Breast augmentation is one of the most frequently performed surgical procedures, addressing women who wish to increase their breast size or improve their breast shape. It also concerns women whose breasts have an uneven size between them, which affects their self-confidence and psychology. In breast augmentation, high-quality silicone implants are used, which are approved by the US Food and Drug Administration ( FDA ).
What is breast augmentation?
Breast augmentation can improve breasts that have lost volume due to pregnancy or weight loss.
Implant Types Silicone implants can contain silicone gel or saline, and in terms of shape, they are divided into two categories: 1. Anatomical Implants (teardrop or drop-shaped) Anatomical implants resemble teardrops, meaning their lower pole projects more than the upper. Their surface can be smooth, textured, or even have a polyurethane coating, a material similar in consistency to a sponge. Many plastic surgeons consider them a better option because they more closely resemble the natural breast shape, providing a more natural result. However, there are also plastic surgeons who argue that the shape of the implant does not play a decisive role in the final shape the breast will have. This is because gravity, muscle pressure, and tissues in general will affect the breast's shape over time. Furthermore, anatomical implants must always be placed with the side that has greater volume positioned lower; meaning if the implants rotate, some asymmetry may occur between the breasts. Finally, anatomical implants have a higher cost than round implants, not due to quality, but due to their manufacturing process. 2. Round Implants Round implants can have a smooth or textured shell and, as their name suggests, have a round shape. Additionally, the advantage of round implants is that even if they "rotate," no deformity will be created in the breast's shape. These were the first implants manufactured and remain a timeless value in breast augmentation for plastic surgeons worldwide.
Doctor's Advice
For women over 40 years old, a mammogram precedes breast augmentation surgery, while for women under 40, a breast ultrasound precedes the procedure.
Size Selection The size of the silicone implant to be placed is something that will likely concern you greatly, and quite rightly so, in our opinion. There are two decisions regarding the suitability of the implant that need to be made. In one of these, you can and should participate , and it concerns the volume in cc/ml . The other decision is solely your doctor's, based on the measurements they will take of your chest and breast, and the aesthetic result you wish to achieve.
There are high, moderate, and low profile implants. The appropriate implant type for each case is selected based on breast size, implant projection, and the desired outcome, naturally after extensive discussion with the interested individual. . Breast augmentation is a procedure that combines art with science. You can find the implant size that suits you on your own. Do the rice test!
Placement Position During the first visit, after the necessary measurements, the incision point and the implant placement position will be chosen.
The incision can be made in the: inframammary fold nipple area (periareolar incision) armpit (less common) The incision is quite small, approximately 4cm , and the sutures used are absorbable, meaning they do not need to be removed. Many women prefer the periareolar incision upon hearing about it, thinking the scar will be well hidden there, and request it from their doctor. However, the inframammary incision is also well hidden, in the fold created by the breast with the chest wall, and moreover, according to literature, it is the safest method for capsule formation.
The implant placement can be: Under the muscle Placing the implant under the muscle is chosen primarily for breasts that do not have enough fat to cover the implant, with the advantage of having a lower chance of capsule formation. However, it usually involves a longer post-operative recovery time and a need for more analgesics (painkillers). Above the muscle and under the mammary gland (breast) In contrast, placement above the muscle is primarily done in breasts that have a sufficient amount of fat and cover the implant, thus providing a more natural visual and palpable result. Dual plane (half of the implant above the muscle and half below) In the third placement technique ( dual plane ), the implant is placed under the muscle on one side and above the muscle on the other side, thus combining the advantages of both aforementioned implant placement methods, and therefore is chosen more frequently .
The surgery in brief Breast augmentation surgery is performed under general anesthesia and lasts approximately 60 minutes . An incision is made at the chosen location mentioned above (inframammary fold, nipple area, armpit) to create the implant “ pocket ” at the selected placement site. After careful hemostasis and inspection of the area, the implants are placed. They have a unique barcode marking that you will receive with your discharge papers and should keep. Skin and muscle suturing, if placement under the muscle was chosen, is performed with absorbable stitches. Drain placement is not necessary and is performed only in cases where the surgeon deems it essential . Hospital stay after the surgery can range from a few hours to an overnight stay . A compressive bandage (sports bra) is applied, while any pain can be managed with analgesics. In the following days, some doctor's appointments are scheduled to monitor the postoperative course and check the incisions.
Durability of silicone implants Due to their excellent quality, silicone implants can remain without any problem for decades. However, after a few years from their placement, it is advisable to check them with ultrasound or MRI , and if a problem arises, they may need to be replaced.
Helpful tips
Most companies offer a lifetime warranty in case of implant rupture, providing you with a free replacement.
Post-operative instructions For the first 2-3 days , rest is recommended, while gentle athletic activity such as walking is permitted 1 week later . Furthermore, immediately after the surgery and for one month , a compressive bandage (sports bra) is worn, while strenuous physical exertion is forbidden for the same period .
Bibliography Grabb and Smith's Plastic Surgery, 8th edition, Kevin C. Chung Manual of Aesthetic Surgery Vol. 2, 2005, Werner L. Mang Özalp B, Aydinol M. Breast Augmentation Combining Fat Injection and Breast Implants in Patients With Atrophied Breasts. Ann Plast Surg . 2017;78(6):623–628. doi:10.1097/SAP.0000000000000935 Cheng F, Cen Y, Liu C, Liu R, Pan C, Dai S. Round versus Anatomical Implants in Primary Cosmetic Breast Augmentation: A Meta-Analysis and Systematic Review. Plast Reconstr Surg . 2019;143(3):711–721. doi:10.1097/PRS.0000000000005371 Tebbetts JB. Dual plane breast augmentation: optimizing implant-soft-tissue relationships in a wide range of breast types. Plast Reconstr Surg . 2001;107(5):1255–1272. doi:10.1097/00006534-200104150-00027 Atiyeh B, Chahine FM. Design for Natural Breast Augmentation: The ICE Principle. Plast Reconstr Surg . 2017;139(2):568e–569e. doi:10.1097/PRS.0000000000003002
Consultation Consultation Appointment with Plastic Surgeon — 50,00 € Video Call with Plastic Surgeon — 25,00 € The treatment price is set individually after the assessment.
How long will I have to be away from work?
Time off work does not exceed 1 week, while driving should be avoided for 2 weeks, or until any discomfort subsides.
Does breast augmentation affect breastfeeding?
No, silicone implants do not affect breastfeeding, except in less than 2% of cases.
Are there complications?
Breast augmentation is a safe procedure with an excellent postoperative course in most cases. However, as with any other surgery, there are potential complications, such as: Capsular Contracture This is a natural process of the body to create a membrane that surrounds any foreign object placed in our body. However, if this membrane is too hard, it can press on the implant, deforming the shape of the breast, which is called a capsular contracture. In such a case, a procedure called capsulectomy and implant replacement may be performed. Implant Rupture Implant rupture is a complication that can be due to material failure, surgical error, or injury to the implant. Confirmation of rupture is done by MRI, and treatment is surgical with implant replacement. Most major companies offer a lifetime warranty for their prostheses and provide new implants free of charge to replace ruptured ones, unless it is proven to be a consequence of an accident or iatrogenic injury. Loss of Nipple Sensation A common, but almost always temporary, complication is a change in nipple sensation. Patience is needed as sensation may fully return after 6 or even 12 months. Asymmetry Something that naturally occurs in all women is breast asymmetry, and this is one reason why a woman may undergo breast augmentation. However, slight asymmetry may still be observed post-surgically. Incision Dehiscence - Hypertrophic Scars Scar healing varies for each patient. Rarely, and especially in smokers, there may be a small dehiscence of the incision. Hematoma Accumulation of a small or larger amount of blood in the breast. This is an extremely rare complication. Infection This is not a common complication, as the surgical conditions strictly follow all antiseptic rules. However, if it occurs, it is treated with antibiotic therapy, or in the worst case, with implant removal.
