Mammograms may be more complicated. Additional views are necessary when obtaining images of your breasts. The quality of the mammogram will depend on the experience of the tech doing the procedure. They may even employ ultrasound. As for self exams, since it is sa surgical procedure to enhance the breast, scar tissue formation is always present. Depending on the procedure used (nipple insertion, underarm, under breast, or umbilical) the scar tissues may or may no be as noticable. Also some impnats can ripple during certain positions, but relax when arms are at rest.