Both Allergan and Mentor publish data with respect to adverse outcomes after breast enlargement surgery with either silicone or saline breast implants. Disappointment with cosmetic outcomes of breast enlargement surgery with either silicone or saline breast implants are a result of miscommunication in preference or obvious defects. The former comes from the plastic surgeon and his or her patient not being on the same page with respect to shape, size, or incision placement. The latter is either an unavoidable fact of breast augmentation or a technical problem. Breast implant rippling and wrinkling, possible asymmetry with implant migration, scar migration, or audible sounds with manipulation that present months after the procedure are usually not the result of surgical misadventure. Asymmetry in shape, size, or incision placement immediately after the surgery can be attributed miscalculation. Hypertrophic scarring, implant visibility, implant palpability, and hardening of the breast capsule with resultant distortion in shape are typically not a result of surgical error.