Will Breast Density Limit My Plastic Surgery Options?

Getting good news about breast density and plastic surgery options

The last time you got your mammogram results, did you notice a little note about your breast density? If you are like 40 percent of women, it might have said something like, “Your breasts are heterogeneously dense, which may obscure small masses and may put you at greater risk of developing breast cancer in the future.” Though this may sound a bit scary, it’s actually a normal reading.

Normal breast density exists on a spectrum from not dense at all to extremely dense. Knowing this information is important; it helps women and their doctors decide which breast screening methods are best, and how often they should get them. According to the American Cancer Society, whether a woman has dense breasts or not, regular screenings (mammograms in particular) are still the best way to find cancer early.

Because of the relationship between breast density and cancer risk, it is now the law in many states that breast density information be conveyed to each woman who has a mammogram. You may have seen talk of this newer legislation on the news.

What this means is that more women than ever before know that breast density matters, and many can tell you just how dense their own breasts are. Knowing this has also left some women wondering if their breast density will affect their options when it comes to cosmetic breast surgery.

To help answer this question, it will help if we first explain what doctors mean when they talk about breast density.

Breast density is a radiologic (mammogram) finding that has nothing to do with how breasts look or feel from the outside. The classification of density has to do with the ratio of fat (not a dense tissue) to everything else that makes up the breast, including glandular and fibrous tissue. On a mammogram, the fat shows up dark and the other stuff shows up white. The more white seen on a mammogram, the more dense the breast classification. The breast density classifications that may be assigned are – from least dense to most dense – the following:

  1. Fatty
  2. Scattered Fibroglandular
  3. Heterogeneously Dense
  4. Extremely Dense

Only about 10 percent of women are categorized as having extremely dense breast tissue. You can learn more about these breast density types, and see images too, at the American Cancer Society.

Here at North Texas Plastic and Reconstructive Surgery, Dr. Slack performs a wide range of cosmetic breast procedures including breast implants, liposuction, breast lifts, and breast reductions. In some cases, he may perform a combination of one or more of these procedures, depending on the goals of the patient. Here is how breast density may come into play with each of these procedures:


Breast implants are placed underneath the breast tissue not within in. This means that the breast tissue itself, no matter how dense, sits on top of the implant and therefore has little bearing on whether a breast implant is possible.


Liposuction alone is sometimes an option for women who are looking for a mild reduction in breast size. It is possible that a woman with extremely dense breasts, which means they have a lower ratio of fat to other tissue, may have a limit as to how much fat can be successfully removed using this method.

Breast Reduction or Lift

A breast reduction or lift sometimes includes liposuction, and the limitation just mentioned may come in to play to some degree. However, because these procedures also include an open surgical component, the goal of the reduction usually isn’t limited by breast density.

Here is the big takeaway: None of these procedures are off limits to a woman simply because she has higher breast density.

There are many factors that will limit a person’s plastic surgery options, including poor health, weight instability, and a bad smoking habit, but breast density usually isn’t one of them. That said, every person who walks into our clinic has their own unique anatomical identity, and that includes breast density. Dr. Slack takes all of this (and more) into consideration when advising each patient and planning their surgery.

If you have more questions about breast density and which breast procedures might be right for you, call our office today and schedule a consultation with Dr. Slack.

Breast Implants and Mammograms

Woman waiting for mammogram

“Mammograms are so fun, I can’t wait to get my next one,” said no woman ever.

Nonetheless, every year millions of women do get them because early detection is one of the keys to surviving breast cancer. So, what if you have breast implants; can you still get a mammogram? Is a mammogram still effective? The short answers are yes and yes.

The American Cancer Society tells us, “If you have breast implants, you should still get regular screening mammograms.” While breast implants can make it harder to see certain parts of the breast, mammograms are still effective.

A 2015 study, published in the journal The American Surgeon, found no significant difference in cancer detection rates between women with or without breast implants. “Because implants did not significantly affect mammogram results,” say the authors. “Women with implants should be reassured that mammography remains useful in detecting cancer.”

That said, if you have breast implants and are going to get a mammogram, there are a couple things you should know.

Your exam will be a little different

Your breast implants are nobody’s business – most of the time. But when it comes to mammograms and issues relating to breast cancer, it is in your best interest to let your doctor and mammogram technician know about your implants. This is because they need to slightly alter your exam.

Four extra pictures (two on each breast) called implant displacement (ID) views will be taken. For these, the implant is pushed back against the chest wall, and the breast tissue is pulled forward. These views are a little tricky to do and they can be uncomfortable, especially for women who have a lot of scar tissue.

Your mammogram technologist should also be aware of your breast implants because, though very rare, implants have ruptured. Further, if you already have any breakage or leaking, a mammogram can make it worse.

The type of implant you have may matter

All breast implants are not created equal. The older they are, the easier they can be damaged by undue force. The materials used and the design of the implant can also impact the risk of rupture. Read more in our post, Saline or Silicone: Choosing the Right Breast Implant for You.

Some radiologists say that mammograms are better and easier for women if the breast implants are under the chest muscles. Others say it has no effect at all. Talk to your plastic surgeon before you have a mammogram if you have any questions or concerns.

“The benefits of getting a mammogram far outweigh the risks of implant damage,” say experts at the University of Texas MD Anderson Cancer Center. If you are considering breast implants, you should get a mammogram before and, as soon as it’s safe, after. This way you will have a baseline for further mammogram comparison.

More than anything it is important to keep the lines of communication open between you, your doctors, and technicians involved in the examination of your breasts. Don’t be shy; before you have a mammogram tell them about your breast implants.

If you are thinking about having a breast augmentation but have concerns about its impact on breast examinations and cancer prevention, Dr. Slack would be happy to answer your questions. Get in touch to schedule your consultation.