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Breast augmentation is an operation that increases the size of the breasts and improves their shape using implants. It is one of the most frequently performed cosmetic procedures worldwide. Women choose it for many reasons: breasts that have always been small, volume lost after pregnancy or weight loss, asymmetry between the two sides, or a wish for better proportion between the chest and hips. The aim is breasts that look and feel natural for your body, not a standard size applied to everyone.
The quality of the result depends on planning as much as on surgery. Choosing an implant that suits your chest width and tissue, placing it in the right pocket and making the incision in the right place determine how the breasts will look in the first year and in ten years’ time.
Is breast augmentation right for you?
You may be a good candidate if:
- your breasts are small or have lost volume, particularly in the upper part
- you want to improve breast shape and proportion
- your breasts are uneven in size
- your nipples sit above the fold beneath the breast, meaning there is little sagging
- you are in good health and have realistic expectations
If the breasts have dropped, with the nipple at or below the fold, an implant alone often gives a result that sits too low. In that case a breast lift, with or without an implant, is usually recommended.
Implants: what you need to know
| Choice | Options | Considerations |
|---|---|---|
| Filling | Silicone gel, saline | Most augmentations today use cohesive silicone gel, which feels more natural |
| Shape | Round, anatomical (teardrop) | Round implants give more upper fullness; anatomical implants suit some thin women with little tissue |
| Surface | Smooth, textured, micro-textured | Texture affects implant stability and has been linked to the rare BIA-ALCL |
| Profile | Low, moderate, high | Determines how far the implant projects for a given width |
Modern silicone implants are made with a cohesive gel that holds its shape and does not flow if the shell is damaged. They are among the most studied medical devices. Your surgeon will explain the specific implant recommended for you, its manufacturer and the evidence behind it, and you will receive an implant card with its details.
Where the implant is placed
- Behind the muscle (dual plane): the upper part of the implant sits under the pectoral muscle, the lower part under the breast tissue. This gives extra soft tissue cover at the top, which is useful in slim women with thin tissue, and may slightly reduce the risk of capsular contracture.
- Behind the breast tissue (subglandular): the implant sits above the muscle. It can suit women with enough natural tissue and avoids movement of the implant when the chest muscle contracts.
- Under the muscle fascia (subfascial): a variation that adds a thin layer of support above the muscle.
The choice depends on your tissue thickness, your breast shape and your lifestyle, including whether you do a lot of upper-body training.
Incision options
The most common incision is in the fold under the breast (inframammary). It gives the surgeon a clear view of the pocket, avoids the milk ducts and leaves a scar hidden in the fold. Other options include an incision around the lower edge of the areola, which can be useful when a small lift is needed, and an incision in the armpit, which avoids a scar on the breast but gives less control of the pocket.
Choosing your size
Size is the question most women worry about, and cup size alone is a poor guide. The implant is chosen mainly by measuring the width of your breast, the stretch of your skin and the amount of tissue you have. An implant that is wider than your chest can lead to implants that sit too far apart or under the arms, and one that is too heavy for the tissue can stretch the skin and drop over time. Trying on sizers in a well-fitting bra, and discussing photographs of looks you like, helps to translate your wishes into a sensible choice.
Implants or your own fat?
Some women prefer not to have implants at all. Fat transfer breast augmentation uses fat taken by liposuction from the abdomen, flanks or thighs and injects it into the breasts. It gives a very natural feel and slims the donor area at the same time, but the increase is modest, usually around one cup size per session, and part of the fat is reabsorbed. Implants give a larger, more predictable change in a single operation. A combination, known as composite or hybrid augmentation, uses an implant for volume and a thin layer of fat to soften its edges in slim women.
Preparing for surgery
Stop smoking and nicotine products at least four weeks before and after surgery. Stop blood-thinning medicines and supplements two weeks beforehand, after checking with your doctor. If you are over forty, or have a family history of breast cancer, a breast ultrasound or mammogram may be requested before surgery. Buy two soft, front-fastening support bras, or the clinic will provide a post-surgical bra.
The operation
Breast augmentation is performed under general anaesthesia and usually takes one to two hours. The pocket is created precisely, the implant is inserted using a no-touch technique to reduce contamination, and its position and symmetry are checked with you sitting up on the operating table. The incision is closed in layers.
Recovery
- Days 1–2: tightness and aching across the chest, stronger if the implant is behind the muscle; arm movement is limited
- Days 3–7: discomfort improving; short walks; most people can do desk work after about five to seven days
- Weeks 2–3: stitches removed or dissolved; lower-body exercise possible
- Week 6: support bra can be replaced with normal bras; upper-body exercise resumes
- Months 3–6: implants settle into their final position (“drop and fluff”)
The breasts often look high and tight at first. They soften and settle into a more natural shape over the following months.
Risks and long-term safety
Possible risks include bleeding, infection, changes in nipple sensation, visible rippling in thin tissue, asymmetry, implant malposition and, over time, capsular contracture, where the scar tissue around the implant tightens and hardens. Implants can rupture, usually silently with silicone implants, and MRI or ultrasound can detect this.
BIA-ALCL is a rare lymphoma associated mainly with textured implants. It typically appears as a late swelling of the breast from fluid, often many years after surgery, and is highly treatable when diagnosed early. Breast implant illness is a term used by some women who report symptoms such as fatigue, joint pain or poor concentration that they attribute to implants. The evidence is still evolving, and some women report improvement after implant removal. These topics are discussed openly at consultation.
Breast augmentation in Istanbul
International patients usually stay six to seven days. This allows for the consultation, the operation and a check-up before the flight home. Avoid carrying heavy luggage, and ask for assistance with bags at the airport.
Dr. Mehmet Özdemir is a plastic, reconstructive and aesthetic surgeon holding the EBOPRAS qualification of the European Board of Plastic, Reconstructive and Aesthetic Surgery, with breast surgery among his main areas of focus. He trained in Germany, Poland and Brazil, consults in Turkish, Kurdish, English and German, and practises in Bakırköy, Istanbul.
