Making the decision to get breast implants, like making the decision to get any plastic surgery, is a deeply personal choice, and should never be influenced by what other people want. Since this is invasive surgery, and not generally covered by insurance, it should also never be done on a whim. While many of us may joke about famous actors and top models getting "boob jobs" the reality is that most women who get this surgery, while certainly financially comfortable, are not celebrities.

Breast enlargement - the surgical placement of breast implants - is the most frequently done surgery in the US, and the reasons for getting them include everything from wanting to improve self-esteem because women feel like their natural breasts are too small or mismatched in size, to reconstruction after a mastectomy.

The process of getting implants involves a series of discussions with your surgeon, covering everything from your reasons to having it, your ability to pay for it, what the risks are, and what you want for an end result. While your doctor will have input, especially with regard to what results you can reasonably expect, most of the decisions are yours.

When you go to your consultation appointment for your breast augmentation surgery, one of the things you will discuss with your surgeon is what types of implants you will be receiving, and what they are filled with. While your existing anatomy will dictate some of the factors (shape, size) and your plastic surgeon's suggestions will be important as well, it's good for you to have some understanding of exactly what implants are.

Breast implants are generally a solid silicone rubber shell, which is filled with either elastic silicone gel or saline solution (sterile salt water). Both types are approved by the Food and Drug Administration of the United States, which means they have been thoroughly tested and researched, as well as reviewed by an independent panel of physicians. They are safe.

Breast implants are measured by volume - how many cc's (cubic centimeters) of filling goes inside. Why size and substance vary, there are four other factors that should also be considered:

• Diameter is the width of the implant measured across the interior surface (the side of the implant that faces the chest wall).
• Profile is the degree of curvature - the measurable contour. It's measured by degrees of projection: low, medium, or high.
• Shape refers to whether the implant is round or approximates a more natural teardrop or tapered shape.
• Texture refers to the surface of the implant shell, which may or may not be smooth. It does not refer to the texture of your breast.

While we have all heard stories about sixteen-year-old cheerleaders getting breast augmentation surgery for their birthdays, it is recommended that a woman's breast be completely developed before such surgery takes place. Saline implants are approved by the FDA for use in women over the age of 18, while silicone implants are approved for women aged 22 and over. Either type of implant may be used for women at younger ages, if they are recommended for reconstruction purposes.

Whatever type and shape of implants you and your surgeon select, the actual surgery is essentially the same: you will usually be given general anesthesia so you will be asleep, though some surgeons prefer to use local anesthesia as the recovery time is shorter, and it is safer for the patient.

Your surgeon will create a "pocket" behind your breast tissue, and insert the implant into it, on each side of your body, and will then suture the incisions, and tape the stitches. You'll spend a little while in a recovery room, and then be sent home the same day to begin healing, and after several days you'll begin to resume your normal life, with larger, or more evenly sized, breasts. (For a detailed description of the surgery, click here.)

Breast implants are neither designed nor guaranteed to last a lifetime, and you may have to have a second surgery sometime in the future, to replace on or both of yours. As well, it is extremely important to have regular breast examinations to assure yourself that your implants are fine, and monitor the overall health of your breasts.

You also need to be aware that while people may perceive you differently on first impression, implants will not magically change your life, or make you into a social butterfly if you weren't one before. What they will do, is help you to present yourself to the world the way you wish to be seen, and give you a boost of self-esteem.