Plastic Surgery

Augmentation Surgery


What Is Breast Augmentation Surgery?

Breast Augmentation, colloquially known as “augmentation mammoplasty” or “silicone placement surgery”, is a surgical procedure performed in an operating room by an Aesthetic, Plastic and Reconstructive Surgery specialist to enlarge the breast, increase its fullness, and change its shape by placing a silicone implant (prosthesis) under the breast tissue or chest muscle.

How is Breast Augmentation Surgery Performed?

It is performed under general anesthesia in an operating room. A skin incision is made in the predetermined area to create a pouch under the breast tissue, where the silicone implant will be placed. This pouch is carefully controlled for bleeding, and the pouch is cleaned with solutions that contain various antibiotics or antiseptics.

After the test implants are inserted into the pouch to see whether the size and shape of the implants are appropriate, and the real implants are then placed there. Depending on the plastic surgeon’s preference, a silicone tube called a “drain” is placed in the pouch and one end is pulled out to discharge the blood and tissue fluid that will accumulate around the implant. The incision made at the beginning of the operation is sutured using “hidden (intradermic) and self-dissolving” sutures, and the operation is terminated by applying a bandage.

Characteristics of Candidates Suitable for Breast Augmentation with Silicone Implant

  • Those over 18 years of age, whose thorax development has been completed
  • Those who are in good physical and psychological health
  • Those who have an obvious problem in their breasts. For example, those with small, asymmetrical, deflated, flattened or sagging breasts
  • Those who have realistic expectations from breast augmentation surgery
  • Those who are aware of the risks and complications of procedure.

Characteristics of Candidates Unsuitable for Breast Augmentation with Silicone Implant

  • Those younger than 18
  • Those with serious general health problems (such as infection, untreated cancer, immune system diseases)
  • Those with serious psychological problems
  • Pregnant or breastfeeding women
  • Those with untreated breast cancer
  • Those who consume an excessive amount of alcohol, tobacco products, or drugs
  • Those who have unrealistic expectations from the procedure

What is the Ideal Breast Shape and Size in Women?

The ideal female breast shape and size or the most preferred, aesthetically attractive female breast shape and size vary depending on cultures, gender and age groups. For most middle-aged women, the ideal breast size is C-size, while the most preferred size by men is D.

Breast shape is a concept different from size and it is evaluated together with size in breast aesthetics. Approximately 12 different breast shapes have been described. The aesthetically most attractive shape among these is the round breast shape, where the upper and lower halves of the chest are equal and full.

When viewed from the side, the nipple must be above the inframammary fold, that is, it should not have a sagging appearance. The nipples should be slightly upturned. The contour of the part above the nipple should not be concave or convex. The lower pole contour of the breast between the nipple and the inframammary fold should be a bit convex but tight.

What the Types of Silicone Implant?

The implants most commonly used for breast augmentation are structures filled with silicone gel of varying consistencies, which are placed in a medical silicone sheath. There are also silicones filled with physiological saline, but these are not preferred in our country.  There are two types of silicone implants: “round” and “anatomical (teardrop)”.

Since the horizontal and vertical diameters of round implants are equal, they do not cause a problem even if they turn in the body. The volume of silicone in round implants is evenly distributed, so this type of implants is more successful in filling the upper portion of the breast. On the other hand, anatomical type implants used to reshape zero-size breasts have vertical and horizontal diameters different from each other. Their surfaces are purposefully designed to be textured in order to prevent them from turning inside the body. Surfaces of round-shaped implants can be smooth or textured.

Some studies have revealed that large cell anaplastic lymphoma can develop around silicone implants, and that it is more common around implants with textured surface. Although there is inadequate data to make a definitive judgment on this subject, there has been a trend toward less use of implants with textured surfaces, such as anatomical implants. Currently, there is no official restriction on the use of implants with textured surfaces.

My Implant Preference

Although implants with textured surface have some advantages, such as a lower risk of capsular contracture development or displacement, I mostly use round implants with softer consistency and smoother surfaces in my practice, placing them on the submuscular plane. After deciding on the shape and surface characteristics of the implant to be used, implants suitable for use are chosen from a catalog that includes various base diameters and heights. The final decision on the size of the implant to be used is made after determining the most ideal implant shape and size by placing the test implants in the pouch created during the surgery.

How to Determine the Right Size of Silicone Implant to be Used in Surgery?

First of all, it should be known that it is not possible to use implants in the size of each person’s own preference. The diameter of the person’s chest base, which varies from person to person, is the most fundamental factor that determines the size of the implant to be used. The breast tissues should allow the volume placed under the breast by flexing sufficiently; so the elasticity of the breast tissue and skin is other important factor that determines the implant size.

It is not possible to place a big implant in a size zero breast with extremely tight skin on the first try. Implants inserted underneath the muscle should have a smaller base diameter and volume than supramuscular implants. The volume of the existing breast tissue is another factor to consider. In short, there are some anatomical criteria that limit the size of the implant to be used, and attempting to place an implant larger than the optimal size by pushing the limits of these criteria, which is a mistake that I frequently witness, causes different deformations and complaints after the surgery, necessitating the need for a second surgery to replace the implant with a smaller one.

The very large breasts we see in the media were not achieved in one go through a surgical operation. The first silicone implant in appropriate sizes causes the breast tissue and skin on it to loosen and adapt to its new condition over time, like a pregnant woman’s belly.

If desired, the first implant can then be replaced with a larger silicone implant with the same base dimensions but with a higher projection. In this way, it is possible to gradually increase breast size with a few surgical operations. However, it should be remembered that as the implant volume increases, the weight of the implant will also increase, and as a result, the sagging of the breasts will accelerate and increase over time.

Where In The Breast Is The Silicone Implant Placed By Making An Incision? What Type Of Incision Is Better?

Making a 3-4 cm incision from one of the areas listed below, the intended area under the breast is accessed;

  • The inframammary fold (the line where the lower half of the breast meets the rib cage)
  • The lower half of the brown area around the nipple (areola)
  • The armpit area

Each type of incision has certain advantages and disadvantages specific to it. The status of the case and the surgeon’s personal preferences influence the choice. In most of the surgeries I perform, I make the incision on the inframammary fold because this type of incisions, unlike the incisions made around the nipple, do not involve the breast tissue and milk ducts, and enable me to create a pocket for implant placement in a much more comfortable and controlled way.

With axillary (through the armpit) incision, it is difficult to prepare the area for implant placement, and the implant tends to move upwards and outwards. In addition, the armpit area is likely to be seen by others in daily life (when wearing a swimsuit, short-sleeved clothing, etc.), and if the incision scar does not heal well, it will be more difficult to conceal.

Should The Silicone Implant Be Inserted Under Or Over The Muscle?

Under the breast tissue is the pectoral muscle that covers the ribs. The silicone implant can be placed in the subglandular plane (supramuscular-submammary plane) or in the subpectoral plane (submuscular-dual plane). Implants with wider bases can be placed in the subglandular (supramuscular) plan in a shorter time, but if the breast tissue on the implant is not thick enough (this is the case in most patients), a clear border appears around the implant, and as a result, the breast-to-thoracic cage transition does not look natural, giving the breast an artificial appearance.

Since the implants placed under the muscle is covered by both muscle and breast tissues, the breast looks more natural when viewed from the outside. In addition, subpectoral (submuscular) implants are less likely to develop capsular contracture.  In my own practice, I mostly prefer the subpectoral (submuscular) placement technique, also called “dual plan or double plan”. In this technique, the portion of the implant that remains above the nipple level is under the muscle, while its portion below the nipple level is in the supramuscular (submammary) plane.

breast enlargement

Before Breast Augmentation with Silicone Implant

Before undergoing breast augmentation surgery, the patient should meet with the Aesthetic Plastic Surgeon who will perform the surgery, and discuss the entire procedure in detail, without rushing this meeting. First of all, during this interview, it is determined whether the individual is a good candidate for breast augmentation surgery.

The chest, rib cage, and body measurements of suitable candidates are taken, photographs of the body part between the neck and belly button are taken from various angles, and the surgeon evaluates many features such as the structure of the rib cage, the shape of the breasts, and whether there is any asymmetry.

Then, the details such as the shape and size of the silicone implant to be placed, through what type of incision the implant will be inserted, and in which  plan (under or above the muscle) it will be placed are discussed to make the required decisions. Information is given about the possible risks and complications of the procedure. All questions of the patient are answered.

A routine chest examination by a general surgeon should be performed in the preoperative period to clearly reveal the health status of the breasts, and ultrasound and other methods deemed necessary should be used to check the patient for any mass or pathology. These tests can also detect previously undetected problems; so they should be performed even at very young ages and in women with breasts that look completely normal.

The patient is given an information form that explains in detail what she should pay attention to in preparation for the surgery, as well as what to consume and what not to consume, and she is then expected to strictly follow all these recommendations.

Tea, vitamins, medicines, and nutritional supplements, such as green tea, which has blood thinning effect, should be discontinued for at least 15 days before surgery.  If no problems that may pose an obstacle to the operation are identified during the preoperative meeting with the anesthesiologist after the necessary examinations, the operation phase is initiated.

Is There Any Non-Surgical Breast Augmentation Method?

I don’t believe there is a nonsurgical breast enlargement method that is healthy, safe, and long-lasting. Silicone implant placement continues to be the gold standard in breast augmentation.

How Long Does A Breast Augmentation Operation Take?

A breast augmentation operation takes 1 to 3 hours depending on the surgical technique used and the way the surgeon use it.

What Is The Most Preferred Type of Silicone implant?

In my own practice, I prefer placing round and flat surface silicone implants in the subpectoral (submuscular) plane, based on the most recent information in the literature. However, I make a decision on the shape and surface characteristics of the silicone implant, such as whether it will be smooth or textured, after evaluating all the parameters for each case.

After Surgery

The patient starts consuming food orally 2 hours after the operation, and stands up and walks 4 hours later. The bed is adjusted for a semi-sitting position. It is helpful to spend the night of the operation in the hospital in order to be closely monitored and treated.

During this process, it is necessary to avoid movements that push the limits of the arm, excessively raising the arm, excessive straining on the toilet, and excessive walking during this process. It is decided whether the drains will be removed by looking at the color and amount of the fluid coming from the drains within 24 hours, and this usually takes 2 to 3 days.. In patients who move and use their arms more, more fluid flow is observed and the drains are removed later. The patient wears a special bra and corset in the postoperative period.

At the time of discharge from the hospital, the patient should request and keep the operation note explaining the details of the surgery and the implant identification document issued by the manufacturer company that contains information about the silicone implant used.

One week after surgery, she can gradually return to her daily life, as long as the arms are not excessively strained. Sports that require using the arms intensively, such as swimming or tennis, can be started after 6-8 weeks.

Especially in cases where the implant is placed in the subpectoral (submuscular) plane, it is recommended to avoid sports that strain the chest muscles excessively, such as heavy lifting and pull-ups, because the repelling force of the muscles may displace the silicone implant downwards and outwards. In the first two postoperative months, the patient should avoid saunas, solariums, and long-term active sunbathing.

The breasts swell and tighten significantly in the first three days after surgery; but after the third day, the edema gradually subsides and the breasts begin to soften. The appearance of the breast observed in the first weeks is not the final aesthetic appearance.

In the first weeks, the breast becomes tense and immobile, the nipples look excessively protruding forward, but from the 2nd month, this appearance begins to change, the breasts become softer and more mobile, the edema in the cleavage area subsides, the nipples turn a bit rises; in short, the breast starts looking more natural within 1 to 6 months after the breast augmentation surgery and finally gains its final appearance.

It is normal to experience uncomfortable conditions during this process, such as changes in nipple sensation, different pains that feel like electric shock, burning, swelling compatible with menstrual periods, and so on. Some scar reducing creams are applied to the surgical scars, and it takes 2 years for the scar to take its final form.

Periodic postoperative control examinations are important. Control examinations are usually performed 1, 3, 6 and 12 months after surgery. After the first year, it is beneficial to get examined on a yearly basis. In particular, regular annual breast examinations and imaging tests such as ultrasound and MRI procedures are required to closely monitor the condition of the breast tissue, the implant, and the capsule tissue surrounding the implant, and to detect any potential negativity in time.

How Should The Sleeping Position Be After Breast Augmentation Surgery?

It is important to lie on the back in a semi-sitting position for the first two postoperative weeks to avoid complications such as bleeding and dislocation of silicone implants. You should keep wearing the bra and corset given to you while you are lying down. You may involuntarily turn to one side while sleeping; in fact, short turns may not cause serious problems but by placing some supports on your both sides, you can both prevent such involuntary turns and support your arms.

When Can I Lie On My Side Or Back?

Two weeks after the silicone placement surgery, you can lie on your side, provided that you wear the bra and corset given to you. You can lie on your side 2 weeks after the silicone placement surgery, on condition that you wear the bra and corset given to you. The patient should avoid lying face down until the wound healing around the silicone implant has reached a certain stage (in my opinion, this takes at least 3 months), because lying in this position puts the implant under direct pressure, causing the risk of the implant slipping sideways and down. I advise you to try sleeping in a different position if you feel pain in your breasts when you try to lie face down.

Is the Aesthetic Result Obtained With Breast Augmentation Surgery Permanent?

The chest is not a static organ, so the aesthetic appearance obtained after the surgery won’t last a lifetime. The shape of the breasts changes over time as a result of aging, gravity, weight gain and loss, and pregnancy.

Considering also the own weight of silicone implants, we can say that sagging and loosening of the breasts are inevitable over time. Depending on the tightness of the breast skin and the environmental factors to which the person is exposed, this process will be faster in some people and slower in some others.

In the long term, revision surgery may be required due to reasons such as leakage form the silicone implant, bursting or inversion of the silicone implant, excessive capsule contracture around the implant, tumoral mass development in the capsule or breast tissue, fluid accumulation in the breast, and deformities.

Can a Breast Lift Be Performed in Conjunction with Breast Augmentation?

If a breast with small volume is also sagging, that is, if the nipples are at or below the inframammary fold, the breast augmentation procedure can also be performed in combination with the breast lift procedure in the same session. In such a case, a different incision is made on the breast skin. The size and location of the incision vary depending on the degree of sagging in the breast. For more detailed information about this subject, you can visit our page “Breast Lift”.

Risks and Complications of Breast Augmentation Surgery

As with all other surgical procedures, breast augmentation surgery has risks and complications, and patients should be fully informed about them. It is possible to avoid most of these complications in cases where the patient takes her physician’s advice seriously and follow it before and after surgery.

  • BleedingBlood accumulation (hematoma) may occur in the pouch where the silicone implant is placed in the early postoperative period, particularly in the first 15 days after surgery. The breast suddenly swells and enlarges, causing pain. The implant is removed under the operating room conditions, the bleeding is controlled, and the implant is reinserted into the pouch. Blood thinners and certain foods should be discontinued at least 15 days before surgery to avoid such complications. In the postoperative period, it is important to avoid movements that raise blood pressure and strain the chest muscle.
  • InfectionInfection may develop at the surgical site, causing cause symptoms such as redness, pain and discharge in the breasts and high fever. The implant is removed, the surgical area is cleaned and antibiotics are administered to control the infection. A few months later, a new implant can be placed in the same area.
  • Wound healing problems at the incision site: The incision made in the skin for implant placement may not heal normally, and problems such as redness, swelling, stiffness, and discoloration on the surrounding skin may be observed.
  • Excessive capsule tissue development around the implant (capsule contracture):The thin membrane layer called the capsule, that normally forms around each silicone implant thickens more than normal, hardens, and compresses the implant, causing visual deformities and pain. The capsule then may require surgical cleaning, replacement, and placement in a newly created subpectoral (submuscular) pouch if it has been placed in a subglandular (supramuscular) pouch.
  • Loss of sensation in the nipple and areola: Especially in the first weeks after the operation, a decreased or complete loss of sensation may be experienced in the nipple and the entire breast skin. Such a condition that usually resolves spontaneously within months may rarely be permanent.
  • Loss of the integrity of the silicone implant (bursting):The silicone gel inside the silicone implant can be observed to spread as a result of ruptures and openings in the outer sheath that may occur over time. It can manifest itself as a change in the shape of the chest, pain, allergic reactions, or enlargement of lymph nodes in the lungs or armpits, or it can also be detected during routine chest ultrasound or MRI exams. The implant must be replaced with a new one. In such cases, many implant manufacturers guarantee to provide a new implant free of charge. Therefore, the implant identification document that contains information about the implant should be kept after surgery and used in such cases.
  • Seroma: Chest swelling and excessive fluid accumulation around the silicone implant may occur as a result of trauma, strenuous exercise, or the development of a tumoral mass. If this condition, which can sometimes disappear with rest, persists, additional surgical procedures may be required for sampling and drainage of the fluid.
  • “Anaplastic large cell lymphoma” (ALCL) developing around a silicone implant:Although rare, it is reported in the medical literature that a tumor (Breast Implant Associated Anaplastic Large Cell Lymphoma, BIA-ALCL) originating from lymph cells may develop around the silicone implant, on the capsule’s surface facing the silicone implant or inside the capsule, and can be fully treated surgically when diagnosed in time. This tumor is not a breast cancer.
  • Up until 2019, this tumor was found in 577 of approximately 20 million patients with silicone implants in the world. In the cases where tumors have been detected, the majority of the implants were found to have textured surface; and therefore, the manufacturer company Allergan has recalled this type of silicone implants (Biocell) from the market. People who still have this brand and type of silicone implants should keep in touch with their physicians and have their routine examinations done without interruption.
  • The most common symptoms of Anaplastic Large Cell Lymphoma include gradual enlargement of the breast, asymmetry, pain, mass formation in the breast or armpit, hardening of the breast, peeling on the breast skin, or fluid accumulation (seroma) around the implant. These symptoms can start appearing at least one year after the operation and are most frequently observed 8-10 years later.
  • Therefore, people who have silicone surgery should get examined on a yearly basis and should contact their doctor immediately after they notice any of the symptoms listed above.
  • Unsatisfactory aesthetic resultThe aesthetic appearance of the breasts after the operation may not be as the patient expects in terms of size, shape; or symmetry and a second operation may be required.

Breast Augmentation with Fat Injection

In well-selected suitable patients, augmentation can be achieved to some extent by injecting the fat tissue taken from the person’s own body into the breast area, but silicone implant placement still continues to be the gold standard in breast augmentation. In some cases, fat injection can be performed in the same session as a support to the silicone implant placement procedure.

Breast Augmentation Procedures

Breast augmentation with silicone implants is the gold standard for the augmentation of small breasts in in adult women. Fat tissue can sometimes be injected around a silicone implant during the breast augmentation operation to make it look more natural. In selected rare cases, fat injection alone can be adequate to provide a slight increase in the breast size. On the other hand, it is reported that breast augmentation is performed using some synthetic fillers, but I do not find it appropriate to inject large volumes of hyaluronic acid derivative fillers because they may cause allergic reactions and dissolve over time.

Breast Augmentation with Ready-Made Fillers

Albeit in limited volumes, breast augmentation can be provided using ready-made/temporary fillers, active ingredient of which is hyaluronic acid, but I do not prefer or use such fillers for this purpose because they are foreign substances and their effect is temporary.

How Long Is The Expected Life Of Silicone Implants?

The life of a silicone implant may vary depending on the technology used by its manufacturer. In practice, no specific date is given to patients for the replacement or removal of silicone implants. Implants are kept in place as long as the person has no problems with breast aesthetics or general health, and no problems with the implant are observed during routine examinations.

When an implant needs to be replaced due to a structural defect, the faulty implant can be replaced with a new one for free under the lifetime guarantee offered by some silicone implant manufacturers. Moreover, those implant manufacturers also pay the hospital costs if this procedure is necessary within the first 10 years after the surgery.

Do Silicone Implants Interfere With Pregnancy Or Lactation And Do They Pass Into The Milk?

Because the silicone implant is placed under the breast tissue or even beneath the chest muscle, no silicon particles pass into the milk, and the implant does not interfere with lactation.

Can Sagging Breasts Be Corrected With This Surgical Procedure?

Mild cases where the nipple does not hang below the level of the inframammary fold can be corrected with breast augmentation surgery alone, but more severe cases also require a breast lift and mastopexy operations. If the sagging breast is also small in volume and if it is deflated, breast augmentation with silicone implant and a breast lift can be performed in conjunction with each other in the same session. If the volume of the sagging breast is normal, the breast lift procedure alone is performed.

According to my personal experience, in patients with slightly sagging breasts, who initially underwent breast augmentation alone in order not to have additional scars, the sagging breast skin enters the sagging process faster when the weight of the placed silicone implant is added to the current weight of the breasts, and consequently, a breast lift operation is needed in a few months or a few years due to the resulting sagging problem.

Therefore, I often combine the breast augmentation procedure with the breast lift procedure and achieve longer-term and more aesthetic results for my patients who have a mild loosening and sagging problem in their breasts, .

Will It Be Noticeable That I Have Had A Silicone Placement Surgery? Will the Result Look Natural?

It is possible to obtain results that look so natural that it is impossible to notice that a breast augmentation operation has been performed with silicone implants when viewed from the outside. If a large implant is placed just under the thin breast tissue, it looks artificial; however, if an implant of a size compatible with the body dimensions is placed under the chest muscle, or if it is placed over the chest muscle but there is enough breast tissue to cover and camouflage it, it is possible to make the breasts look natural.

Whether or not the presence of the silicone implant can be noticed when the breast is touched varies depending on the softness of the implant and whether a prominent capsule contracture is formed around it; so it cannot be guaranteed that the presence of the implant will not be noticed when the breast is touched. When touched, softer round implants with a smooth surface feel more natural than implants with a textures surface, if there is no capsular contracture.

When a chest X-ray is taken or procedures like computed tomography or MRI that involve the breasts are performed in a hospital for any reason, the implants can be seen on the images.

Will the Breast Augmented by Surgery Sag in the Future?

Sagging of the breasts to some extent is unavoidable in the early or late period, depending on the firmness of the breast tissue and skin, environmental conditions. The weight of the silicone implant also contributes to the sagging; in other words, the larger the implant is, the heavier it is, and the more sagging occurs.

Breast sagging may be more noticeable after pregnancy and lactation periods, especially in cases of excessive weight gain and loss. People who have had breast augmentation surgery should be aware of the fact that their breasts will sag over time and they may require a breast lift surgery at some point in their lives.

When is the Best Season or Period for Silicone Implant Placement?

Silicone implant placement can be performed at any time, but should be remembered that strenuous activities such as swimming, tennis, and heavy lifting should be avoided and the breasts should be protected from the sun in the first one or two postoperative months. Therefore, when making vacation plans, it is necessary to ensure enough time between the date of surgery and such activities.

Is Breast Augmentation Surgery Too Painful?

The level of pain or ache felt during breast augmentation surgery varies depending on several factors. The larger the silicone implant, the more the breast tissue is stretched and excessive stretching may cause pain. In cases where the implants have been placed in the subpectoral (submuscular) plane, arm movements can cause pain as well.

If a drain has not been used to discharge the fluid that accumulates inside after the surgery, the extra pressure created by this fluid may increase the pain. Of course, not all patients have the same pain threshold; so each patient may perceive the pain of the same intensity differently and her reaction to it may be unique.

The pain is felt most intensively in the first few hours and the first postoperative night, and some procedures are performed to reduce the pain Local anesthetic injections can be made into the operation area at the end of the procedure, and strong painkillers are administered intravenously after the procedure, to prevent the patient from feeling serious pain.

The pain starts subsiding on the second postoperative day, and most patients do not need any painkillers. If the patient feels severe pain, she should inform the physician because such a pain may be the sign of a complication such as bleeding. When I discharge my patients the next day after surgery, I prescribe paracetamol tablets alone as a pain reliever and it is adequate.

How Should the Weight Status Be Before Breast Augmentation Surgery?

Weight gain and weight loss are a determining factor for the size and shape of the breasts. Therefore, having surgery when you are at a normal weight will be helpful. It is better to determine the shape and size of the implant according to the normal weight of the patient. Losing weight after an operation performed on an overweight patient may result in changes in the shape and volume of the breast.

What Should the Patient Do To Protect Her Breasts After the Operation?

For the first 6-8 weeks after surgery, it is essential to support the breasts as much as possible and protect them from movements by wearing the special corset given by your physician. Wearing a bra also in the following periods would be helpful to reduce the possibility of sagging that may be occur due to the weight of the silicone implant. In order to prevent downward displacement of the implants placed in the subpectoral (submuscular) plane, it is useful not to overdo exercises that strain the arms such as heavy lifting and pull-ups. Care should also be taken to avoid exposing the breasts to direct intense trauma.

Is Massage Necessary After Breast Augmentation?

The necessity of massage after breast augmentation surgery is controversial. I don’t recommend massage to my patients because massage may cause bleeding or fluid accumulation around the implant. However, if it is observed that the capsule formed around the implant hardens and tightens, a controlled massage can be applied to soften and stretch this capsule.

Will There Be A Loss Of Sensation In The Nipples After The Silicone Placement Surgery?

The push of the silicone implant and swelling of the breast tissue may cause temporary loss of sensation in nerves that give sensation to the nipples. This loss of sensation may last as long as 1 year. Very rarely, permanent loss of sensation may occur due to anatomical passage of the sensory nerves through the area where the implant is placed.

Should I Wear a Bra After Mammoplasty?

Special bras in the form of athletic bra that do not pressurize the incision areas should be worn in the first 6-8 weeks after the operation. Wearing a bra is not necessary after the end of this period, but wearing it has a helpful role in preventing the breasts from sagging again.

When and What Type of Bra Should I Buy After Silicone Surgery?

I recommend that you wear the special bra corset you were given after the surgery for a period of at least 1.5 months. Edema and swelling in the breasts subside in 1.5 to 2 months, and then the final size of the breast appears. If the corset bra that fits well in the first few days begins to feel loose after a few weeks as the swelling and edema subside, it may be necessary to switch to a smaller size.

Since the body sizes of the bra brands may differ, it would be appropriate to buy a bra by trying it on yourself at the end of the 2-month period. When choosing a bra, keep in mind that “push up” bras that push the breasts towards each other and upwards should not be preferred for long-term use. If such bras are worn for a long time, they may cause implant displacement and deformation of the breast.

How Long After The Breast Augmentation Surgery Can I Start Exercising?

Exercises that require the use of the arms can be started 6 to 8 weeks after the silicone implant surgery. If you feel pain in the breasts during the exercise, you should not strain your body. Since the length of the waiting period varies depending on the individual or the nature of the surgery, it is best to get the opinion of the plastic surgeon that performed the surgery.

How Long After The Surgery Can I Have Sex?

The first 15 postoperative days are the period, when risk of bleeding still exists. During this period, it is best to avoid activities that raise blood pressure, such as sex.

Can I Smoke After Surgery?

Smoking impairs the nutrition of the tissues by narrowing the blood vessels that carry oxygen to the tissues. Smoking should be stopped at least one month before the surgery and should not be resumed before the end of the first postoperative month. On the other hand, it takes 1-2 years for the surgical scars to heal aesthetically, and smoking has a negative impact on the healing process of this scar. Therefore, it would be a more appropriate approach not to smoke at all after the surgery.

How Can I Know That The Silicone Implant Is Torn?

If the outer sheath of the silicone implant is torn for any reason and the silicone’s integrity is lost, the silicone gel inside begins to leak around the implant. Subsequent symptoms such as decreased volume, deformity, asymmetry, palpable firmness and mass in the breast, pain in the breast, and swelling in the axillary lymph nodes may develop, but in some cases, no symptoms can be observed and the problem can only be detected during routine ultrasound or MRI tests. The ruptured implant should be replaced with a new one without delay.

Some implant manufacturers guarantee that they will provide new implants free of charge after examining the ruptured implants in their own laboratories. Therefore, both the hospital personnel and the patient should keep the identification card of the implant used in breast augmentation surgery.

Will the Silicone Implant Be an Obstacle For Flying or Diving?

Silicone implants have a silicone outer layer and a silicone gel or liquid inside. There is no air inside the implants.  As a result, implants are not affected by pressure changes. The implants have the capacity to withstand the increased pressure on the body during diving.

Can I Have My Silicone Implant Removed?

If you want to have the silicone implants removed from your breasts for any reason, and it is possible. However, you should be aware of that your breasts will no longer look the same as they did before the surgery.

More or less loosening of your own breast tissue, sagging and a decrease in breast mass, and even collapse in the rib cage bones to some extent may occur as a natural result of the effect of the implant and the passage of time. Therefore, a breast lift is usually required during surgical removal of implants.

What are the Lower and Upper Age Limits for Breast Augmentation Surgery?

Breast augmentation surgery requires the completion of the rib cage and breast tissue development, and this development continues until 18 to 22 years of age. There is no upper age limit for the surgery in terms of the use of implants; so it can be performed on people of any age as long as their general state of health is suitable.

How Long After Breastfeeding Can I Have Surgery?

After weaning the baby, it should be waited until the mammary glands stop producing milk and return to their pre-pregnancy state. The waiting period varies from woman to woman but usually lasts 3 to 6 months. If the breast augmentation will be performed in conjunction with a breast lift procedure, it is beneficial to wait for at least 6 months.

Cost of Breast Augmentation Surgery with Silicone Implant – 2024

The cost of breast augmentation surgery with silicone implant varies depending on the hospital where the surgery will be performed, the price of the silicone to be used and the physician’s fee. You can contact our office to get information about the current surgery price specific to you.

What is the Reason for the Variation in Breast Augmentation Surgery Prices?

Exchange rate fluctuations raise the prices of silicone implants imported with foreign currency. In addition, hospital fees rise at the rate of inflation every year. To get information about the current cost of breast augmentation surgery, you can contact us by filling out the form or via the WhatsApp line.


  1. Breast Augmentation

Frequently Asked Questions (FAQ)

How long after childbirth can silicone implants be placed?

The mammary gland activity, milk production, and breast volume increase as a result of hormonal changes during the birth and subsequent lactation period. After the lactation process is completed, it takes 6 months on average for the mammary glands to completely stop producing milk, and for the breasts to gain their final size and shape. At the end of this period, breast augmentation surgery with a silicone implant can be performed, and in most cases, sagging breast problem is surgically solved in the same operation. These procedures are known as breast augmentation with silicone implant and breast lift (mastopexy).

Can I Have My Breasts Augmented As Much As I Want?

In the first silicone implant surgery, there are some factors that determine or limit the size of the implant to be placed. The base diameter of your breast is the primary one of these factors. Attempting to place a silicone implant with a base diameter larger than your own breast’s base diameter causes the implant to displace downwards and sideways from the lower outer quadrant of the breasts, resulting in extremely poor aesthetic results. The flexibility of the breast tissue and skin is another factor that determines the size of the silicone implant to be used. It is possible to place an implant with higher projection and larger volume in a breast with loose skin and soft tissue, but an implant with lower volume should be placed in a breast with tight breast tissue and skin.

Another important factor is whether the silicone implant will be placed in a subglandular (supramuscular) or subpectoral (submuscular) plane. Implants with a larger base diameter can generally be used in a subglandular plane, while implants with a smaller base diameter should be used in a subpectoral plane. Over time, the breast tissue and skin loosen and adapt to the new volume in the months and years after the first breast augmentation surgery. If desired, the existing implants can be removed about one year after the first surgery, and then silicone implants with higher projection and larger volume can be placed. The very large breasts with silicone implants seen in the media are the result of implant replacements repeated several times in this way.

I’d like to emphasize in particular that the higher the volume and weight of the silicone implant, the greater the sagging rate of the breasts in the following years, and this means the need for another breast lift surgery in the future. On the other hand, after the placement of large-volume implants that exceed normal limits, the incidence rate of complications such as capsular contracture and deformity will rise in the long term.

Does breast augmentation surgery leave scars?

Breast augmentation surgery leaves more or less a scar due to the skin incision made for the placement of the silicone implant. This scar may be on the inframammary fold, around the nipple, or under the armpit, depending on the location of the incision. The person’s wound healing characteristics are the most important factor that determines how well the incision heals. In some people, these incisions heal very well and become almost unnoticeable. In some cases, incision scars may be redder, wider and puffier and may heal later due to the anatomical characteristics of the patient.

Very rarely, poor wound healing known as hypertrophic scar or keloid may occur. Such cases may require additional treatments such as cortisone injection, silicone gel or silicone sheet applications. After the surgery, it takes 6 to 24 months for the scars to take their final form. During this period, it is necessary to be patient and follow the physician’s recommendations..

What are the dos and don’ts before breast augmentation surgery?

  • Drugs, herbal preparations, and nutritional supplements with blood-thinning effect should be discontinued at least 15 days before the breast augmentation surgery, and care should be taken to eat completely naturally. Otherwise, the patient is likely to encounter bleeding problems during and after the surgery. Medicines containing aspirin, herbal products such as green tea, and nutritional supplements such as vitamin E or fish oil can be given as examples of substances that increase the risk of bleeding by reducing blood clotting. A more detailed list is available under the heading “Before Surgery” on my website.
  • In particular, birth control pills containing estrogen should be discontinued at least one month before the operation, because a high level of estrogen hormone in the blood causes increased risk of clot formation in the legs.
  • Heavy smokers should stop smoking, if possible, or minimize smoking at least one month before the operation.
  • People with anemia should first have this disorder treated.
  • Silicone implant surgery should be performed when the patient is physically and mentally at his best; and it would not be appropriate to expose the patient to unnecessary risks by performing the surgery hastily. The patient should answer all questions correctly without concealing anything from the physician, with intent to have the surgery.
  • After the operation, the patient should lie in a semi-sitting position and use her arms as rarely as possible. Especially in the first days, availability of a companion who can help the patient would be helpful.
  • Adequate amount of fluid and protein-rich food should be consumed. Daily works and excessive straining should be avoided.
  • As before the surgery. blood-thinning foods should not be consumed in the first 15 days after surgery,
  • In summary, all these should be thoroughly discussed with the surgeon, and his or her recommendations should be strictly followed. Different drugs or nutritional supplements should not be taken without informing the physician.

What are the causes of pain in a breast with silicone implant?

Since the implant will stretch the breast tissue, some pain is normal in the first few days after silicone implant surgery. Especially in cases where the implant is placed in a subpectoral (submuscular) plane, arm movements cause pain. In cases where a drain is not placed during the surgery, patient may feel more pain due to blood or fluid accumulation. If severe pain is accompanied by an increase in chest volume during this early postoperative period, the physician should be informed without delay because it could be a sign of bleeding and blood accumulation in the chest. If breast pain is felt months after the operation, late complications or certain breast diseases should be considered and investigated.

The possible causes include the development of capsular contracture around the silicone implant, rupture of the implant, and lymphoma or fluid accumulation around the implant. Pain may also begin to be felt after doing sports that excessively strain the arms such as tennis or swimming, or after a trauma to the breasts.

Is it necessary to have the breast implant removed in case of pregnancy?

Being pregnant does not necessitate the removal of the silicone implant. Mothers who have implants can also breastfeed their babies. On the other hand, the breasts may not look the same as before the pregnancy and breastfeeding periods, due to the changes that occur in the breast skin and tissue during these periods. Sagging and deformation to some extent can be observed in the breasts. Therefore, women who are planning a pregnancy in the near future should postpone the breast augmentation surgery for at least 6 months after the end of the lactation period.

Do breast implants placed during breast augmentation surgery need to be replaced?

According to a 2011 report issued by the Food and Drug Administration (FDA) in the United States, 20 out of every 100 patients who had silicone implants had their implants replaced within 10 years after the placement surgery for a compelling reason such as capsular contracture or implant rupture. People who have had silicone implant surgery should know that they may have the same surgery again later in life due to sagging breasts or long-term complications. On the other hand, this study does not mean that everyone should have their breast implants replaced within 10 years.

There is no need to replace the implants as long as the results of routine physical examinations, doctor visits, radiological tests and the follow-up of the implants are all normal. Today, implant technology is also evolving, and some manufacturers offer a lifetime guarantee that covers production problems such as silicone leakage or rupture of the implant, for the replacement of implants with new ones free of charge.

Does silicone implants placed in breast augmentation procedures cause cancer?

To date, scientific studies have found no data indicating that silicone implants cause breast cancer. However, in recent years, a type of lymphoma known as BIA-ALCL, Breast Implant Associated – Anaplastic Large Cell Lymphoma, which develops in the capsule tissue surrounding the silicone implant, has become a topic of discussion. The incidence rate of this disease is approximately 1/30,000 and the total number of BIA-ALCL cases reported in all countries is around 800. This type of lymphoma that develops around the silicone implant is easy to diagnose early and is largely treatable.

Therefore, patients who have had silicone implant surgery should not delay routine breast ultrasonography and MRI checks, and should contact their physicians immediately if they notice abnormal symptoms such as swelling, pain, hardening, palpable mass, and asymmetry in the breasts, or redness and rash on the breast skin. According to reports, this disease is usually observed 8-10 years after surgery.

Do Breast Enlargement Exercises Work?

When the chest muscles gain volume as a result of exercises intended for chest muscles, the breast comes forward slightly more, but such exercises do not increase the volume of the breast itself. Unfortunately, no exercise can significantly increase breast size. On the other hand, when weight is gained, the breasts also grow to some extent.

Can the silicone breast implant be felt by hand?

When touched, silicone breast implants cannot be felt in some patients, while can be felt in some others. There are many factors determining this situation. Some of these factors include;

1- The softness of the silicone implant: Soft implants filled with silicone gel, known as “Cohesive implants”, which have a smooth surface, feel more natural to the touch. Implants with textured surface are slightly harder.

2- The volume of the implant: Implants that are too large that stretch the breast skin excessively are easier to notice.

3- If the silicone implant is placed just under the breast tissue, it is more likely to be felt due to inadequate amount of tissue covering it. On the other hand, if the implant is placed in a subpectoral (submuscular) plane, it is less likely to be felt.

4- The more breast tissue the patient has, the better the implant will camouflage the implant placed under it. In a size zero breast, the implant is more likely to be felt. On the other hand, the implant is less likely to be felt, in a patient who already has a certain volume of breast tissue but has undergone a breast augmentation operation with a small breast implant.

5-Any capsule contracture around the implant makes the chest harder and more immobile than normal, and as a result, the breast feels unnatural when touched.

In conclusion, if you are considering breast augmentation surgery with a silicone implant, you should know that the implants can be felt when touched, and you should take this risk into account. I would also like to remind you that the implants are also visible in some radiological examinations such as chest x-rays. I would also like to state that from time to time I see some patients who hide their breast augmentation surgery from their husbands.

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