What Is Breast Augmentation (with Implants)?

Breast augmentation is a surgical procedure that provides volume and shape to the breasts by placing silicone implants either under the breast tissue or beneath the muscle. This operation is performed through small incisions of approximately 3–4 cm made under the breast, around the areola, or in the armpit. The choice of incision site and implant placement is determined entirely based on the patient’s existing breast tissue structure and aesthetic expectations.

Silicone implants can be placed both under the muscle and under the breast tissue. However, the most ideal plan differs for each patient. Therefore, breast augmentation is an aesthetic procedure that must be evaluated on an individual basis.

How Is the Implant Placement Plan Determined?

In breast augmentation surgery, implant placement is performed using two main techniques. The choice is determined according to the structure and thickness of the patient’s existing breast tissue.

Subglandular Placement

This option is preferred for patients with sufficient breast tissue. Pain is milder and the recovery process is comfortable.

Subfascial Placement

In this technique, the implant is placed beneath the fascia layer over the muscle, resulting in a natural appearance. The muscle tissue is preserved, the risk of deformation due to muscle movement is reduced, and the recovery process is generally rapid.

Submuscular Placement

This is an ideal method for patients with thin breast tissue, those who do not want the implant to be palpable from the outside, or those who wish to reduce the risk of capsular contracture.

Dual Plane Placement

In breast augmentation surgeries, the dual plane technique involves placing the upper portion of the silicone implant beneath the chest muscle (pectoralis major) and the lower portion beneath the breast tissue. This method helps provide a more natural transition in the upper pole for patients with thin breast tissue, while giving the lower pole a fuller and more aesthetic appearance.

The dual plane technique is frequently preferred because it reduces the visibility of implant edges, supports the natural breast contour, and contributes to the long-term preservation of aesthetic results.

It has been scientifically shown that submuscular placement reduces the risk of infection and capsular contracture. However, it is also known that submuscular placement may cause more pain during the first few days.

Type of Anesthesia Used in Breast Augmentation Surgery

Breast augmentation is performed under general anesthesia. The patient remains completely comfortable and safe throughout the operation.

How Long Does the Surgery Take?

Breast augmentation surgery takes an average of 1–2 hours. The implant placement area, incision technique, and the patient’s anatomical structure may affect the duration.

Is Breast Augmentation Surgery Painful?

When the implant is placed under the breast tissue, pain is usually mild, whereas submuscular placement may cause more noticeable pain during the first few days. However, this discomfort can generally be controlled with oral pain relievers.

Although pain levels vary from person to person, most patients reach a level where they can perform daily activities more comfortably within 3–5 days.

What Happens in the First Days After Surgery?

After the operation, swelling, edema, and mild bruising may occur in the breast area. These are normal and usually decrease within 2–3 weeks. Since implants are placed, the breasts may appear firmer and more elevated in the first days; they settle into a natural form within a few months.

After surgery, the patient will have small dressings. These dressings are generally changed every 2–3 days for a period of 5–7 days.

Expected Changes Immediately After Surgery

If the incision is made around the areola, temporary decreased sensation may occur. This sensation usually returns over time.

In patients with insufficient breast tissue, silicone implants may be palpable when touched.

Implants placed under the muscle provide a more natural feel.

Air travel, swimming, or diving does not cause implants to rupture. Implants can only be damaged by severe trauma or penetrating injuries.

What About Scarring?

After breast augmentation surgery, the incision scar is approximately 3.5–4 cm in length. It may initially appear slightly red or raised, but over time it flattens, takes on the color of the skin, and becomes aesthetically acceptable.

Possible Risks and Complications

Possible Early-Term Complications

Bleeding, infection, and delayed wound healing may occur.

Possible Late-Term Complications

The most common late-term complication is capsular contracture. This occurs when the tissue surrounding the implant hardens excessively.

While it was previously seen at rates of 30–35%, today this rate has decreased to approximately 6–8%. Submuscular placement of the implant and the use of textured surfaces reduce the risk. If capsular hardening reaches an advanced stage, additional surgery may be required.

Recovery Process and Return to Normal Life

Heavy activities should be avoided during the first 7–10 days. Dressing care for the suture line is recommended during the first week. Scar cream is started on the 15th day.

For 2 months, the use of a sports bra–like compression garment with upper support is recommended. Massage is performed for one month by applying pressure from the top and sides as advised by the doctor.

The time to return to work varies depending on job intensity. Swimming and arm exercises can be started after the 6th week. Driving is possible after 1 week.

Who Is Suitable for Breast Augmentation Surgery?

Individuals who are dissatisfied with their breast volume, have congenitally small breasts, experience volume loss after pregnancy and breastfeeding, or have asymmetrical breast appearance are suitable candidates for this surgery.

Having realistic expectations and being in good general health for surgery are important.