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
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
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.
Do breast implants have to be replaced?
Not on a fixed schedule. The old advice to replace every ten years is outdated; modern implants are removed when there is a reason — rupture, capsular contracture, or you want a different size. In practice about one woman in five needs further surgery within ten years. Plan for the possibility rather than the certainty, and budget for a revision you may or may not need.
Above or below the muscle — which placement is better?
Under the muscle suits slim women with little natural tissue: the muscle covers the upper edge so the implant does not show as a visible step, and mammogram images are clearer. Above the muscle suits women with enough breast tissue to hide the implant, recovers faster and does not move when you flex. The deciding factor is how much tissue you can pinch at the top of the breast, which your surgeon should measure.
Will I be able to breastfeed after breast augmentation?
Most women can. Implants sit behind the gland or the muscle and do not interfere with milk production, and studies find no risk to the baby from silicone. What matters is the incision: an approach through the fold under the breast or the armpit leaves the milk ducts untouched, while an incision around the areola cuts through more ductal tissue. Say at consultation that you plan to breastfeed.
What is capsular contracture?
Your body forms a thin scar capsule around any implant, and in some women that capsule thickens and squeezes, making the breast firm, high and eventually painful. It affects roughly one in ten over ten years. Early signs are firmness on one side and a change in shape rather than pain. Treatment means removing the capsule surgically; massage and tablets do not reverse an established contracture.
Do implants interfere with mammograms and cancer screening?
They obscure some breast tissue on a standard mammogram, but this is manageable rather than dangerous. Tell the radiology unit you have implants and they will use Eklund displacement views, which push the implant back and image more of the gland. Ultrasound or MRI supplements the picture where needed. Implants do not cause breast cancer, and screening remains just as important after augmentation as before it.
How do I choose the right implant size?
Size is limited by your chest width and the thickness of your tissue, not by the cup size you have in mind. Your surgeon measures the base width of your breast and selects implants that fit within it; going wider than your own footprint creates visible edges and long-term stretching. Try sizers in a bra at consultation and choose the smaller of two options you like — very few patients regret going slightly smaller.
What is BIA-ALCL and should I worry about it?
It is a rare lymphoma that develops in the capsule around an implant, not in the breast tissue itself, and it is almost exclusively linked to textured implants. Estimates range from one case in three thousand to one in thirty thousand textured implants; smooth implants carry a far lower risk. It is highly treatable when caught early. The usual first sign is sudden one-sided swelling years after surgery — get that checked promptly rather than waiting.
How long is recovery from breast augmentation?
Desk work at five to seven days and normal daily life within two weeks. Implants placed under the muscle hurt noticeably more in the first three days and feel tight when you raise your arms. Wear the support bra day and night for six weeks, avoid chest and shoulder training for six to eight weeks, and expect the implants to sit high at first — they drop into their natural position over three months.
Related reading
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Get a FREE Second OpinionThis 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.