Information about the procedure
Breast enlargement and reshaping with silicone implants or your own fat, tailored to your build and the quality of your tissues.
On this page
What it involves
Augmentation increases breast volume and improves breast shape. Silicone implants are used most often; where a moderate change is wanted, your own fat, harvested by liposuction, can be used instead.
The operation does not lift the breast. If the nipple sits low relative to the inframammary fold, an implant alone will add volume but will not change the saggy appearance. In such cases, combining augmentation with a mastopexy (breast lift) is discussed.
Choosing an implant does not mean choosing a cup size, but a specific width, projection and volume that suit your chest. An implant wider than the base of the breast gives an unnatural result and causes problems in the long term.
Types and approaches
Subglandular implants
The implant is placed between the breast gland and the chest muscle. Recovery is easier and less painful. This approach suits patients who have enough of their own tissue to cover the implant.
Submuscular or partially submuscular implants
The upper edge of the implant is covered by the pectoralis major muscle. This gives a smoother transition in the upper pole and is preferred in slim patients with thin tissue. Recovery is slightly more painful during the first week.
Incisions
The most common incision is in the inframammary fold — it gives the best control and leaves a scar hidden in the natural crease. A periareolar or an axillary (armpit) approach is also possible, each with its own advantages and limitations.
Augmentation with your own fat
Fat from the abdomen or thighs is processed and injected into the breast. This gives a natural result with a small increase in volume — usually half to one cup size. Some of the grafted fat is resorbed, so a second session is sometimes needed.
Who it is suitable for
Suitable for
- Small breasts relative to your build
- Loss of volume after pregnancy, breastfeeding or weight loss
- Marked asymmetry between the breasts
- Congenital variations in breast shape
- Wish to restore volume after previous surgery
Not suitable, or postponed, in cases of
- Pregnancy planned in the coming months — the result will change
- Active infection or an unexplained finding in the breast
- Untreated breast cancer
- Age under 18 for aesthetic augmentation
- Smoking, which increases the risk of poor wound healing
- Expecting an implant to lift a markedly sagging breast
Preparation
- Consultation with measurements of the chest, the width of the breast base and tissue thickness
- Breast ultrasound or mammography, depending on your age and as advised by your doctor
- Pre-operative tests — full blood count, clotting tests, ECG and consultation with an anaesthetist
- Stopping smoking at least two to three weeks before surgery
- Stopping blood thinners and supplements, as agreed with your doctor
- Someone to accompany you and help at home for the first few days
How it is performed
The operation is performed under general anaesthesia and takes about one to two hours. Patients usually stay one night in hospital.
A pocket is created to the exact size of the implant — neither larger nor smaller. Precision at this stage determines whether the implant stays in place over the years.
A drain is placed in some cases. The breasts are dressed and a special support bra is fitted, which is worn day and night for the first few weeks.
Recovery
- The first 48 hoursThis is when discomfort is greatest, especially after submuscular placement. The breasts feel very tight and heavy. Pain relief is given on a fixed schedule.
- The first weekSleep on your back. Do not raise your arms above shoulder level. Most patients stop strong painkillers after the third or fourth day.
- 2–4 weeksReturn to light office work is usually possible after 7–14 days. The swelling visibly subsides, but the breasts still sit higher than their final position.
- 1–3 monthsThe implants gradually settle into their natural position and the breasts soften. This process, known as implant ‘drop and fluff’, is a normal part of recovery.
- 6–12 monthsThe final shape is reached and the scars soften. The result is assessed after this period, not earlier.
Pain and discomfort
The first two to three days are the most uncomfortable, especially after submuscular placement, which patients describe as feeling like severe muscle soreness in the chest. After subglandular placement, discomfort is usually considerably less. Pain is controlled with the prescribed medication and eases quickly after the third day. Sudden pain and swelling on one side after the first week needs to be examined.
Risks and complications
Every intervention carries risks. Listing them does not mean they are expected to occur — it allows you to make an informed decision.
- Capsular contracture — tightening and hardening of the capsule around the implant, which can change the shape of the breast and cause discomfort
- A collection of blood (haematoma) or fluid (seroma) around the implant
- Infection, which with implants sometimes requires the implant to be removed temporarily
- Change in nipple sensation — temporary or permanent
- Visible implant edges or rippling when the overlying tissue is thin
- Asymmetry or implant displacement
- Implant rupture — rare; requires implant exchange
- Very rarely: breast implant-associated anaplastic large cell lymphoma (BIA-ALCL). Extremely rare, but one of the reasons for regular follow-up.
- Resorption of some of the grafted fat after augmentation with your own fat
Results and longevity
Implants do not last forever, but they have no fixed expiry date either. They are not replaced to a set timetable, but when a problem arises — contracture, displacement, rupture — or when you wish to change size.
Periodic follow-up with imaging is recommended, as advised by the manufacturer and your doctor.
Pregnancy, breastfeeding and significant weight changes can alter the breasts after augmentation as well. This is a natural process rather than a complication.