Breast augmentation surgery is a procedure performed by placing implants (prostheses) or by transferring the person's own fat tissue, with the aim of increasing breast volume or reshaping the breasts. Loss of volume after breastfeeding, asymmetry between the two breasts, naturally small breast tissue and breast reconstruction after cancer treatment are the main reasons for the procedure.
Who is breast augmentation suitable for?
- Those who have experienced loss of breast volume after breastfeeding
- Those with marked asymmetry between the two breasts
- People whose breast tissue is naturally small
- Patients whose breast tissue has been removed due to cancer and for whom reconstruction is planned
Breast development is expected to be complete. If a pregnancy is planned in the near future, postponing the surgery is recommended; pregnancy and breastfeeding change the breast tissue significantly. As smoking adversely affects wound healing, patients are asked to stop before surgery.
Choosing an implant: teardrop or round?
The breast implants used today consist of a durable silicone elastomer outer shell and the cohesive silicone gel inside this shell. The consistency and cohesiveness of the silicone gel may vary depending on the implant model. By shape, breast implants fall into two basic groups: round and anatomical (teardrop) implants. The shape is chosen according to the person's chest wall structure, existing breast tissue and expectations:
Round implants have a symmetrical shape in the upper and lower poles. Today there are many round implant options with different diameters, heights, projections and gel properties. Thanks to new-generation cohesive silicone gels, round implants can also adapt to a natural breast shape when standing. For this reason, it is not correct to say that the result will be “natural” or “artificial” simply by looking at the shape of the implant.
Anatomical (teardrop) implants, on the other hand, are designed to be thinner at the top and fuller at the bottom. However, rotation of the implant around its own axis is a significant disadvantage of these implants, as it can distort the shape of the breast.
Today, instead of focusing only on the question “teardrop or round?”, implant selection should take into account the patient's chest wall structure, existing breast tissue, breast base width, skin quality, desired breast volume and cleavage appearance together.
The surface characteristics of the implant are also important. An association has been shown between a rare lymphoma called BIA-ALCL, which can develop in relation to the capsule around a breast implant, and textured (rough-surfaced) implants in particular. For this reason, implant selection today considers surface characteristics and safety data as well as shape.
Implants do not have a fixed lifespan; as long as no problem develops, they can remain in place for many years. However, they are not "lifelong" — replacement may be needed due to rupture, capsular hardening or changes in body shape. For this reason, regular check-ups and the recommended imaging follow-up over the long term (approximately 10-15 years) are important.
Where is the implant placed and through which incision?
The implant can be placed behind the chest muscle, beneath the muscle fascia or beneath the breast tissue. The placement is chosen according to the thickness of the person's breast tissue and their chest wall structure. The incision options are as follows:
| Incision site | Feature |
|---|---|
| Breast fold (inframammary) | The most common approach; the scar is hidden in the fold under the breast and the surgical field of view is wide |
| Around the nipple (areola edge) | The scar lies at the edge of the areola; it carries a relatively higher likelihood of affecting breastfeeding and nipple sensation |
| Armpit | No scar is left on the breast; the scar forms in the armpit. |
The most critical point of the operation is placing the implant under sterile conditions; this is decisive in preventing early and late problems. For this reason, the procedure must be performed in a healthcare facility that meets sterilisation requirements.
The surgery and the period afterwards
The procedure is performed under general anaesthesia and takes approximately 1.5-2 hours, depending on the plan. The patient usually stays in hospital for one day. Pain after surgery is low and easily controlled with painkillers. If the implant has been placed beneath the muscle, arm movements may be restricted for the first few days.
| Period | What to expect? |
|---|---|
| First day | A short period of observation follows surgery. Pain and tightness are controlled with medication. |
| First week | Swelling, tightness and tenderness may occur in the breasts. Regular use of a supportive medical bra is recommended. |
| 7–10 days | Most patients can return to daily life and desk work. Recovery may vary from person to person. |
| 4–6 weeks | Swelling gradually decreases and the implants begin to settle into a more natural position. Heavy lifting and intense exercise are avoided; return to sport is gradual, according to the surgeon's check-ups. |
| 3–6 months | The shape of the breasts and the position of the implants largely settle, the tissues soften and the final appearance is approached. |
Risks and what you should know
In addition to the general risks of anaesthesia and surgery (drug reactions, bleeding, infection, blood clots), there are risks specific to breast surgery: changes in sensation around the nipple, differences in shape or size between the two breasts, thickened scars, the edge of the implant becoming visible and the need for further surgery in the future.
Capsular contracture: It is normal for the body to form a thin layer of scar tissue (capsule) around the implant, and this helps keep the implant in place. If this capsule thickens and hardens, the shape of the breast may change and firmness and pain may occur; in this case an additional procedure may be needed.
A rare type of lymphoma associated with implants (breast implant-associated anaplastic large cell lymphoma) has been reported; its symptoms are swelling or a mass around the implant. You should consult your doctor for current information and recommendations on this subject.
Breastfeeding and breast cancer screening
Under normal conditions, implants do not affect pregnancy or breastfeeding; the milk ducts and milk glands are preserved during surgery. Even so, no absolute guarantee can be given for any technique.
Having implants is no reason to neglect your breast cancer screening. A mammogram can be performed; always inform the imaging centre that you have implants — special imaging techniques are used for breasts with implants, and ultrasound or MRI is added when necessary.
If the breast tissue is also sagging, the surgery can be planned together with a breast lift. For other procedures you can visit the breast aesthetic surgery page, and you can contact the clinic for an assessment.
Frequently Asked Questions
How is breast augmentation surgery performed?
Breast augmentation is performed by placing silicone implants or by transferring the person's own fat tissue. The implant is placed beneath the breast tissue or the chest muscle through an incision made in the fold under the breast, around the nipple or in the armpit. In fat transfer, fat taken from another area of the body is processed and injected into the breast. The method is determined at the consultation according to the person's tissue structure and expectations.
What is the recovery process like after breast augmentation?
In the first days there is a feeling of tightness and pain, which is controlled with medication. Most people return to daily life within 3-7 days. A sports bra is worn continuously for a few weeks. Heavy lifting with the arms and movements that strain the chest muscles are postponed for about a month. It takes 3-6 months for the implant to settle into the tissue and for the breast to take its final shape.
How long do silicone implants last, and do they need to be replaced?
Today's implants do not have a fixed "expiry date"; as long as no problem develops, they can remain in place for many years. However, implants are not considered lifelong: replacement may be needed in cases such as rupture, capsular hardening or a change in the person's expectations. For this reason, regular medical check-ups and the recommended imaging follow-up are important.
Does breast augmentation prevent breastfeeding?
Generally it does not. Because the implant is placed beneath the breast tissue or the muscle, the milk ducts are preserved with most techniques. Still, as with any surgery, no absolute guarantee can be given; with incisions made around the nipple, the likelihood of the milk ducts being affected is relatively higher. If you plan to breastfeed, the technique can be chosen accordingly.
Can I have a mammogram after breast augmentation?
Yes. A mammogram can be performed when implants are present, but you must always inform the imaging centre that you have implants; special imaging techniques are used for breasts with implants. Ultrasound or MRI is added when necessary. Do not neglect your breast cancer screening because you have had surgery — your follow-up programme is planned together with your doctor.