Breast Augmentation

What is breast augmentation?

Breast augmentation (augmentation mammoplasty) increases breast volume and fullness using silicone implants, tailored to your anatomy and aesthetic goals. It can also address volume asymmetry between the breasts. In some cases, autologous fat transfer is used as an alternative or supplement, though volume increase is more limited and less predictable than with implants.

Modern breast augmentation aims for more than enlargement — the goal is a result that complements your body proportions, shoulder width, chest dimensions and existing breast tissue. Personalized planning is the most critical step. Implant type, size, incision location and placement plane are all selected based on individual anatomy, expectations and lifestyle.

Who is a candidate?

Candidates include women dissatisfied with breast volume (genetically small breasts — breast hypoplasia), those with volume loss after weight loss or pregnancy/breastfeeding, women with significant asymmetry between breasts, and patients seeking volume/shape adjustment after breast reconstruction.

Evaluation includes overall health, smoking status, medications, prior breast surgery, family history of breast cancer, and pregnancy plans. Implant augmentation is not recommended under age 18 — breast tissue must be fully developed. Patients planning pregnancy in the near future should typically wait, as pregnancy and breastfeeding can produce permanent breast changes.

Patients with significant breast ptosis (sagging) may not be served by implants alone. In such cases, a combined breast lift (mastopexy) is planned. International patients receive a thorough video consultation prior to travel to confirm candidacy.

Implant options

Implants vary by content (silicone gel/saline), shape (round/anatomical), and surface (smooth/textured). Selection is personalized based on desired outcome, tissue thickness, chest measurements, and surgical plan.

Content: Modern silicone gel implants (cohesive gel) are the most commonly preferred option. The gel consistency feels close to natural breast tissue and maintains shape even in case of leakage ("gummy bear" implants belong to this class). Saline implants are less commonly used; they may feel firmer and have higher rippling risk.

Shape: Round implants give a fuller upper pole and a more "aesthetic" profile. Anatomical (form-stable) teardrop implants give a more natural sloping profile, especially valuable for patients with thin breast tissue. Anatomical implants carry a small risk of malrotation; modern technique minimizes this.

Surface: Smooth-surface implants offer a safety advantage in light of recent associations between textured surface implants and BIA-ALCL (a rare lymphoma). Smooth implants combined with the dual plane technique provide safe and effective results.

Placement options

Implants can be placed above the muscle (subglandular), below the muscle (submuscular), or in a dual plane position. The best option depends on your tissue thickness, activity level, and desired upper fullness.

Subglandular (above muscle): Shorter recovery, less pain. Suitable when breast tissue is thick enough. In thin-tissue patients, implant edges may be visible and rippling risk is higher. Capsular contracture rates are slightly higher than submuscular.

Submuscular (under muscle): More natural upper-pole contour, better edge concealment in thin-tissue patients. Mammographic screening is easier. Disadvantages: implant displacement during muscle contraction (animation deformity), prominent movement during chest exercises in active women.

Dual plane: The upper portion of the implant lies under the muscle, the lower portion under breast tissue. Combines the advantages of both subglandular and submuscular techniques: natural curve above, breast tissue control below. The most commonly preferred technique in modern practice for thin-skinned patients and those with mild ptosis. May reduce the need for a separate lift in mild-to-moderate sagging.

Incisions

The most commonly used incision sites are the inframammary fold (under the breast), periareolar (around the nipple), and axillary (armpit). Scar visibility depends on incision location, skin type and individual healing.

Inframammary: A 4-5 cm incision in the breast crease. Provides the surgeon with the broadest surgical view and access. The scar hides in the crease — invisible standing, only noticeable when lying down or with arms raised. The most commonly preferred incision in modern practice.

Periareolar: An incision around the dark border of the areola. The scar is well concealed but ductal structures are closer to the dissection plane, slightly increasing the risk of breastfeeding interference. May be insufficient for implant passage in patients with small areolae.

Axillary: An incision in the armpit. Avoids breast scarring but is technically demanding, often requires endoscopic assistance, and is generally not suitable for revision through the same approach. Used in selected cases.

Preoperative preparation

Smoking should be stopped at least 4 weeks before surgery. Smoking impairs wound healing and increases the risk of infection, tissue necrosis, and capsular contracture. Even passive smoke should be minimized.

Blood-thinning medications (aspirin, NSAIDs) are stopped 10 days before surgery. Vitamin E, fish oil, ginkgo, garlic supplements should also be stopped — they increase bleeding risk. All medications and supplements are reviewed during the preoperative visit.

Standard preoperative tests: complete blood count, biochemistry, coagulation, ECG and chest X-ray when appropriate. Breast ultrasound is performed in patients over 35; mammography is recommended over 40. These imaging studies are critical for evaluation prior to implant placement.

You will be asked to be NPO (nothing by mouth) for at least 8 hours before surgery. Bring a button-down shirt; raising your arms can be uncomfortable in the early postoperative period.

The surgery

Breast augmentation is performed under general anesthesia in an accredited hospital. The procedure averages 1-2 hours. Hospital stay is typically 1 night, occasionally same-day discharge.

A compression dressing and surgical bra are applied postoperatively. Drains are placed in some cases and removed in 1-2 days.

Mild-to-moderate pain is expected in the first 24 hours, more pronounced in submuscular/dual plane techniques due to muscle manipulation. Pain is controlled with prescribed analgesics and decreases significantly within 48-72 hours.

Recovery timeline

First week: Surgical bra worn 24/7. Showering is generally possible from day 2. No heavy lifting, no raising arms above shoulder, no driving. Office workers can return to work in 5-7 days.

Weeks 2-4: Light walking and gradual return to daily activities. Surgical bra worn for 4-6 weeks. Pain decreases but tenderness persists. Swelling subsides significantly.

Weeks 4-6: Light cardio (walking, treadmill, stationary bike) can resume. Upper-body strength training is not yet appropriate. Patience is required for implant position to stabilize.

Weeks 6-8: Vigorous exercise and upper-body strength training can begin. Final breast softening and "drop and fluff" take 3-6 months — during this time, breasts feeling high and firm is normal.

Beyond 3 months: Most healing is complete. Scar maturation (fading of redness) takes 6-12 months.

Risks and complications

Modern technique and proper surgical planning keep risk rates low; however, every surgery has potential complications. Informed decision-making requires understanding these risks.

Early-period risks: Hematoma (1-3%), infection (under 1%), seroma, wound healing problems. Smokers see significantly elevated risk in all categories.

Late-period risks: Capsular contracture (5-10% in Baker grades III-IV), implant rotation (with anatomical implants), implant rupture/leakage, asymmetry, temporary or permanent nipple sensory changes. BIA-ALCL is a recognized late complication, though no association has been established with modern smooth-surface implants.

Aesthetic risks: Size expectations not met, position asymmetry, rippling (especially in patients with thin tissue), implant palpability. These risks are minimized with preoperative planning; revision surgery is rarely needed.

Scar management

Breast augmentation scars fade significantly over time, but optimal results require active scar care during the first 6-12 months. Standard protocol: silicone gel or silicone tape application after the wound has fully closed (typically after week 2), continued for 6 months. Sun protection is essential, especially during the first 6 months — UV exposure causes scars to remain dark.

Breast augmentation in Istanbul — Assoc. Prof. Dr. Ayhan Işık Erdal's practice

Dr. Erdal's private clinic is located in central Istanbul, in the Nisantasi district — Istanbul's premier neighborhood for plastic surgery and luxury services. Address: Teşvikiye Cad. No:9/12, Istanbul. The clinic is easily accessible from major Istanbul hotels and from Istanbul Airport (IST) and Sabiha Gökçen Airport (SAW).

Istanbul has become a leading destination for breast augmentation surgery worldwide, attracting patients from Europe, North America, the Middle East, and Asia. International patients choose Istanbul for the combination of board-certified plastic surgeons, modern accredited hospitals, competitive pricing compared to Western Europe and the US, and the cultural-tourism appeal of the city.

Dr. Erdal's Istanbul practice is structured to provide international patients with seamless coordination: video consultation prior to travel, airport-hotel transfer, English-speaking medical team, accommodation arrangements at partner hotels near the clinic, and full postoperative follow-up. Hospital partners are accredited facilities in central Istanbul with international anesthesia standards.

Patients typically stay in Istanbul for 7-10 days following breast augmentation surgery — sufficient time for the initial postoperative review, drain removal if applicable, and clearance for safe travel home. WhatsApp consultations are available at +90 544 850 72 32 for international inquiries.

Frequently Asked Questions