Breasts have historically been a symbol of femininity. Breast augmentation is one of the surgeries that create the highest level of satisfaction amongst all aesthetic procedures. The desired shape and size of the breast boosts self-confidence of women. Breasts can undergo changes at any stage of life. These changes can be caused by hormonal factors, pregnancy, weight changes or aging. Generally, patients’ breasts cannot grow sufficiently during adolescence or they become smaller after delivery and implants are needed.

As is the case with all aesthetic surgeries, breast augmentation procedures are usually performed after 18 years of age. Unless patients have a disease that contraindicates general anaesthesia or causes a risk for surgery, most patients at or above 18 years of age can undergo a breast augmentation procedure.

We prefer re-examining our patients and completing the preoperative preparations on the day or days leading up to breast augmentation surgery. At this stage, preoperative routine tests and anaesthesiology examinations are performed. We prefer discussing informed consent forms and taking photos of patients a day before or in the days leading up to the surgery. We decide, together with the patient, the shape and size of the breast implant to be used specifically for breast augmentation surgery in the days before the surgery. We will make surgical markings on the morning of surgery day and answer any additional questions of our patients. The breast is an organ that is sensitive to hormones and imaging tests should be performed for this organ at certain intervals. Therefore, we ask our patients to have mammography and breast ultrasound before the surgery. These images are quite useful for postoperative follow-up of augmented breasts.

In the preoperative period, the patients should know that the silicone prostheses used for breast augmentation surgery provide the safest and the most certain outcomes. Although breast augmentation procedures can be performed with fat injection or saline-based implants, silicone implants are still the best option for breast augmentation where a significant increase in size is desired. Therefore, breast augmentation is the aesthetic procedure that provides the highest satisfaction rates amongst women.

Various types of implants can be used for breast augmentation. Those are silicone implants, saline (saline-filled) implants and polyurethane implants. Polyurethane implants are used especially for the patients who request very big implants since they are lighter comparing to other implants.

Breast prosthesis is the gold standard for breast augmentation procedures. Breast prostheses are divided into two groups in terms of their shape. Those that are round and those tat are anatomical (eye drop shaped) implants. Measurements are crucial for deciding the type of breast prosthesis. Round implants fill the upper part of the breast better while anatomical implants can provide a more natural appearance for the breast. Moreover, there are textured and smooth silicone implant options. Textured implants are generally preferred where the implant is placed beneath the breast tissue. The risk of capsule contracture, which is a late complication of breast augmentation, is lower in texture implants.

Some prostheses are filled with saline instead of silicone. There are valve systems integrated to these types of prostheses. The area for which the prosthesis is placed in the breast region is surgically assessed. Next, the prostheses are placed beneath the breast. The prosthesis are then inflated with saline. Tubes integrated to the valve system of the prosthesis are used to inflate the prosthesis. After the inflation, these tubes are pulled out and the valve systems are automatically closed. Saline-based implants are also covered with a silicone sheath. The most important problem regarding these implants is the leakage in the valve system that occurs in time and results in drainage of saline inside the implant. Another problem can be a sloshing type sound that is heard during movement of the fluid.

There are two layers of silicone sheath in silicone gel-filled implants. These sheaths are filled with non-fluid silicone. Therefore, they feel more like natural breast tissue.

Before the surgery, many patients think that breast implants are placed inside the breasts during the breast augmentation procedure. However, this thought is incorrect. Regardless of its type and size, the implant is never placed inside the breast tissue. It is placed under the breast, under the fascia or under the pectoral muscle. In this way, the implant is easily covered with breast or muscle tissue.

Also, the lactiferous ducts are left untouched and thus, patients experience no problem regarding milk flow. Implants placed beneath the breast tissue are associated with less pain and bleeding. Implants placed under the muscle and fascia may cause a little bit more pain. However, long-term outcomes of these methods are better than under-the-breast placement of the implant. Patients for whom implants have been placed under the muscle may suffer pain during arm movements for the first several weeks. The pain gradually regresses and disappears. Implants placed under the breast are more likely to develop capsule. This can lead to a capsular contracture which is a common late complication.

It is very important to determine the size of the implant to be used in breast augmentation procedures. The size of the implant to be selected should be directly proportionate to the width of the patient’s chest. So, large implants can be used for patients with large chest sizes. On the other hand, it is beneficial to prefer smaller implants for those with smaller chest sizes. Otherwise, breast implants protrude towards the armpit which may cause an unnatural appearance. Thus, the size of the implant varies from patient to patient. Size, shape, height and width of the implant are determined completely in porportion with the patient’s anatomical structure. If these measurements are done properly, it is possible to perform an ideal breast augmentation procedure. Thus, the patient suffers less pain in the postoperative course and has soft breasts.

The breast implant is placed under the breast tissue in breast augmentation procedures. Regardless of the technique applied, the breast implant is never placed inside the breast tissue. Therefore, the breast implant does not harm the breast tissue. In cases where a very large breast implant is placed, the breast tissue above the implant may be compressed and the breast tissue may become thin. A careful preoperative assessment can easily figure out this issue and the patient’s desired postoperative appearance can be maintained for a long time.

As previously mentioned said before, the breast implant is not placed inside the breast tissue. Thus, patients experience no problem with breastfeeding after breast augmentation procedure.

In the breast augmentation procedure, the implant can be placed in different regions. The first one is under the breast tissue. The second one is immediately under the fascia beneath the breast. This is also called the subfascial plane. In breast augmentation surgery, another region for the placement of the breast implant is under the subpectoral muscle.

The purpose of the breast augmentation procedure is to cover the breast implant with normal breast tissue, making the implant invisible. The breast implant can be placed under the breast if the patient has sufficient breast tissue. If the patient has no sufficient breast tissue, the breast implant can be placed under the pectoral muscle or under the fascia.

Here, the major definitive factor is the preoperative shape of the breast and the shape of the breast the patient would like to have after the surgery. For example, an anatomic implant will be appropriate if a patient does not want augmentation in the upper part of the breast. On the other hand, round implants are preferred for patients who request a voluminous upper part of the breast and striking décolleté. In summery, round implants fill the upper part of breasts better than the anatomic implant.

Pain will not be severe, if an implant with appropriate size is used for breast augmentation. If an unnecessarily large implant is used, pain may occur due to tension and sprain. Pain can be more severe for implants that are placed beneath the muscle, as the muscle is divided.

Implants are mostly inserted through the incision made over the bra line in breast augmentation surgeries. Therefore, a scar is left over the bra line after breast augmentation surgeries. Thus, it cannot be seen by other people. To make it less visible and to fade it out, patients start using silicone cream three weeks after the surgery, and tattoing a residual scar is also an option to make it visible.

We expect that the breast prosthesis migrates down slightly through natural ways after breast augmentation surgery. Thus, breasts get their final position through natural forces. To achieve this goal, breasts should not be limited with bras with underwire. Bras prevent downward movement of the implant, if bras with underwire are worn after the surgery. Therefore, sports bras are preferred instead of bras with underwire following breast prosthesis surgery.

Patients should use their arms very carefully within the first ten days after the surgery. They can easily perform activities of daily life, but they should not lift heavy objects or raise their arms too much. Patients may gradually start using their arms at a wider range beyond the ten-day interval.

Breast augmentation surgery is most commonly combined with breast lift. Here, the aim is to lift up the breast characterized with sagging and loss of volume and to increase its volume.

As is the case with all breast surgeries, lactation should have stopped before the breast implant surgery. Breast augmentation surgery can be performed one year after breastfeeding has stopped.

Breast augmentation surgery has the highest satisfaction rate among all aesthetic surgeries. Moreover, breast augmentation surgery is one of the most commonly performed aesthetic procedures. This surgery boosts self-confidence of patients. In terms of the satisfaction mostly reported by the patients after surgery, their clothes fit their body more beautifully and their confidence has increased.

Since breast augmentation is relatively short and it is performed in a single body part, the risk is lower compare to other surgeries. However all surgery carries risk and this will be explained to you by your doctor.

Cost of breast augmentation surgery starts from €5,000