patients. “This technique allows for a very natural result and avoids issues such as unnatural breast movement when the pectoral muscle contracts.”
What’s next for breast implants?
The future of breast augmentation is being shaped by exciting innovations. One of the most anticipated developments is the introduction of nanostructured breast implants, which are expected to receive US approval soon, according to Dr. Henry Mentz. “I think it will change the way we think about breast enhancements,” she says. “Motiva’s new implants will likely create a trend towards smaller sizes, more natural appearance and better breast retention. Back in the 80s, I trained with Dr. Tom Cronin, who invented the breast implant in the 60s. His preference was for an implant over the muscle, similar to the Motiva approach, because it felt the most natural.”
Denver plastic surgeon Philippe A. Capraro, MD, also sees promising developments in implant technology. “Although I haven’t noticed any new trends in the process itself, we have made significant progress. The Keller Funnel, which allows for touch-free implant insertion, helps minimize biofilm and reduce the risk of encapsulation and rupture. Additionally, the industry has moved away from textured implants because of their links to ALCL. I believe these developments lead to consistently healthier and more beautiful results.”
