Breast Implant Surgery

What Is Breast Implant Surgery?

Breast implant surgery is a surgical intervention in which medical implants (prostheses) are placed under the natural breast tissue or under the chest muscle to increase breast volume and projection. Breast implants are divided into two main categories based on filler material: saline (saltwater) and silicone. Today, silicone implants are much more widely used because they create a more natural consistency that more closely resembles actual breast tissue. The new generation of silicone implants, known as "gummy bear" or Cohesive Gel implants, maintain their shape if ruptured and their material does not spread in the body.

In addition to material, implants are also classified by shape into two types: round and teardrop or anatomical. Round implants create more fullness in the upper part of the breast, while teardrop implants provide a more natural appearance with most of their volume concentrated in the lower part. The type, material, and size of the implant are determined by the surgeon based on chest width, skin quality, and the patient's aesthetic goals.

Who Is a Suitable Candidate for Breast Implant Surgery?

Suitable candidates for this surgery are women who are in good general health and are dissatisfied with the small size or asymmetry of their breasts. Individuals whose breast tissue has not developed sufficiently due to genetic reasons (breast hypoplasia) are among the most important candidates for this procedure.

Additionally, women who have experienced breast tissue atrophy and volume loss (involution) after pregnancy and breastfeeding can restore their previous volume and firmness to their breasts with this surgery. Furthermore, correction of congenital asymmetries where one breast is noticeably smaller than the other can be effectively treated using implants of different sizes.

Who May Not Be a Suitable Candidate?

Women who are pregnant or breastfeeding should postpone this surgery for at least 6 months after the complete end of the breastfeeding period to allow the breast tissue to reach a stable state. Additionally, women planning pregnancy in the near future should delay surgery, as weight and hormonal fluctuations can affect the results of the procedure.

Individuals with uncontrolled autoimmune diseases, active infections in the body, or those undergoing breast cancer treatment (without oncologist approval) are not suitable candidates for this surgery. Furthermore, women with severe breast sagging (ptosis) will not achieve the desired result with implants alone, as implants do not lift the breast. These individuals require breast lift surgery (mastopexy) in conjunction with implants.

How Is Breast Implant Surgery Performed?

This surgery is performed under general anesthesia. To place the implant, the surgeon chooses one of three standard incision types: incision in the inframammary fold (under the breast), periareolar incision (around the areola), or transaxillary incision (in the armpit area). The most common and safest method is the inframammary incision, as it causes the least damage to breast glandular tissue and the scar is well hidden in the breast crease line.

After making the incision, the surgeon creates a pocket for implant placement. This pocket can be created above the chest muscle (subglandular) or below the chest muscle (submuscular / dual plane). Placing the implant under the muscle provides better tissue coverage for the implant, creates a more natural appearance, and reduces the risk of capsular contracture. After precise placement and symmetry checking, the incisions are closed with multi-layer absorbable sutures.

How Long Does the Surgery Take?

Breast implant surgery is relatively short and typically takes between 1 to 2 hours. If this procedure is performed simultaneously with breast lift surgery (mastopexy-augmentation), the surgery time will be longer and may take between 3 to 4 hours.

When Do Results Become Visible?

Immediately after the surgery, the increase in breast volume is clearly visible; however, the result at this stage is not final. In the early days and weeks, the breasts are positioned higher than normal due to tissue swelling and muscle tightness (especially in the submuscular approach) and may appear firm and unnatural.

The process of the breasts settling into their natural shape takes time. It usually takes between 3 to 6 months for the swelling to completely subside, the tissues to soften, and the implant to settle into its final and natural position, a process medically known as "Drop and Fluff."

What Is the Recovery Period Like?

The patient is typically discharged on the same day of surgery. The initial recovery period is between 1 to 2 weeks. During this time, sensations of pain, soreness, skin tightness, and swelling are normal and are managed with pain relievers and muscle relaxants.

Wearing a surgical and compression bra begins immediately after surgery, and the patient should wear it continuously for 6 to 8 weeks (except during bathing) to ensure the implants settle in the correct position. Sleeping on the back is mandatory during the first month. Additionally, lifting heavy objects, raising arms above shoulder level, and high-impact physical activities should be avoided for up to 6 weeks.

Are Breast Implant Results Permanent?

Breast implants are not lifetime devices. Although the new generation of implants have very high resistance and longevity, on average an implant is expected to remain in the body without issues for 10 to 15 years (and in many cases up to 20 years).

The natural aging process, weight changes, and gravity continue to affect breast tissue. Additionally, there is a possibility of implant shell erosion over time. The US Food and Drug Administration (FDA) recommends that women with silicone implants periodically check the health of their implants through ultrasound or MRI (Magnetic Resonance Imaging) several years after surgery. In the event of rupture or severe capsular contracture, implant replacement or removal surgery will be necessary.

What Is the Difference Between Breast Implant Surgery and Fat Grafting to the Breast?

Both methods aim to increase breast volume, but they have fundamental differences. In fat grafting, the individual's own fat tissue (e.g., from the abdomen or flanks) is used. This method is suitable for very subtle and natural volume increases (maximum one cup size) and does not introduce any foreign material into the body. However, some of the injected fat is absorbed by the body, and precise shaping like that achieved with implants cannot be created.

In contrast, breast implant surgery allows for significant volume increase, very precise shaping, and mild tissue lift simultaneously. The implant result is more predictable and longer-lasting than fat grafting.

Potential Complications of Breast Implant Surgery

Breast implant surgery is a safe procedure with a very high satisfaction rate, but it does have its own specific complications. The most common specific complication of this procedure is "capsular contracture." The body naturally forms a tissue capsule around any foreign object; in some individuals, this capsule becomes thick and contracts, causing hardening and change in breast shape.

Other complications include the possibility of long-term implant rupture, infection, hematoma (blood accumulation), implant displacement, and changes in nipple sensation (which is usually temporary). Choosing a board-certified plastic surgeon and strictly following post-operative instructions minimizes these risks.

Is Breast Implant Surgery Painful?

The surgery is performed under general anesthesia, and the patient does not feel any pain. Post-operative pain is more noticeable in the submuscular placement method, as the chest muscle undergoes stretching and spasm. This pain is described as a feeling of pressure and heavy soreness and peaks in the first 3 to 5 days. With regular use of prescribed pain medications, this period is easily tolerable and the pain subsides quickly.

What Should Be Checked Before Surgery?

In pre-operative consultation sessions, the surgeon performs thorough clinical examinations including measuring chest dimensions and breast tissue thickness. Ultrasound or mammography of the breast before surgery is mandatory to ensure breast tissue health and the absence of suspicious masses.

The patient must inform the surgeon of all medical history and current medications. Blood-thinning medications (such as aspirin), herbal supplements, and vitamin E should be discontinued at least two weeks before surgery. Complete cessation of smoking and hookah due to the harmful effects of nicotine on tissue healing and increased risk of infection is absolutely necessary from one month before to one month after surgery.

Conclusion

Breast implant surgery is a proven, safe, and effective medical solution for increasing volume and improving breast shape. The use of advanced silicone implants delivers very natural and long-lasting results that, in addition to improving body proportion, have a profound impact on enhancing women's self-confidence.

To achieve the best possible result, accurate assessment of the patient's physical condition, selection of implant size and shape appropriate for chest width, and performance of the surgery by a board-certified plastic surgeon are essential. Adherence to post-operative care and regular check-ups in the years following surgery ensure the health and longevity of the results of this aesthetic procedure.