Aesthetic Surgery

Breast Augmentation

Breast augmentation adds volume with an implant or with your own fat. The decision that matters most is not the brand of implant but where it is placed and what size your tissue can actually support — oversizing is the single most common cause of problems years later.

What is breast augmentation?

Breast augmentation increases breast size and improves shape, either with a silicone or saline implant placed in a surgically created pocket, or by transferring your own fat harvested by liposuction. Implants give a predictable, larger increase; fat gives a subtler, softer change limited by how much fat survives.

It does not lift a breast that has descended. If the nipple sits below the inframammary fold, an implant alone will make the breast larger but still low — a lift (mastopexy) is needed, with or without an implant. Confusing the two is the commonest source of disappointment in this operation.

Implant type, shape and placement

Silicone vs saline

Cohesive silicone gel feels closest to breast tissue and is what most surgeons use. Saline implants are filled after insertion so need a smaller incision, but ripple more and feel firmer. A silicone rupture is silent, which is why imaging surveillance is recommended.

Round vs anatomical

Round implants give more upper-pole fullness and cannot rotate. Anatomical (teardrop) implants mimic a natural slope but can rotate and are textured, which has been linked to a rare lymphoma. Most surgeons now favour smooth round implants for that reason.

Under or over the muscle

Partly under the pectoral muscle (dual plane) gives better upper-pole coverage in thin patients and lower capsular contracture rates, but a longer recovery and possible movement of the implant when the muscle contracts. Over the muscle suits patients with more of their own tissue.

Fat transfer instead of implants

Uses your own fat, so nothing foreign is placed and there is no implant to replace. But the increase is modest — usually less than one cup size per session — a proportion is reabsorbed, and it requires enough donor fat. It is the right choice for subtle change, not for a large one.

Who is a good candidate?

Breast development complete, and generally at least eighteen years old
Enough soft tissue to cover an implant; very thin patients need under-muscle placement
Nipple still above the inframammary fold — otherwise a lift is needed as well
Stable weight, and no pregnancy or breastfeeding planned in the next year
Understanding that implants are not lifetime devices and will need attention later
Up to date with breast screening appropriate for your age and family history
Non-smoker, or able to stop four weeks before and after

Preparation

Measurement of chest base width, tissue thickness and existing asymmetry — implant width is chosen from your anatomy, not from a cup size
Trying sizers in a bra to agree on volume, and photographs from standard angles
Mammogram or breast ultrasound where appropriate for your age
Written record of the implant brand, model, size and serial number for your own files
Blood tests and an anaesthetic review
Stopping smoking four weeks before, and blood thinners about ten days before
A soft front-fastening support bra bought in advance

How the operation is performed

The most common incision is in the inframammary fold, where the scar hides under the breast and gives the surgeon direct control of the pocket. Alternatives are around the lower edge of the areola or through the armpit; each trades scar position against precision and infection risk.

The pocket is created with careful control of bleeding, washed with antibiotic solution, and the implant inserted through a funnel without being touched by skin — steps that measurably reduce capsular contracture. The wound is closed in layers and taped; drains are usually not needed.

Anaesthesia, duration and hospital stay

Anaesthesia: general
Operating time: 1–1.5 hours; longer if combined with a lift
Hospital stay: same-day discharge or one night
Stay in the country: 7–10 days, until the wound check is done
Support bra: worn day and night for six weeks, no underwiring
Time off work: 5–7 days for desk work; 4–6 weeks before chest or upper-body training
Sleeping on your back for the first 2–4 weeks

Recovery

Week 1

Tightness across the chest, worse with under-muscle placement, and a feeling of pressure rather than sharp pain. Arms should be used gently but not kept still. Implants sit high and firm — this is normal and temporary.

Weeks 2–6

The implants begin to settle downwards into the pocket and soften — the 'drop and fluff' phase. Light cardio resumes; chest and shoulder work waits. Nipple sensation may be altered and usually recovers.

Months 3–6

Shape and position are settled and the result can be judged. Scars are still maturing and continue to fade for a year. Full exercise, including chest training, has resumed.

Results and implant lifespan

Implants are not lifetime devices. Manufacturers and regulators expect that a proportion will need replacing or removing over the following decades, whether because of rupture, capsular contracture, or a change in what you want. Planning for that from the start is part of doing this properly.

Because silicone rupture causes no symptoms, imaging surveillance is recommended — typically MRI or ultrasound starting a few years after surgery and repeated periodically. Keep the implant card with brand, model and serial number: it matters if you ever need revision surgery elsewhere.

Risks and complications

Capsular contracture — scar tissue tightening around the implant, causing firmness, distortion or pain; the commonest reason for revision
Implant rupture, which for silicone is usually silent and found on imaging
Infection, which occasionally requires implant removal and a delay before replacement
Altered or lost nipple sensation, usually temporary but sometimes permanent
Rippling or visible implant edges, more likely in thin tissue or with saline
Malposition, asymmetry, or implants sitting too close together
BIA-ALCL — a rare lymphoma associated with textured implants, treatable when caught early
Difficulty with breastfeeding in a minority of patients, and altered mammogram views

Cost and what should be included

The implants themselves are a real, named cost. Ask which brand and model is quoted and what warranty the manufacturer offers — reputable manufacturers provide lifetime rupture warranties and limited financial cover toward revision, but only for their own registered devices.

Named surgeon's fee and the specific implant brand, model and size
The manufacturer's warranty documents and your implant card
Anaesthesia, the anaesthetist's fee and theatre
Pre-operative tests and any breast imaging required
Support bra, dressings and medication
All follow-up during your stay, including the wound check
The written policy on capsular contracture and on revision within the first year

Choose the implant that fits your chest, not a cup size

Implant width should match the base width of your own breast. Going wider than your tissue can support is what produces rippling, visible edges, thinning skin and implants that drift towards the armpit over the years. A surgeon who measures you and then tells you the size you asked for is not achievable is protecting your long-term result.

Frequently asked questions

How long do implants last?

There is no fixed expiry date, but they are not lifetime devices. Many women keep the same implants for well over a decade; others need revision sooner because of capsular contracture or rupture. Plan financially and practically for at least one further operation in your lifetime — and be sceptical of anyone who tells you otherwise.

Can I still breastfeed?

Most women can. The risk is highest with an incision around the areola, which can interrupt milk ducts and nerves, and lowest with an inframammary approach. Tell your surgeon if future breastfeeding matters to you — it should influence where the incision is placed.

Will implants affect breast cancer screening?

They obscure part of the breast on a standard mammogram, so extra views (Eklund displacement views) are used, and ultrasound or MRI may be added. Screening remains effective but must be done at a unit familiar with implants — always tell the radiographer you have them, and continue screening on the schedule appropriate for your age.

Implants or fat transfer?

If you want a clear increase in size, implants — fat transfer rarely achieves more than a modest change per session. If you want a subtle improvement in shape or fullness, have enough donor fat and prefer nothing artificial, fat transfer is a genuine option. They can also be combined, using fat to soften the edges of an implant in thin tissue.

Have your case reviewed before you decide anything

Send your photographs and medical history. A board-certified surgeon reviews them and comes back with an honest assessment of what is achievable, which technique suits you, and an itemised written quote — before any money changes hands.

Get a FREE Second Opinion

This page provides general information about this procedure; it is not medical advice, a diagnosis, or a treatment recommendation. Capital Oncology Group is a care-coordination service and not a medical provider. All procedures are performed by independent, accredited hospitals and licensed physicians, and the decision to operate must be made by a qualified surgeon after examining you individually.