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Most women opting for any of the three breast procedures are young and healthy; however, a full medical evaluation is still required. For instance, if you smoke or are overweight, your health care professional may counsel you to quit smoking and/or lose weight, both of which reduce the risk of complications from surgery. Other things to tell your surgeon include:

• Other surgeries you've had on your breast or chest wall

• Medications you're taking, including over-the-counter drugs, herbal and nutritional supplements and vitamins

• Any family history of breast cancer. While it is safe and recommended to have a mammogram with breast implants, you should ask your physician to direct you to a screening facility that offers a specialized technique that has been shown to improve the accuracy of mammograms in women with breast implants.

  Additionally, if you're having breast reduction surgery, it's a good idea to ask your surgeon to have the breast tissue evaluated by a pathologist. This evaluation could pick up early signs of breast cancer or cellular changes that signify an increased risk of developing breast cancer.

• Your expectations. Be very honest with yourself and your surgeon. What do you expect your breasts to look like after surgery? How long do you expect the recovery to take? What is your understanding of the risks and limitations? Do you expect the breast implants to last forever?

At the same time, you need to ask your surgeon for a realistic description of what the surgery will entail, how long recovery will take and what complications might arise.

Additionally, your surgeon should explain what type of anesthesia will be used, where the surgery will be performed (typically in a hospital operating room, outpatient surgical center, or office operating suite), and how much the procedure costs. Very few insurance companies cover breast augmentation or lift for cosmetic reasons, and costs for the surgeon's fee alone can run more than $4,000. The national average for breast augmentation surgery is $3,600, and the national average for a breast lift is $4,220. You'll also have to pay for the operating room, postsurgical hospital stay, anesthesia and other costs.

Breast Augmentation

The decision to have breast augmentation is a personal one, often driven by a woman's individual motivations to look as good as she feels. Women choose breast augmentation for many reasons: to restore and reshape, to reduce, to increase the size and shape of their breasts and to enhance their bodies. A recent NWHRC survey found that life-changing events such as childbirth, significant weight loss or divorce often trigger changes in a woman's mindset, inspiring improvements around health, fitness, and, for 42 percent of women, physical appearance. Of those women motivated to improve their appearance, nearly half (45 percent) said they would consider plastic surgery to do so. If they were to consider breast augmentation surgery, 54 percent of women would be motivated to reshape their breasts after a major physical change, such as childbirth, breastfeeding or significant weight loss.

Some women have very small breasts, called micromastia. For these women especially, breast augmentation can significantly improve their overall self-confidence, self-perception and sense of attractiveness.

Make sure you ask your physician about the long-term implications of living with breast implants. For instance, when you have a mammogram, your mammography technician should use a specialized technique that has been shown to improve the accuracy of mammograms in women with breast implants. This technique involves shifting the implant so the compression paddles compress and examine only breast tissue.

Similar to other medical devices, breast implants—saline or silicone—are not lifetime devices. It is likely that at some point they may need to be removed or replaced and you should talk to your surgeon about this prior to surgery. A U.S. Food and Drug Administration study found that about one third of the 907 women interviewed said they had at least one operation to replace or remove a breast implant, and the average time between getting implants and having additional surgery was 11.5 years.

Also consider the costs of the procedure. The national average cost for breast augmentation is $3,600 for the surgeon's fee alone. You'll also have to pay for the operating room, postsurgical hospital stay, anesthesia and other costs. If your breast implants need to be removed or replaced at some point, this will involve additional costs. However, some breast implant manufacturers offer financing plans, which allow you to pay over time, and extended warranty plans (free and for a small charge) that cover all or part of future replacement costs.

Breast Lift

Gravity, pregnancy, nursing and age all contribute to the drooping and sagging of a woman's breasts over time. As the skin stretches and the breasts begin to sag, some women turn to a procedure called mastopexy, or breast lift, to restore their breasts to a perkier, more youthful appearance.

Sometimes mastopexy is performed together with a breast implant, particularly if a woman's breasts have shrunk after pregnancy. The American Society of Plastic Surgeons (ASPS) says the best candidates for mastopexy are healthy, emotionally stable women with realistic expectations of what the procedure will accomplish, particularly women with small, sagging breasts.

If you haven't finished childbearing, the ASPS recommends you wait; another pregnancy and breastfeeding may stretch your breasts again, although the procedure doesn't affect your ability to breastfeed. Also keep in mind that the results aren't permanent; gravity and age may eventually take their toll once again.

Breast Reduction

For some women, extremely large breasts can cause numerous problems beyond potential dissatisfaction with their appearance. These include neck and back pain, shoulder pain, chafing or rash, significant limitation in your activities and unhappiness with your appearance. Other problems include chronic headaches and even nerve damage.

Psychological issues include depression and stigmatization and poor self-esteem and anxiety. You may also have problems finding clothing that fits. Extremely large breasts, especially in adolescents, can significantly affect a woman's body image.

The significant emotional and physical repercussions of extremely large breasts mean that many health insurance companies are willing to pay for breast reduction surgery, also called reduction mammaplasty, but some may require that a certain amount of breast tissue be removed. Check your policy, including whether your surgeon needs to write a "predetermination letter." Although considered "cosmetic" in nature, reduction mammaplasty has functional benefits for the majority of women.

The surgery is considered one of the most rewarding breast operations, with profoundly positive effects on the physical and mental health of women who have unusually large breasts (also called hypermastia). One study even found a significant improvement in a woman's sexual satisfaction if she was satisfied with the results of her surgery.

Although the procedure is performed on women of all ages, it may also be performed on adolescents whose psychological health is threatened because they are teased about their breast size or unable to wear typical teenage clothing.

Before deciding on breast reduction, you should undergo a full medical evaluation. If you smoke, your doctor will likely ask you to quit, since smoking can interfere with the healing process. You should also stop taking any herbal supplements and should undergo a mammogram before the procedure.

If you're overweight, your doctor may recommend that you lose weight before the procedure. There are two reasons losing weight is important before the surgery: the risk of surgical complications increases if you're obese, and the surgery itself is easier to perform if you're at your ideal weight. Additionally, excess weight may be contributing to the size of your breasts.

Many women worry about their ability to breastfeed after breast reduction surgery. In most instances, breastfeeding shouldn't be a problem, assuming you have adequate support and encouragement.