Breast Augmentation Surgery (Breast Enlargement with Silicone Implants)
Today, the only scientifically valid and reliable method for breast enlargement is augmentation using breast implants.
The fundamental principle of breast augmentation surgery is placing a silicone-filled implant beneath the breast tissue. This can be done using different approaches.
Implant Placement
Implants may be placed either under the pectoral muscle or over the muscle and directly beneath the breast gland.
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Submuscular implants may look slightly less natural but are considered safer because the muscle provides protection and helps reduce the risk of capsular contracture—a complication in which the scar tissue around the implant becomes excessively thick.
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Subglandular implants sit closer to the surface and tend to create a more natural appearance, but they do not have the protective advantage of muscle coverage.
Incision Options
Breast implants can be inserted through three main incision sites:
1. Transaxillary (Armpit) Incision
A 3–4 cm incision is made in the armpit, and the implant is placed under the muscle. The scar fades completely after six months.
This method is technically more challenging and preferred by highly experienced plastic surgeons. Typically, saline-filled implants are used with this technique to avoid damage to the breast tissue in young women. It is difficult to place silicone gel implants, anatomically shaped implants, asymmetric implants, or titanium-coated implants through this approach.
2. Periareolar (Around the Nipple) Incision
A half-moon incision is made along the junction of the areola and the surrounding skin. The resulting scar is usually minimally visible.
However, there is a small risk of temporary nipple sensation changes and breastfeeding difficulties. Both submuscular and subglandular placement can be performed through this incision.
3. Inframammary Fold (Under-Breast) Incision
A 3–5 cm incision is made along the natural crease under the breast. In patients with good skin quality, the scar becomes very faint and remains hidden in the fold.
Possible Complications
Complications can be categorized into surgery-related and implant-related issues.
Surgery-Related Risks
As with any surgical procedure, bleeding or infection is possible but extremely rare when the surgery is performed by an experienced surgeon in proper conditions.
Implant-Related Risks
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The body recognizes the silicone implant as a foreign object and forms a thin capsule around it.
In rare cases, this capsule may become excessively thick—known as capsular contracture. When severe, it can distort breast shape and may require treatment. Most cases can be managed before reaching this advanced stage. -
Rough-textured implants and submuscular placement reduce capsular contracture risk.
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Minimal infections, hematomas, or chemical contaminants (such as glove powder) may increase risk.
Implant Rupture
Although sensationalized in media, implant rupture is highly unlikely. Modern implants are extremely durable and do not rupture under normal circumstances. Rupture typically occurs only with sharp-force trauma. Although older implant models were more susceptible, newer-generation implants have greatly reduced this risk.
Breastfeeding and Cancer Risk
A mother with breast implants can safely breastfeed. Implants are placed under the breast gland, so they do not interfere with milk ducts or milk production.
The incision technique influences this risk—periareolar incisions may slightly increase the chance of affecting nerves or ducts, but careful surgical technique prevents this issue.
Breast implants do not cause cancer. After extensive FDA research, silicone implants were confirmed safe and approved again for general use.
Postoperative Care and Recovery
After surgery, a light compression bandage is applied. Patients who feel well may be discharged on the same day and usually return to work within 3–4 days.
Mild discomfort is normal during the first night, but simple oral pain relievers are usually sufficient.
Bruising and swelling are generally minimal. Slight tightness in the chest and mild pain during arm movements may occur during the first few days. Dissolvable sutures are used, so no stitch removal is necessary.
Activity Timeline
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Week 2: Long walks may begin.
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Week 3: Light jogging may be resumed.
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Week 4: Upper-body exercises, tennis, and fitness activities may start.
Final Results
During the first 1–2 months, breasts appear approximately 30% larger due to postoperative swelling.
Final shape and settling occur around the third month.
