For breast augmentation, we can place the incisions under the breast, under the nipple or in the armpit. The implants we use, round or anatomical, are from well-known and proven companies and are completely safe. They are placed above or below the muscle, depending on the case.
At a glance
For breast augmentation, we can place the incisions under the breast, under the nipple or in the armpit. The implants we use, round or anatomical, are from well-known and proven companies and are completely safe. They are placed above or below the muscle, depending on the case.
Severity
Medium
Type of Anaesthetic
Local / General
Clinic Stay
Same Day Discharge
Stitch removal
No
Recovery
4 - 6 weeks
Breast augmentation cost
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Breast augmentation is often associated with large or excessively big breasts. However, the primary goal of breast augmentation surgery is to create an aesthetically pleasing bust that enhances overall body proportions and fully meets each woman’s personal expectations.
The selection of the appropriate silicone implant, determined through precise body measurements, thorough consultation, and outcome simulation, always provides a fully balanced solution tailored to the individual’s body type and consistently results in very high patient satisfaction rates.
Indications for Breast Augmentation
Thus, silicone implant placement is not solely aimed at increasing breast size—it also simultaneously corrects many other aesthetic breast concerns.
Let’s examine the situations in which breast augmentation is indicated:
- When the breasts have not developed sufficiently, resulting in a juvenile or underdeveloped appearance
- When a patient simply desires larger breast size
- When there is breast asymmetry in terms of size
- In cases of breast deformities, such as tuberous breast
- When the breast atrophies and loses volume due to weight loss, pregnancy, or other factors
- In combination with a breast lift (mastopexy with augmentation, also known as augmentation mastopexy)
- Breast augmentation for reconstruction following breast cancer
In all the above cases, the goal of the procedure remains the same: to create a beautiful bust. We often use the term breast plastic surgery to describe this intervention because it is not a one-size-fits-all procedure—it is fully customized to address any aesthetic imperfection of the breasts.
Depending on the individual case, we may employ different surgical techniques, select different types of silicone implants, and combine the procedure with other methods.
Whatever the reason a woman chooses to undergo breast augmentation, it is of utmost importance to receive comprehensive and multifaceted information regarding the implants to be used, the surgical technique, and the expected outcome of the procedure.
Show your confidence.
Breast augmentation can give you the confidence you desire with a safe and natural result.
Breast augmentation techniques
Marketing-driven, catchy names are often used to present breast augmentation as something innovative and unique. However, it’s important to note that this type of breast plastic surgery has been performed for over 40 years, with countless scientific studies providing robust evidence.
Thanks to this extensive body of research, we can offer globally accepted techniques and solutions that are time-tested, deliver consistent and predictable results, and carry a very low risk of complications.
Let’s examine some of the most common breast augmentation techniques, along with the advantages and disadvantages of each method. Regarding surgical approach—the incision site chosen to place the implant—we have the following options:
- Breast augmentation via the inframammary fold
- Breast augmentation via the periareolar (around the nipple) approach
- Breast augmentation via the transaxillary (armpit) approach
Breast Augmentation via the Inframammary Fold Approach
The inframammary approach is statistically the most common. The other two approaches were developed primarily to minimize visible scarring. However, studies show that both the periareolar and transaxillary approaches carry a higher microbial load compared to the inframammary fold, which statistically increases the risk of capsular contracture.
Additionally, the transaxillary approach is typically performed with endoscopic assistance, which increases both the duration and cost of surgery. This method only allows placement of the implant fully beneath the pectoralis major muscle and is usually feasible only with smaller silicone implants.
As for the periareolar approach, it allows implant placement either above or below the muscle—but not in the dual-plane position. Its main drawback is that it requires extensive undermining of tissue from the nipple down to the inframammary fold. This can create relative tissue instability, which over time may lead to implant malposition (“bottoming out”), overly superficial implant placement (resulting in a firm feel in the lower pole), or visible/ palpable rippling.
*We use specialized measurement algorithms in every case to ensure a harmonious and aesthetically pleasing outcome.
How Do We Choose the Right Implant for Successful Breast Augmentation?
A critical factor in the success of the procedure is the selection of the appropriate implant. All implants we use contain the latest-generation silicone gel, carry international certifications, and come with a lifetime warranty on the implant material.
For each woman, there is a range of ideal implants that best complement her body type and breast anatomy. The ideal implant is determined through precise measurements of the breasts and chest, and using a specialized algorithm, we can identify the optimal dimensions.
Implant Shape in Breast Augmentation
To feel confident about the outcome of breast augmentation, the patient should definitely discuss key details with their chosen plastic surgeon. One of these is the shape of the implants to be used. Generally, there are three main categories:
- Breast augmentation with round implants
- Breast augmentation with anatomical (teardrop-shaped) implants
- Breast augmentation with ergonomic implants
In general, round implants provide greater fullness in the upper pole and décolletage area. Anatomical implants offer a more natural teardrop shape, with a softer décolletage and maximum projection at the level of the nipple—mimicking the appearance of a natural breast.
Choosing Breast Augmentation Based on Implant Shell and Silicone Type
Regarding the implant shell, we distinguish the following types:
- Breast augmentation with textured-surface implants
- Breast augmentation with smooth-surface implants
- Breast augmentation with polyurethane-coated implants
Both textured and smooth implants offer high safety profiles and are selected based on the individual case. Polyurethane-coated implants are not widely used in Europe or the United States.
Regarding the type of silicone gel filling, we differentiate the following categories:
- Implants filled with soft silicone gel (e.g., Cohesive I, Progressive Gel, etc.)
- Implants filled with highly cohesive “memory” silicone gel (e.g., Cohesive II, Cohesive III)
- Implants containing silicone gel with microspheres of air (B-Lite)
- Saline-filled implants (no silicone)
The material inside the implant used in breast augmentation is always in gel form—never in liquid form. What varies is the firmness or softness of this gel. Highly cohesive, firmer, and more densely filled implants are commonly referred to as “Gummy Bear” implants. B-Lite implants represent a specialized category that is approximately 30% lighter than conventional silicone implants. Finally, saline implants (filled with sterile saltwater) are primarily used in the United States.
Show your confidence.
Breast augmentation is tailored to your needs, with respect for the physiology and aesthetics of your body.
Discover the difference in your body
With FaceTouchUp you can see for free what your face will look like after breast augmentation, simply by uploading a photo. Explore the before-and-after, easily and quickly, before making any decision.
Breast augmentation with placement above or below the muscle
Technically, breast augmentation surgery differs in terms of placement above or below the pectoralis major.
For this reason, we distinguish the following cases:
- Breast Augmentation Fully under the pectoral muscle (submuscular)
- Breast Augmentation Partially below the pectoral muscle (dual plane)
- Breast Augmentation Above the pectoral muscle (subglandular)
- Breast Augmentation Under the fascia of the pectoral muscle (subfacial)
In general, when it comes to a relatively thin person, without a particularly large chest, breast augmentation with placement of implants under the muscle is preferable. This way, the prosthesis can be better camouflaged, especially in the upper pole.
Also, with under-the-muscle techniques we can give an even more natural shape to the breast and ensure greater stability over time, since the prosthesis is better fixed on the chest wall and does not subside due to gravity downwards.
When the implants are placed above the muscle, they are more easily palpable but offer other advantages, such as better centering of the breasts, as well as the fact that we can place larger implants and emphasize the upper pole and the neckline more.
In each case, an individual assessment is made and the choice for breast augmentation arises after an extensive discussion, in order to offer exactly the desired result. This means that in addition to size, we can choose any of the above techniques, shapes and material characteristics.
Dual plane no touch technique
& combination of procedures
However, in our practice, the most common choice is the so-called dual plane no touch. This technique probably suits the expectations of most women, who do not want oversized breasts and generally aim for a very natural result. The advantage of this technique is the simultaneous breast lift with pseudo-relaxation, without additional scars, reduced pain and the completely predictable and harmonious result.
Any of the above breast augmentation techniques can be combined, if deemed necessary, with other procedures, such as breast lift, fat transfer, etc. The simultaneous breast augmentation and lift aims to create a stable base and a full upper pole with the prosthesis.
At the same time, thanks to breast augmentation, the sagging is removed and the nipple is moved to the appropriate position. Fat transfer together with silicone implants is a hybrid technique that can in some cases correct problems such as the large distance between the breasts and the undulations of the implants. More generally, breast augmentation can “erase” imperfections without additional scars.
After Breast Augmentation
Breast augmentation is typically performed by the plastic surgeon under general anesthesia and does not require an overnight hospital stay. In rare cases, it may be performed using local anesthesia combined with sedation. A special supportive surgical bra is placed immediately after surgery, allowing patients to resume light daily activities right away—avoiding only sudden or large arm movements and heavy lifting.
Following breast augmentation, there are no drains, and no suture removal is needed. Pain during the first 1–2 days is minimal because long-acting local anesthetic is infiltrated into the surgical areas during the procedure, numbing the tissues. Thereafter, discomfort is very mild—similar to a dull ache or tightness—and easily managed with over-the-counter pain medication.
Regarding pain, our experience shows it tends to be more noticeable when larger silicone implants are used or when the breast tissue is naturally very tight. Exercise can be resumed 6 weeks after surgery, and specific chest muscle training (e.g., pectoral workouts) is not recommended for the first 6 months.
The scar beneath the breast is hidden precisely within the inframammary fold and typically becomes virtually invisible after about 6 months. The final breast shape stabilizes around 3–4 months postoperatively.
After Breast Augmentation
Breast augmentation is typically performed by the plastic surgeon under general anesthesia and does not require an overnight hospital stay. In rare cases, it may be performed using local anesthesia combined with sedation. A special supportive surgical bra is placed immediately after surgery, allowing patients to resume light daily activities right away—avoiding only sudden or large arm movements and heavy lifting.
Following breast augmentation, there are no drains, and no suture removal is needed. Pain during the first 1–2 days is minimal because long-acting local anesthetic is infiltrated into the surgical areas during the procedure, numbing the tissues. Thereafter, discomfort is very mild—similar to a dull ache or tightness—and easily managed with over-the-counter pain medication.
Regarding pain, our experience shows it tends to be more noticeable when larger silicone implants are used or when the breast tissue is naturally very tight. Exercise can be resumed 6 weeks after surgery, and specific chest muscle training (e.g., pectoral workouts) is not recommended for the first 6 months.
The scar beneath the breast is hidden precisely within the inframammary fold and typically becomes virtually invisible after about 6 months. The final breast shape stabilizes around 3–4 months postoperatively.
Breast Augmentation Results
After surgery, the breast retains normal function—both in terms of milk production and nipple sensitivity and responsiveness. In cases of mild breast ptosis (sagging) combined with small breast volume, augmentation alone can lift the breast by approximately 1–2 cm. However, in cases of significant sagging, a breast lift (mastopexy) must be combined with augmentation to reposition the nipple to its ideal level.
Today, silicone gel implants are the standard of care. After 45 years of use and extensive long-term research, they have been proven completely safe. Technological advances have improved implant shells to such a degree that silicone gel leakage outside the implant shell is virtually impossible. Therefore, breastfeeding after augmentation is not contraindicated. Moreover, the implants we use for breast augmentation are highly durable, resistant to external stress, and designed to last over time.
“I was looking for a perfect, natural-looking result—without pain. My doctor recommended the dual-plane technique. The outcome couldn’t have been better!”
When do silicone implants need to be changed after breast augmentation?
When can I return to work after a breast augmentation?
Is there a risk of traveling by plane after breast augmentation?
Dr. Prodromos Papaioannou
He completed his plastic surgery specialization in Germany, at the Pirmasens Hospital, the Asklepios Wandsbek Hospitals in Hamburg, the University Hospital in Magdeburg and the Braunschweig Clinic. He worked as a specialist-deputy director at the Braunschweig Clinic (specializing in breast reconstruction after cancer and cosmetic surgery). He also participated in scientific research and completed his doctoral thesis (Dr. Med.) at the Magdeburg Clinic.