Breast Augmentation

What is breast augmentation surgery?

Breast augmentation, also called breast enlargement or augmentation mammoplasty, is surgery to increase breast volume and change its relationship to your body proportions. Implant-based augmentation involves placing a breast implant, often referred to as a silicone breast implant.

Naturally small breasts, volume loss after pregnancy and breastfeeding, or certain asymmetries may prompt an assessment. I plan surgery by considering breast tissue, the chest, skin and nipple position together, rather than volume alone.

Who may be considered for breast augmentation?

I assess cosmetic augmentation in adults whose breast development is complete. Turning 18 alone does not establish suitability: general health, decision-making maturity, expectations and the selected product's conditions of use also matter.

Active infection, an unevaluated breast lump, pregnancy or breastfeeding, and uncontrolled medical conditions may require postponing surgery. Smoking and nicotine use can increase healing risks.

An implant alone may be insufficient when there is significant sagging. The possible changes and limits of surgery are discussed during the consultation; the same technique or implant is not recommended for everyone.

How is implant size selected: cc, base width and cup size?

Bra band numbers such as 80 or 85 in European sizing relate to chest circumference. Cup letters such as A, B, C and D describe breast fullness. Sizing varies between brands; achieving a particular bra size through surgery cannot be guaranteed.

Implant volume is expressed in cc or ml. A 250 cc, 300 cc or 350 cc implant will not produce the same appearance in different people. Base width, profile, existing breast tissue, skin elasticity and body measurements are assessed together.

I listen to your expectations and plan a size your tissues can support. Excessive volume can stretch tissues, make the implant more noticeable, contribute to sagging and increase the need for further surgery. Existing chest and breast asymmetry should not be expected to disappear completely.

Silicone breast implants: teardrop and round shapes

The outer shell, filling, shape and surface are separate implant characteristics. Silicone gel-filled and saline-filled options exist. A round or anatomical (teardrop) shape alone does not determine whether a result will look natural or artificial.

The implant's diameter, height, projection and covering tissue influence appearance. Rotation of an anatomical implant can change breast shape. A round implant also produces different results in different anatomies.

The risks of smooth and textured surfaces should be discussed. BIA-ALCL is associated with a higher risk in textured implants. Implant selection should consider more than shape or volume.

Product information, CE marking and ÜTS

The implant model, manufacturer, CE marking and conformity documentation, registration in Türkiye's Product Tracking System (ÜTS), packaging integrity and traceability information are important. The selected product's instructions for use and patient safety information should be discussed before surgery.

Keep your implant card, serial/lot details and surgical records, and share them at follow-up or when seeing another doctor. CE marking or ÜTS registration does not guarantee that complications will not occur or that the desired appearance will be achieved.

Under the muscle, over the muscle, subfascial and dual-plane placement

The implant pocket may be prepared beneath the breast tissue, beneath the muscle fascia, or in different relationships to the chest muscle. In a dual-plane approach, the upper implant is covered by muscle while the lower portion has a more direct relationship with breast tissue.

In people with thin tissues, implant coverage and visible edges are important considerations. Other placements may be considered when tissue coverage is adequate. Each approach has different implications for pain, visibility, capsule formation and changes with movement.

With muscle-related placement, the breast or implant may change appearance when the muscle contracts. Exercise habits and occupation are considered during planning. No placement is the single correct option for every patient.

Where is the incision made, and will there be a scar?

In my practice, I commonly insert the implant through an incision in the fold beneath the breast. Incision length depends on the product and the procedure required; with my current approach, it may be approximately 3.5–4 cm.

Other access routes, such as around the areola or through the armpit, may be considered in selected circumstances. If a breast lift is also needed, scars may extend around the areola, vertically down the breast or along the breast fold.

Every incision leaves a scar. Placing it in the fold aims to reduce visibility, but an invisible or inconspicuous scar cannot be guaranteed. Raised, widened or discoloured scars may develop.

Augmentation, breast lift, reduction and fat transfer

Breast augmentation adds volume; breast lift surgery addresses sagging and nipple position. Breast reduction decreases volume. These procedures meet different needs, and augmentation and a lift may be planned together when appropriate.

Breast augmentation using fat taken from another part of the body may be considered in suitable people. Adequate donor fat is needed; some transferred fat may be absorbed, and more than one session may be required. The amount that will remain cannot be predicted precisely.

Fat transfer can cause fat necrosis, cysts, infection and calcifications that require assessment on imaging. Implants and fat transfer carry different risks. For breast augmentation, I do not consider fillers other than implants and the patient's own fat appropriate.

Breast ultrasound and assessment before surgery

Tell me about previous breast operations, a family history of breast cancer, lumps, nipple discharge or pain, and bring existing imaging. Assessment includes the chest, breast base width, skin, sagging and nipple position as well as volume.

Breast ultrasound has an important place in my preoperative assessment. I consider mammography according to age and individual risk, and check screening status particularly in people aged 40 and over. Bring any recent examinations.

Breast ultrasound, mammography and MRI serve different purposes and are not interchangeable in every situation. Any suspicious finding should be assessed by the appropriate breast specialist before cosmetic surgery.

Disclose all medicines and supplements, including blood thinners; do not stop prescribed medication without consulting the prescribing doctor. Smoking/nicotine, medical conditions and fitness for anaesthesia are assessed separately. Follow the anaesthesia team's individual fasting instructions.

How is breast augmentation performed, and how long does it take?

I perform breast augmentation in hospital under general anaesthesia. Assessment and markings are made while you are standing before surgery; the planned pocket is prepared and the implant is inserted.

My operations involving augmentation with implants alone may take approximately 1–1.5 hours. An additional lift, correction of asymmetry or procedures related to previous surgery can change the duration.

I use drains in my practice. A drain helps remove fluid or blood that may collect, but does not eliminate the risk of bleeding. I generally do not remove drains at discharge. Removal is based on drainage volume and examination findings.

Same-day discharge may be possible in suitable patients. Hospital stay, restarting food and drink, and mobilisation are determined by the surgical and anaesthesia teams' assessment.

Recovery after breast augmentation and support bras

Pain, tightness, swelling and bruising may occur during the first days. Muscle movement can increase discomfort. Pain relief and complete tissue healing are different stages; appearance continues to be assessed over weeks and months.

In my follow-up plan, I recommend a supportive, non-wired sports bra day and night for one month. Follow wound-care instructions and attend follow-up appointments.

In my own follow-up approach, showering may be considered two days after drain removal if the wound and general condition are suitable. Follow your individual incision and dressing instructions.

Light daily activities are resumed according to healing. Before driving, pain and movement restrictions should have resolved sufficiently, and sedating medication should no longer affect you. Heavy lifting and chest/arm exercises are restarted gradually when permitted.

Wait for wound healing and medical clearance before swimming in the sea, using a pool or a hot tub. Restrictions on sauna use, excessive heat, trauma and significant breast pressure are determined individually. Do not massage the breasts unless your doctor recommends it.

Do silicone implants last a lifetime?

Breast implants are not devices that can be assumed to remain trouble-free for life. Rupture, capsular contracture, displacement or other problems may require removal or replacement over time.

There is no single year when everyone must automatically replace their implants. Decisions depend on symptoms, examination, imaging and product information. A manufacturer's warranty differs from the implant's clinical lifespan and the possible need for another operation.

Long-term follow-up, mammography and MRI

Breast health screening and checking implant integrity serve different purposes. Having implants does not remove the need for breast cancer screening appropriate to your age and risk. Tell the imaging team about your implants beforehand.

Implants can make some breast tissue harder to see on mammography; additional views or other examinations may be needed. Assessment should be performed by a team experienced in imaging breasts with implants.

Silicone gel implant rupture can be silent, so imaging may be needed even when the appearance is normal. For asymptomatic silicone gel implants, the US FDA recommends an initial ultrasound or MRI at 5–6 years, followed by imaging every 2–3 years. This is a US recommendation; your individual follow-up plan and product information are also considered.

Do not wait for that schedule if new symptoms develop. Ultrasound or MRI to check implant integrity does not automatically replace screening mammography when this is indicated.

Pregnancy and breastfeeding with breast implants

Having a breast implant alone does not necessarily prevent breastfeeding, but augmentation surgery may affect milk production. The incision, placement, existing tissue, milk ducts and nerves matter. Full breastfeeding capacity cannot be guaranteed.

If you are planning pregnancy soon, discuss the timing of surgery. Pregnancy and breastfeeding can change breast volume, skin and sagging. After breastfeeding ends, timing is individualised once milk production has ceased and breast volume has stabilised.

Breast cancer, implant-associated lymphoma and other conditions

Breast cancer and breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) are different diseases. BIA-ALCL is a lymphoma usually associated with the capsule or fluid around an implant; the risk is higher with textured implants.

Squamous cell carcinoma (SCC) and other lymphomas have also been reported in the capsule around breast implants. These reports are rare; the causes, incidence and risk factors for SCC are not fully understood. New or late swelling, firmness, a lump or pain should be assessed.

Possible breast cancer symptoms include a new lump, bloody nipple discharge, skin dimpling or a new nipple change. Other causes are possible, but these findings should not be dismissed as purely cosmetic or implant-related. Early breast cancer may have no symptoms, which is why screening matters.

Alternatives to surgery and making a decision

Choosing no surgery and using supportive bras or external breast forms are options. Fat transfer, a lift or other operations should be considered only with their suitability and individual risks.

The decision to have breast augmentation includes the possibility of future surgery and regular follow-up. Appearance, symmetry and satisfaction are not guaranteed.

Possible risks and unwanted outcomes of breast augmentation

This page does not replace an individual examination, discussion with your doctor or the preoperative informed consent process. Reading it does not constitute consent to surgery.

Frequently asked questions about breast augmentation

What affects the cost of breast augmentation in Antalya?

Breast augmentation costs depend on implant characteristics, any additional lift or asymmetry correction, anaesthesia, hospital services and follow-up. The hospital where surgery is performed also affects the fee.

Comparing implant prices alone does not explain the full surgical plan. Individual treatment and fee information are shared after assessment. The scope of future follow-up and any additional surgery should be discussed in advance.