What is Breast Augmentation?
What is breast augmentation, what does it change and what does it not change?
Breast augmentation (augmentation mammoplasty) is a surgery that increases breast volume using silicone implants or the patient’s own fat. In everyday language it is also called breast enlargement, silicone breast or breast prosthesis surgery. It is considered for breasts that appear deflated after pregnancy, breastfeeding or weight loss, for breasts that are small relative to body proportions, and for volume differences between the two breasts. An implant is placed behind the breast tissue or the chest muscle to project the breast forward and provide upper‑pole fullness.
Knowing the limits of breast augmentation is important to set realistic expectations. Significant ptosis, downward‑pointing nipples and excess skin are not corrected simply by adding volume; in such cases breast lift is discussed additionally. Natural asymmetry of the chest wall, rib structure and the distance between the breasts cannot be completely changed with implants. Separate information is available for relief of symptoms due to large, heavy breasts (breast reduction) and for male breast enlargement (gynecomastia).
Implant, fat transfer, or combined with a lift?
The method in breast augmentation is chosen not by the name of the request but according to the volume deficiency, excess skin and nipple position found on examination. The table below summarizes the general relationship between examination findings and commonly considered approaches; the personal plan is determined during the consultation.
| Finding | Commonly considered approach | Note |
|---|---|---|
| Low volume, nipple in place, tight skin | Breast augmentation with implant | Incision and placement chosen according to tissue thickness |
| Limited volume increase desired, sufficient donor fat | Fat transfer | Part of the transferred fat is resorbed; a second session may be required |
| Thin skin and little breast tissue | Submuscular or dual plane placement | Reduces the likelihood of visible implant edges |
| Thin tissue coverage, sufficient donor fat | Implant plus fat transfer (hybrid) | Fat helps to camouflage implant edges |
| Volume loss and significant ptosis | Implant with breast lift | Planned in the same session or staged; scar is larger |
| Marked asymmetry | Different volume implants or additional procedures | Difference is reduced; perfect symmetry should not be expected |
Which implant characteristics are discussed?
Implant selection in breast augmentation is not only about volume (cc); filler material, shape, surface and profile are considered together. The table below summarizes what each characteristic affects; a brand or model name alone does not indicate overall quality.
| Characteristic | Options | What it affects |
|---|---|---|
| Filler material | Silicone gel or saline | Feel to the touch and follow‑up; rupture of a saline implant is noticed by deflation, whereas silicone often requires imaging to detect |
| Shape | Round or anatomic (teardrop) | Upper‑pole fullness; rotation of an anatomic implant can distort shape |
| Surface | Smooth or textured | Stability in position; textured surfaces have been more frequently associated with BIA‑ALCL |
| Profile | Low, medium or high | How far the breast projects forward |
| Volume (cc) | Determined according to chest measurements | The same volume appears more prominent on a narrow chest and less so on a wide chest |
Op. Dr. Hasan Büyükdoğan explains during the consultation why the recommended implant was chosen by comparing your measurements and expectations. After surgery you will be given an implant card showing the manufacturer, model, volume and serial number; keeping this card is important if you later see another physician.
What can be done at the same operation as breast augmentation?
The procedures most commonly planned together with breast augmentation are breast lift, postpartum changes addressed with tummy tuck, and liposuction in areas where fat will be harvested for transfer. Fat harvested for transfer can be used not only to augment the breast but also to improve the contour of the donor area. Additional procedures complement the result but can prolong operative time and recovery; therefore each additional procedure’s necessity and its effect on the recovery timeline are discussed individually at consultation.
Where will the breast augmentation scar be?
The scar from breast augmentation is most often located in the inframammary fold (under‑breast crease); in some patients the lower edge of the areola or the axilla is chosen. The inframammary incision is covered by bras and swimsuits and usually lies within the fold when standing. Scars at the areolar edge may become less noticeable over time because they coincide with the color transition; the axillary incision leaves no scar on the breast. Scars appear pink in the early months and mature over 6–12 months. If a breast lift is added there will be a scar around the areola and, if needed, a vertical scar as well.
How is follow‑up performed over the years with breast implants?
Breast augmentation does not end with the operation; implants require regular follow‑up while they remain in place. Because silicone implant rupture often does not produce symptoms, imaging in addition to clinical examination is important. The schedule below provides a general framework; your personal follow‑up plan will be given after surgery.
| Time | What is done |
|---|---|
| First week | First check; wound, swelling and support bra are evaluated |
| First year | Planned checks monitor shape, symmetry and scars |
| 5–6th year | Even without symptoms, first MRI or ultrasound for silicone implants |
| Afterwards | Imaging and examination every 2–3 years |
| At any time | New swelling, hardening, pain or change in shape should prompt immediate review |
Implant follow‑up does not replace age‑appropriate breast cancer screening. Inform imaging personnel about your implant and keep your implant card with you when having mammography or ultrasound.
What is different in a second‑time breast augmentation?
For patients who already have implants, exchange may be considered because of capsular contracture, implant malposition, rupture or desire to change volume. These operations often include removal of the old implant, partial or complete capsulectomy if necessary, and redesigning the pocket; the plan differs from a primary operation. Bring the date of the previous surgery, the implant card and any imaging reports to the consultation.
How should breast augmentation offers be compared?
When comparing breast augmentation offers, look at what is included before the total price. Two operations with the same name may involve implants from different manufacturers, different placement planes and different services. Asking the following questions when requesting a quote will help you compare offers properly:
- Which method is recommended: implant, fat transfer, both together, or implant with lift?
- Is the manufacturer, model, surface and volume of the implant to be used specified in writing?
- Into which plane and through which incision will the implant be placed?
- Who will perform the surgery, and does the price include anesthesia and hospital fees?
- Are support bras, medications and follow‑up visits included in the quote?
- What does the manufacturer’s implant warranty cover, and what are the conditions for corrective surgery if needed?
- Should MRI or ultrasound checks over the years be arranged separately?
Cosmetic breast augmentation is not covered by SGK; cases with a medical indication are evaluated separately.
If you are coming from another city or abroad
Op. Dr. Hasan Büyükdoğan's clinic is located on Bağdat Caddesi in Kadıköy on the Asian side of Istanbul. Patients coming from other cities or abroad are generally advised to stay in Istanbul for 5–7 days after breast augmentation; the first postoperative check and wound assessment are performed during this period. Pre‑assessment photos can be shared securely; however, a definitive plan requires in‑person measurements during the consultation. Consultations can be conducted in Turkish, English or German.
What the procedure can address
Not every patient receives the same treatment; the points below may be considered together or separately, depending on the person:
- 01Breasts that are small relative to overall body proportions
- 02Loss of volume and a deflated appearance after pregnancy, breastfeeding or weight loss
- 03Lack of fullness in the upper pole of the breast
- 04Volume difference between the two breasts (asymmetry)
- 05Need for implant exchange or correction after a previous breast augmentation
Who may be a candidate?
Who may be a candidate?
Breast augmentation is considered for individuals whose breast development is complete, who are in adequate general health for surgery and who have realistic expectations; cosmetic implant augmentation is generally planned after age 18. After pregnancy and breastfeeding, it is usually advisable to wait at least 6 months for breast tissue to settle. The decision should be the patient’s own, weight should be stable and the ability to stop smoking is important; breast health investigations are completed before surgery according to age and history.
Who may not be suitable?
- Pregnancy or breastfeeding period
- Breast mass, nipple discharge or a new breast complaint without completed medical evaluation
- Uncontrolled chronic disease or any health condition that contraindicates surgery
- Inability to stop smoking or nicotine use before surgery (increases risks of wound healing problems and capsular issues)
- Significant planned weight change in the near future
- Decision based on someone else’s desire or a promise of a specific clothing size
Breast augmentation does not correct ptosis by itself and cannot guarantee a specific bra size. The goal is to achieve a volume and shape harmonious with the patient’s breast anatomy.
The doctor's examination approach
The examination looks beyond appearance to the person's overall anatomy and expectations. Key points assessed:
- Chest width and breast base diameter
- Breast tissue and skin thickness
- Skin laxity and elasticity
- Nipple position and degree of ptosis
- Differences between the two breasts
- Rib cage and sternum structure
- Pregnancy, breastfeeding and previous breast procedures
- Desired volume and level of naturalness
The process
In planning breast augmentation, breast and chest measurements are taken during the consultation, standard photographs are taken, and the capacity of the skin and breast tissue to support volume is assessed. Implant volume, shape (round or anatomic), surface, placement plane and incision site are discussed based on these measurements; the manufacturer and model of the product to be used are provided in advance. If ptosis is present, the need for a lift is explained in the same visit. Pregnancy plans, desire to breastfeed and regular sports activities are also discussed because they can affect placement and incision choice. Preoperative blood tests, age‑ and history‑appropriate breast imaging and, if necessary, anesthesia evaluation are completed before surgery.
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1
Consultation and measurements
Breast and chest measurements are taken; expectations, medical history and previous procedures are discussed.
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2
Implant and plan selection
Volume, shape, surface, placement plane and incision site are determined together; product information is provided in writing.
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3
Preparation
Blood tests and required breast imaging are completed; instructions regarding smoking, medications and supplements are given.
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4
Surgery
Usually takes 1–2 hours under general anesthesia; the implant is placed into the planned pocket and the incision is closed in layers.
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5
Discharge
Most patients are discharged the same day or after one night wearing a support bra.
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6
Follow‑ups
First check is within the first week; subsequent checks and long‑term implant follow‑up are planned and you are given an implant card.
Technique and medical approach
The method depends on the patient; no single technique suits everyone. Main points considered:
| Approach | Description |
|---|---|
| Inframammary fold incision | The incision is placed in the natural crease under the breast and is covered by a bra. It is commonly used for implant placement and for potential future changes. |
| Periareolar incision | The incision is made at the lower edge of the areola. It is considered if the areola diameter is sufficient or if a minor lift is planned; breastfeeding and sensation are discussed separately. |
| Transaxillary incision (through the armpit) | Leaves no scar on the breast; the incision is located in the axillary crease. It is not suitable for every implant type or breast anatomy. |
| Submuscular and dual plane placement | The upper portion of the implant sits under the chest muscle. It is often preferred when skin and breast tissue are thin to reduce visible implant edges; the implant may move somewhat when the chest muscle contracts. |
| Subglandular placement | The implant is placed behind the breast tissue and in front of the chest muscle. It is considered when breast tissue thickness is sufficient; implant shape does not change with muscle contraction. |
| Fat transfer and hybrid approach | Fat harvested by liposuction from the abdomen, flanks or thighs is processed and injected into the breast. Alone, it is considered for patients wanting limited volume increase who have sufficient donor fat; part of the transferred fat is resorbed. It can also be used with an implant to help camouflage implant edges (hybrid augmentation). |
Preparing for the procedure
The points below are general information and do not replace personal medical instructions. Your own preparation is set at the examination.
Recovery
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Day 0–1
First day
You are discharged the same day or after one night wearing a support bra; there is a feeling of tightness and pressure in the breasts. Short walks are started immediately.
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Day 2–7
First week
Swelling and tenderness are most pronounced; the first check is performed within this week. Sleep on your back with the head slightly elevated; use your arms for daily tasks but avoid heavy lifting. Showering is allowed on the day specified by your surgeon.
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Day 8–14
Second week
Pain markedly decreases; most patients return to desk work and daily life within 1–2 weeks. Back‑sleeping is usually advised for the first 2 weeks; after that, with your surgeon’s approval, you may lie on your side while wearing the support bra.
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Week 3–8
First two months
Driving and increased walking are resumed with surgeon approval. The support bra is generally worn for 4–6 weeks; return to running and lower‑body exercise at 4–6 weeks and to chest and arm weight training at 6–8 weeks with approval.
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3–6 months
Months
Implants settle, upper‑pole fullness softens and the final shape becomes clearer; changes in nipple sensation mostly improve during this period.
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6–12 months and beyond
Long term
Scars mature and lighten. Even without symptoms, the first MRI or ultrasound for silicone implants is recommended at 5–6 years, then every 2–3 years.
In the first days after breast augmentation patients more often describe tightness and pressure rather than severe pain; this sensation may be more noticeable if the implant was placed under the muscle and is generally controlled with prescribed medications. Rapidly increasing swelling, increasing pain, redness, discharge or fever in one breast should be reported to the surgical team without waiting for the scheduled appointment; for shortness of breath or chest pain seek emergency medical care.
Results and realistic expectations
The result of breast augmentation becomes clear within 3–6 months as swelling subsides and implants settle. Pregnancy, breastfeeding, significant weight changes and aging continue to alter breast tissue over the years; even if implant volume remains the same, surrounding tissue may sag. Breast implants are not lifetime devices; even without problems regular checks are necessary and implant exchange or removal may be considered at some stage of life.
Risks and limitations
The risks of breast augmentation are explained before surgery according to the patient’s health and the implant to be used. In addition to general surgical risks, there are long‑term risks specific to implants; the most commonly discussed is capsular contracture. Smoking, infection and hematoma increase this risk; therefore preparation and long‑term follow‑up are important.
- Collection of blood or fluid under the skin (hematoma, seroma)
- Infection, anesthesia‑related risks and thromboembolism
- Capsular contracture: hardening of tissue around the implant and distortion of shape
- Implant rupture (silent rupture in silicone implants that often gives no symptoms), malposition or visible rippling under the skin
- Temporary or permanent changes in nipple and breast skin sensation
- Asymmetry, noticeable scarring and the need for revisional surgery
- A rare lymphoma associated with implants (BIA‑ALCL) and other rare tumors reported in the capsule; more commonly associated with textured surfaces
- Systemic symptoms some patients associate with implants (breast implant illness) such as fatigue, joint pain and concentration difficulties; causes are not yet fully understood
Alternative and complementary options
In some cases other methods may be considered. Each has its own limits and is not right for everyone:
| Method | Description |
|---|---|
| 1Breast lift | If the main complaint is ptosis and low‑lying nipples, a lift elevates and reshapes the breast without adding volume. |
| 2Fat transfer | Provides a more limited volume increase for patients who do not want implants and have sufficient donor fat; multiple sessions may be required. |
| 3Padded or molded bras | Create a fuller appearance within clothing without surgery; do not produce permanent change. |
| 4Non‑surgical methods | Injectable fillers into the breast are not an FDA‑approved use for breast augmentation; creams, pills and exercises have not been shown to increase breast volume. Therefore they are not recommended for permanent volume increase. |
