Breast augmentation is an operation performed to increase breast volume, improve symmetry, or restore a deflated look after pregnancy and weight loss. Silicone implants are used in most cases; for some patients, the person’s own fat tissue can be an alternative. This guide is for people considering the operation who want to understand the key decisions in choosing an implant.
Key decisions in choosing an implant
Implants are made filled with either silicone gel or saline. Today, silicone gel implants, which feel close to natural breast tissue when touched, are mostly preferred.
In terms of shape, there are round and anatomical (teardrop) implants. A round implant gives more fullness in the upper pole; a teardrop implant gives a look with a fuller lower pole and a softer transition at the top. Which shape is suitable is determined by the width of the chest wall, the existing breast tissue and the look you expect.
The surface can be smooth or textured. Because a rare type of lymphoma (BIA-ALCL) associated with textured-surface implants has been described, the choice of surface should be discussed openly with the physician.
There are two main options for placement: under the chest muscle, or under the breast tissue on top of the muscle. Under-the-muscle placement hides the edges of the implant better in patients with thin tissue; over-the-muscle placement can make recovery somewhat easier. The dual plane technique, which combines the two approaches, is also commonly used.
The incision can be in the fold under the breast, at the edge of the areola or in the armpit. The incision in the fold under the breast is often preferred both because the scar is hidden in the fold and because it allows precise placement of the implant.
Choosing the size is not just a question of how many milliliters. The physician measures your chest width and the elasticity of your skin; implants that are too large for the body can lead to sagging and thinning of tissue in the long term.
Who is it suitable for?
- Adults whose breast development is complete
- People who are not pregnant or breastfeeding, and who have waited the period the physician recommends after finishing breastfeeding
- People whose weight has been stable for a long time
- People who are not planning a pregnancy soon; pregnancy and breastfeeding can change the result
- People with no active breast disease, who share any family history with the physician
- Non-smokers, or those who can quit during the period of surgery
- People who know that if there is marked sagging, augmentation alone may not be enough and it can be combined with a breast lift (mastopexy)
The surgery process
Initial assessment and measurements
A specialist physician reviews your photos and health information; chest measurements, breast tissue and expectations are assessed. The implant type, placement and incision plan are sent to you in writing. If the physician considers it necessary, breast imaging is requested before surgery.Day of surgery
The operation is performed under general anesthesia and usually takes one to two hours. Most patients stay one night in the hospital.The first days
There is tightness, swelling and tenderness in the chest. A special sports bra is worn from the first day. Daily activities can be resumed quickly as long as the arms are not raised above shoulder level.Checkups
At the first checkup, the dressing is changed and the position of the implant is assessed. The stitches mostly dissolve on their own; if non-dissolvable stitches were used, they are usually removed within the first two weeks.A stay of 5-7 days is usually planned for breast augmentation. The first dressing is done the day after surgery or within a few days, fitness to fly is assessed after the checkup, and if there are non-dissolvable stitches they are removed either here or in your own country. The exact duration varies according to the physician’s plan.
Recovery and what to watch for
Light activities are usually resumed within the first week; for heavy lifting, running and exercises that work the chest muscles, the physician usually asks you to wait several weeks. The sports bra is worn day and night for the period set by the physician. It can take months for the swelling to go down and the implant to settle into place; during this time the breasts may sit a little high and feel firm.
Possible risks include a hard capsule forming around the implant (capsular contracture), rupture or displacement of the implant, a rippling appearance under the skin, a change in nipple sensation, bleeding, infection and asymmetry. Implants are not lifelong devices; replacement or revision surgery may be needed over the years. When having a mammogram, you need to say that you have an implant. Breastfeeding is possible for most patients but may be affected.
Augmentation with fat transfer
A person’s own fat tissue can be taken by liposuction and injected into the breast. This method contains no foreign material and is useful for fine corrections. However, the volume increase that can be achieved is limited, some of the fat is absorbed over time, and it may not be possible in thin patients who do not have enough fat stores. For patients who want a marked increase in size, an implant gives a more predictable result; the two methods are sometimes used together.
You can get a free initial assessment by sending your photos and health information; a specialist physician reviews your photos, and implant options and the plan are sent to you in writing. This article is for general information only; a definitive diagnosis and treatment plan are determined by a specialist physician’s examination.
