Breast Augmentation

Some women may naturally have small breasts, or experience a loss of breast volume due to factors such as weight loss, breastfeeding, or aging. Based on personal expectations, aesthetic concerns, and social factors, breast augmentation surgery may be requested.

Today, the most effective and long-lasting method for breast augmentation is the use of silicone implants. In selected patients, breast augmentation with fat grafting is also an option.

Breast Augmentation with Fat Grafting

In this technique, the patient’s own fat is usually harvested from suitable areas of the body, most commonly the abdomen. After being processed with special techniques, the fat is injected into the breasts. Since the procedure is performed through very small incisions, visible scarring is minimal.

As the patient’s own fat is used, there is no risk of foreign body reaction. However, a portion of the injected fat may be reabsorbed over time. The amount of fat that remains permanently depends largely on the individual’s tissue characteristics and cannot be predicted precisely. Therefore, this method generally provides a limited increase in breast volume.

Breast Augmentation with Silicone Implants

Silicone breast implants are available in various sizes and in round or anatomical (teardrop-shaped) forms. During the preoperative evaluation, the shape and size of the implant are determined together based on the patient’s body structure and aesthetic expectations. In patients with sufficient breast tissue where the implant is not expected to be noticeable from the outside, a subglandular (over-the-muscle) placement is preferred. In cases with insufficient breast tissue, a submuscular (under-the-muscle) placement is performed to achieve a more natural appearance.

The surgery can be performed under general anesthesia or, in selected cases, under sedation with local anesthesia. Implants are usually placed through an approximately 4 cm incision in the inframammary fold or through an incision around the areola. Drains may be used after surgery to prevent fluid accumulation.

Patients can typically return to their daily activities about one week after surgery. Wearing a supportive shaping bra for approximately six weeks and avoiding strenuous physical activities during this period are recommended.

Possible Risks and Long-Term Follow-Up

Since silicone implants are foreign materials, the body naturally forms a thin layer of tissue, known as a capsule, around the implant. In rare cases, this capsule may thicken and lead to a condition called capsular contracture. Mild to moderate capsular contracture usually does not cause significant discomfort or visible deformity. In advanced cases, implant replacement may be required.

Implant rupture is a rare complication. If it occurs, the implant needs to be replaced.

Although very rare, breast implant–associated ALCL (Anaplastic Large Cell Lymphoma) has been reported in association with silicone breast implants. With early diagnosis and appropriate treatment, this condition can generally be successfully managed.

Conclusion

When performed with proper patient selection and appropriate surgical techniques, breast augmentation surgery can provide highly satisfying aesthetic and psychosocial outcomes.