Breast Augmentation

Breast augmentation is a surgical procedure that increases the size, improves the shape, or restores the volume of the breasts by placing an implant — a soft, sealed pouch — behind the breast tissue or chest muscle.

During the operation, the surgeon creates a small pocket either behind the breast tissue (called subglandular placement) or behind the pectoralis major muscle (called submuscular placement) in the chest. A silicone or saline implant is then placed inside that pocket. The choice of implant material, shape, and size is decided together by the patient and surgeon before the operation. The goal is to achieve a breast size and contour that matches the patient's body proportions and personal goals.

Breast augmentation is used both for cosmetic (appearance-related) and reconstructive (restoring what was lost or underdeveloped) purposes. A plastic surgeon will assess whether the procedure is appropriate based on your overall health, breast anatomy, and personal goals.

• Naturally small breasts that the patient wishes to make larger (primary cosmetic augmentation).
• Significant difference in size between the two breasts (breast asymmetry).
• Loss of breast volume after pregnancy, breastfeeding, or significant weight loss.
• Underdeveloped breasts due to a condition such as tuberous breast deformity (a shape disorder present from birth).
• Breast reconstruction after mastectomy (surgical removal of the breast, usually for cancer).
• Correction of a previous augmentation where the result was unsatisfactory or complications occurred.

This procedure is generally not suitable in certain situations. Your surgeon will discuss these with you in detail.

• Active infection anywhere in the body, especially near the breast area.
• Active or untreated breast cancer.
• Pregnancy or current breastfeeding.
• Unrealistic expectations about the outcome.
• Certain autoimmune diseases or conditions that affect wound healing — the surgeon will evaluate these individually.
• Patients who have not yet reached full physical maturity, as breast tissue is still developing.

Breast augmentation is a commonly performed operation, but like all surgery it carries risks. Your surgeon will explain which of these are most relevant to your individual situation.

• Pain and swelling in the breast area in the days and weeks after surgery.
• Scarring at the incision sites, which usually fades over time but does not disappear completely.
• Capsular contracture — scar tissue that naturally forms around the implant tightens and hardens, which can cause discomfort or change the breast shape.
• Implant rupture or leakage — a silicone implant leak may be silent (not immediately noticed), while a saline implant deflates visibly.
• Changes in nipple or breast skin sensation, which may be temporary or, less commonly, permanent.
• Asymmetry — the two breasts may heal differently, leading to an uneven appearance.
• Implant displacement — the implant shifts out of its intended position.
• Infection around the implant, which in some cases requires the implant to be removed temporarily.
• Breast implant illness (BII) — a term used to describe a range of symptoms some patients report, such as fatigue and joint pain, that they associate with their implants. The relationship is still being studied.
• Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) — a rare type of immune system cancer linked to certain textured implants. Reported cases are uncommon.
• The need for additional surgery in the future, whether to replace an implant, address complications, or remove the implants entirely.
• Breastfeeding may become more difficult in some cases, though many women with implants breastfeed successfully.
• General anaesthesia (medication that puts you into a deep sleep for the operation) carries its own small set of risks, which the anaesthesiologist will discuss with you.

Good preparation helps the surgery go smoothly and lowers the risk of complications. Your surgical team will give you personalised instructions — always follow those over any general guidance.

Before the operation, your doctor will usually ask you to:

• Stop smoking for several weeks before surgery. Smoking reduces blood flow and seriously slows wound healing after breast surgery.
• Avoid alcohol for at least a few days before the procedure.
• Pause blood thinners (medications that reduce clotting) and certain herbal supplements — such as fish oil, vitamin E, and ginkgo — as these can increase bleeding during surgery. Your doctor will specify which ones and for how long.
• Fast (not eat or drink, including water) for a set number of hours before surgery, as required for general anaesthesia. Your team will give you the exact fasting window.
• Arrange for a responsible adult to drive you home after discharge, as you will not be able to drive yourself.

Pre-operative tests and assessments typically include:

• Blood tests to check your general health and ability to clot normally.
• A baseline mammogram (breast X-ray) or breast ultrasound (USG), especially in patients over a certain age or with a family history of breast cancer, so that future scans can be compared accurately.
• An electrocardiogram (EKG — a tracing of the heart's electrical activity) if required based on your age or heart health.
• A detailed consultation to choose implant type, size, shape, and placement — often using imaging tools or sizing samples.

On the day of surgery, the procedure itself typically follows these steps:

• 1. You change into a surgical gown and the nursing team checks your identity, consent forms, and allergy information.
• 2. An intravenous (IV) line is placed in your arm to deliver fluids and medications.
• 3. The anaesthesiologist gives you general anaesthesia. You will be asleep and feel nothing during the operation.
• 4. The surgeon marks the incision lines on your skin. The most common locations are along the fold underneath the breast (inframammary), around the lower edge of the areola (periareolar), or in the armpit (transaxillary). The choice depends on your anatomy and the type of implant.
• 5. The surgeon makes the incision and carefully creates the pocket behind the breast tissue or muscle.
• 6. The implant is inserted, positioned, and checked for symmetry.
• 7. The incision is closed in layers with sutures (stitches), and a dressing or surgical bra is applied.
• 8. You are moved to a recovery area where the team monitors you as the anaesthesia wears off.
• The total time in the operating room varies and depends on the complexity of the case.

Recovery after breast augmentation is gradual. Most patients are discharged on the same day or after one night in hospital, but healing continues for weeks to months. Your surgeon will set a personalised recovery plan, and attending every follow-up appointment is important for catching any early problems.

• Pain and tightness in the chest area are common for the first week or two. The surgical team will provide guidance on pain management during this period.
• Wear the surgical bra or supportive garment recommended by your surgeon for as long as advised — usually several weeks — to support the implants and help with swelling.
• Avoid lifting the arms above the head, carrying heavy objects, and strenuous upper-body exercise for several weeks. Your surgeon will advise when it is safe to gradually resume these activities.
• Keep the incision sites dry and clean as instructed. Do not submerge them in water — no baths, swimming pools, or the sea — until the surgeon confirms the wounds are fully healed.
• Light walking is usually encouraged from early on to promote circulation, but intense exercise should wait until your surgeon approves.
• Sleeping on your back with your upper body slightly elevated is usually recommended in the first few weeks to reduce swelling.
• Attend all scheduled follow-up appointments. The surgeon will check the wounds, assess how the implants are settling, and address any concerns.
• Inform your surgeon immediately if you notice sudden changes in breast shape, increasing redness or warmth around the wound, fever, unusual discharge from the incision, or severe pain — these may be signs of a complication.
• Implants do not last forever. Most guidelines suggest having the implants assessed by imaging — usually MRI — at regular intervals after the operation. Your surgeon will advise on when this should start.
• Long-term lifestyle habits such as maintaining a stable weight and wearing a supportive bra during physical activity can help preserve the appearance of the results over time.