Breast augmentation adds volume and improves symmetry with an implant placed behind the breast tissue or behind the muscle. It changes size and shape; it does not lift a breast that has already drooped.
The starting point is the tissue you have — its thickness, its elasticity and where the nipple sits — not the cup size you want. The implant is chosen to fit the chest.
If the nipple sits below the fold under the breast, the issue is ptosis, and an implant alone will not correct it — it may make it worse. That needs a lift, with or without an implant. Mammography or ultrasound is arranged before surgery according to your age and family history, and any lump is investigated first.
Three decisions are made together: what goes in, where it goes, and how it is inserted. Each changes the look, the recovery and the risk.
Modern implants are filled with a cohesive silicone gel that holds its shape. Round implants give fullness in the upper pole; anatomical (teardrop) implants are shaped to follow the natural slope, and are usually textured to stop them rotating. Surface and shape are chosen with the surgeon, and both have trade-offs.
Placement behind the pectoral muscle hides the implant edge and suits thin tissue; a dual-plane releases the lower part of the muscle so the implant sits naturally while the upper part still covers it. Above the muscle is quicker to recover but shows more in thin patients.
Under the breast in the fold is the most common, and gives the most direct control. Around the areola hides the scar in the pigment change but carries a slightly higher risk of changed nipple sensation; through the armpit leaves no scar on the breast but is less precise.
Measurements of the chest, skin quality and nipple position, and a conversation about the size you want — tried with sizers, not chosen from a photograph. Mammography or ultrasound where indicated, blood tests, and a written plan naming the implant.
Smoking stops four weeks before, blood thinners and some supplements about ten days before, and you fast for six to eight hours. Buy the surgical bra in advance, and arrange help for the first three to four days: lifting and driving are not possible.
Under general anaesthesia, one to two hours. The implant is placed, the position is checked with you sitting up during the operation, and the incision is closed in layers. Most patients stay one night, with a compression bra fitted before discharge.
Tightness and swelling are worse in the first three to five days, and the breasts sit high. The compression bra is worn day and night, drains are rare, and the first shower is scheduled at the clinic. Sleeping on the back, propped up, is more comfortable.
Swelling settles and the implants drop into position over six to twelve weeks. Desk work is usually possible after one to two weeks. Gym, running, swimming and heavy lifting wait four to six weeks; upper-body work is introduced gradually after that.
An implant is a device, and it has a lifespan and a failure rate. These are the risks that matter, including the rare ones.
Tell us about any previous breast surgery, a family history of breast or ovarian cancer, autoimmune disease and smoking. Implants do not stop you being screened for breast cancer, but they change how mammography is done — say that you have them when you book it.
They are not lifetime devices. Many last ten to fifteen years or more, but rupture, contracture or a change in shape can bring the exchange forward. There is no fixed schedule for replacement: the implant is checked — by examination and, where needed, ultrasound or MRI — and exchanged if there is a reason.
Most women can, particularly with an incision in the fold and a dual-plane placement, which leave the milk ducts and the nerve supply largely intact. Some women produce less, and an areolar incision carries a higher risk of changed nipple sensation. It is worth planning the operation with future pregnancy in mind.
Silicone implants have not been shown to cause breast cancer. BIA-ALCL is a separate, rare lymphoma of the scar capsule around the implant, not breast cancer, and it is why any new swelling, lump or pain around an implant is investigated rather than watched. The risk is low, but it is real and you should know it exists.
If the nipple sits at or below the fold, yes — or a lift with a smaller implant. An implant adds volume forward, not upward, and in a drooped breast it can produce a heavier, lower shape. This is examined standing up, and it is the most common reason a plan changes at consultation.
Front and side views, in a fitted top, are enough to discuss whether an implant alone will do, roughly what volume fits your frame, and what the operation involves. A coordinator replies with a plan and a written quote.
This page is general information, not medical advice. Suitability, technique and risks are decided in a consultation with a surgeon.
