Breast Augmentation Surgery in Ankara, Turkey

Breast augmentation surgery is an aesthetic procedure performed to add volume to the breasts using silicone implants or the patient’s own fat tissue. Small, volume-depleted, or asymmetric breasts can be enhanced to achieve a fuller and more balanced appearance. The method to be used is planned in line with the patient’s body structure, existing breast tissue, and personal expectations.

Silicone implants can be placed through incisions made in the inframammary fold (under the breast) or around the areola (the nipple-areola complex). The choice of submuscular or over-the-muscle positioning is determined according to anatomy and aesthetic goals. The silicone implants used are made of medically approved, safe, and long-lasting materials. The implant method is a suitable option for patients who desire a more pronounced increase in volume.

As an alternative, breast augmentation with fat transfer is performed by harvesting fat from areas such as the abdomen, waist, or thighs, processing it with special techniques, and injecting it into the breasts. This method is preferred by patients who want a more natural look and aim for a limited increase in volume. It also offers the added benefit of body contouring, and it does not require large incisions or the use of foreign material.

Surgery is generally performed under general anesthesia and takes approximately 1–2 hours depending on the chosen method. Although the recovery process varies from person to person, most patients can return to daily activities within a few days. Results after breast augmentation are visible early on; as swelling subsides, the final appearance becomes clearer within 1–3 months. The goal is to achieve natural, symmetrical, and aesthetically satisfying outcomes.

What Is Breast Augmentation Surgery?

Breast augmentation surgery (augmentation mammoplasty) is a surgical procedure performed to increase breast volume and achieve a fuller appearance. Silicone or saline implants are commonly used; in selected cases, the patient’s own fat tissue may also be preferred. The procedure is performed for congenitally small breasts, volume loss, or asymmetry. The aim is to create a natural and aesthetic breast contour that is harmonious with body proportions.

How safe is silicone implant technology, and how has it evolved from the past to today?

One of the most common concerns patients express when they walk into the clinic is the safety of having a foreign material placed in their body. This concern is understandable, as there has been confusing information in the past. However, when we look at the history of silicone technology, we see that it has undergone an incredible evolution since the 1960s. Today, we are discussing 5th-generation implant technologies, and in terms of safety profile, we are in the most reliable era in surgical history.

Older implants contained a more fluid, runny gel. If the outer shell was damaged, this could create a risk of the content leaking into surrounding tissues. The technology we use today is entirely different. We now use what is called “cohesive gel,” a filler material strengthened with cross-links at the molecular level. When explaining this to patients, I often use the “Turkish delight” analogy: just as a piece of Turkish delight keeps its shape even if you cut it in half and does not flow, new-generation implants behave similarly. Even if the outer shell is cut, the gel remains in place; it does not spread into tissues or mix into the body.

Large-scale scientific studies involving tens of thousands of patients have clearly demonstrated that medical-grade silicone has no proven link with cancer, rheumatologic diseases, or immune system disorders. The FDA-approved implants we use are produced from materials with very high biocompatibility. Therefore, patients can feel reassured about material safety.

What silicone implant shapes and types are available?

Implant selection cannot be made with a “one size fits all” approach. Every woman’s anatomy is unique, and different implant shapes and gel technologies have been developed accordingly. When we classify implants by shape, the main groups are:

• Round implants
• Teardrop (anatomical) implants
• Ergonomix (hybrid) implants

Round implants are ideal for patients who want more noticeable fullness, especially in the upper breast (cleavage) area. While they may take on a more natural teardrop-like contour when standing due to gravity, they tend to maintain upper-pole fullness. In addition, even if a round implant rotates, the breast’s external appearance does not change because the implant is symmetrical in every direction.

Teardrop, also known as anatomical implants, are designed to mimic the natural slope of the breast. They have a fuller lower portion and a more gently tapered upper portion. We often prefer this shape in very thin patients with minimal breast tissue to avoid an artificial “ball-like” look. However, placing these implants requires more delicate surgical planning.

In recent years, “Ergonomix” series implants have become quite popular thanks to smart gel technology that adapts to the patient’s movements. When the patient lies down, the implant spreads into a rounder shape; when standing, it takes on a natural teardrop form under the effect of gravity. This dynamic structure offers an excellent middle ground for patients who want both a natural look and upper-pole fullness.

What is the biodimensional planning system, and why is it important?

Many patients arrive to the consultation with a photo of a celebrity they like, or with a fixed number in mind such as “I want 350 cc.” However, in plastic surgery, success is not just about placing a desired volume into the body—it is about calculating, millimeter by millimeter, how that volume will look on that specific body. This is where the “Biodimensional Planning” system comes into play. It is the process of matching the patient’s dream outcome with anatomical realities.

During the examination, we do not only look at the existing breast tissue. We measure the width of the chest, the current breast base diameter, the distance between the nipple and the inframammary fold, and skin elasticity. For example, trying to place an implant with a very wide base diameter into a patient with a narrow chest can end in disaster; the implant may migrate toward the armpit, or the two breasts may meet in the middle and create the “symmastia” (joined breasts) appearance.

One of the most critical steps in this planning is the “Pinch Test,” which evaluates tissue thickness. The thickness we feel when we pinch the skin and tissue in the upper breast region guides us. If this thickness is under 2 cm, it indicates thin tissue coverage. In thin-tissue patients, hiding the implant is more challenging. In such cases, submuscular or dual-plane techniques should be preferred so that implant edges do not become visible and issues such as “rippling” are avoided. In short, implant size and shape are chosen not to be “big,” but to look as if they naturally belong to the patient’s body, within anatomical limits.

Where are the surgical incisions (approaches) made?

In breast augmentation surgery, where the scar will be located is very important for patients from an aesthetic perspective. Our goal is always to place the scar in the least visible areas, concealed within natural folds. The main entry points we use to place the implant are:

• Inframammary fold (under the breast)
• Around the areola (periareolar)
• Armpit (axillary)

In the vast majority of cases—perhaps around 85%—we prefer the inframammary fold. There are very good reasons for this. We make a 3–4 cm incision within the natural crease where the breast meets the chest wall. This approach allows us to see the surgical field directly, control bleeding perfectly, and position the implant with millimetric precision. Most importantly, with this method we can reach the correct plane without disturbing the milk ducts, breast tissue, or nerves. The scar remains hidden under a bra or bikini.

In periareolar incisions, the entry is made at the lower border of the pigmented area. It can be advantageous for hiding the scar, but the likelihood of encountering milk ducts and nerves is somewhat higher. In addition, the theoretical infection risk may be slightly higher than with inframammary incisions because the work is closer to the milk ducts, where bacterial flora can be more prominent.

The axillary incision is an option for patients who do not want any scar on the breast. However, this technique typically requires endoscopic (camera-assisted) methods. Implant positioning is more difficult to control, and if a revision is needed in the future, re-intervention through this route can be challenging. Therefore, it may not be suitable for every patient.

What is the Dual Plane technique, and what are its advantages?

In the past, implant placement was discussed mainly as either “under the muscle” or “over the muscle.” Today, surgical techniques have become far more sophisticated, and the “Dual Plane” technique is widely considered the gold standard. So, what is Dual Plane?

Simply put, it is a placement method where the upper part of the implant sits under the pectoral muscle, while the lower part sits under the breast tissue. This technique combines the advantages of submuscular and over-the-muscle approaches, while minimizing their disadvantages.

With over-the-muscle placement, recovery is faster, but implant edges may be visible in thin-tissue patients. With full under-the-muscle placement, the implant is well hidden, but “animation deformity” can occur—meaning when the patient exercises or uses the arms, contraction of the chest muscle can pull and move the implant upward.

In the Dual Plane technique, we release the lower attachments of the pectoral muscle. This allows the muscle to cover the implant and create an excellent, natural transition, while reducing the tendency of the muscle to pull the implant upward during contraction. In addition, because the lower part of the implant is in direct contact with the breast tissue, the lower breast pole takes on a more natural and fuller shape. Especially in patients with mild sagging, this technique can also provide a subtle lifting and tightening effect.

Does the implant surface affect capsule formation?

Our body tends to isolate any foreign material placed inside it (such as a pacemaker, hip prosthesis, dental implant, etc.) by covering it with a biological membrane. In breast implants, this membrane formation is a completely natural and expected part of healing; we call it the “capsule.” The problem arises when this capsule becomes excessively thick and contracts, compressing the implant. This condition, called “capsular contracture,” can cause the breast to harden and its shape to become distorted.

This is where implant surface technology becomes important. Implants are categorized by their surface structures:

• Smooth-surface implants
• Textured-surface implants
• Micro- and nano-surface implants

Smooth implants can lead to a thinner capsule, but they are more mobile within the tissue. Textured surfaces are designed to help the capsule fibers organize in a way that reduces contraction and helps the implant adhere more securely to tissue.

Micro-textured and nano-surface implants developed in recent years represent the peak of technology. These surfaces initiate such a gentle interaction between the implant and the tissue that the body’s foreign-body reaction is minimized. With less friction and inflammation, the risk of capsular contracture decreases dramatically. As surgeons, we determine the most suitable surface technology based on the patient’s tissue characteristics and risk factors.

Which implant brands are used in Turkey?

Because Turkey is one of the world’s leading centers in aesthetic surgery, we have full access to the highest-quality and most reliable implant brands available on the global market. We offer our patients only brands with FDA or CE approval and proven long-term safety data. These brands include:

• Mentor
• Motiva
• Polytech

Mentor is a US-based brand and one of the most established companies in the sector. It is among the first names that come to mind when we talk about reliability and offers a wide range of sizes.

Motiva is a brand that has shaped the industry with innovations in recent years. It stands out especially with its Ergonomix series and “Q-Inside” microtransponder technology placed inside the implant. With this passive chip, even years later, a special reader can scan the implant externally and access the serial number, manufacturing date, and size. This provides significant convenience for long-term patient follow-up.

Polytech is a product of German engineering and is particularly known for its “Microthane,” polyurethane-coated surfaces. This special surface can reduce capsular contracture risk to very low levels. In addition, with its “B-Lite” series, Polytech produces implants that are up to 30% lighter than standard implants, offering a revolutionary solution for patients who want a larger breast size but are concerned about sagging due to gravity.

What should be considered during the preoperative preparation period?

A successful surgery and a smooth healing process begin long before entering the operating room. During this period, we ask patients to make certain lifestyle adjustments. Some substances that should be stopped at least 3 weeks before surgery include:

• Smoking and tobacco products
• Aspirin and blood-thinning medications
• Herbal teas (e.g., green tea)
• Vitamin E supplements

Smoking impairs blood circulation, significantly delays wound healing, and increases the risk of infection. For this reason, smoking is a strict red line for us. Stopping foods and medications that have blood-thinning effects is essential to minimize bleeding and bruising risks during and after surgery.

Radiological screening is also a non-negotiable part of our preparation process. We perform breast ultrasound in all patients under 40 and mammography in patients over 40 to create a “map” of the breast tissue. This is crucial both for detecting existing masses and for having baseline data for postoperative follow-up.

How does the surgery day and hospital process work?

Breast augmentation surgery is performed under general anesthesia and takes approximately 1 to 1.5 hours. In surgery, our most important rule is “respect for tissue.” The more gently we work, the faster and more comfortable recovery tends to be.

To minimize infection risk, we use the “No-Touch” technique. We utilize a sterile funnel, often referred to as a “Keller Funnel,” which resembles a pastry piping bag. The implant slides into the prepared pocket through this funnel without ever touching the patient’s skin. This prevents contact with skin flora bacteria and may reduce the risk of capsular issues.

At the end of the surgery, we fit the patient with a specialized medical support bra. In most cases, we do not need to use drains. Patients are usually discharged the same evening or the next morning. In the first hours, a feeling of pressure in the chest area is very normal. Patients often describe it as “as if someone is sitting on the chest cage.” This is not so much an incision pain, but rather a fullness and tightness sensation due to the stretching of tissues and muscle, and it is easily controlled with pain medication.

When does recovery happen and when can you return to social life?

Recovery is a linear journey and can vary from one patient to another, but we can describe a general timeline. The first 3 days are the “acute phase,” when swelling is at its peak. During this time, rest, good hydration, and taking medications regularly are important.

Returning to social life and work is usually possible by the end of the first week. Patients with desk jobs can often return within 4–5 days, while those with more physically demanding work may return after about 1 week. For driving, it is safest to wait until the end of the first week, when arm movements are more comfortable.

Another common question is when the breast will take its final shape. Immediately after surgery, the breasts are swollen, so they may appear larger, firmer, and positioned higher than expected. Over time, the “Drop and Fluff” process begins. The implants gradually settle downward with gravity, swelling resolves, and tissues relax. Regaining true softness and full settling typically takes about 3–6 months. Scar maturation and fading to a skin-toned color can take up to 1 year.

Do silicone implants prevent breastfeeding?

This is one of the biggest fears for younger patients who plan to become mothers in the future. I can answer this very clearly: No, silicone implants do not prevent breastfeeding.

In the techniques we use, the implant is placed either under the muscle or behind the breast gland tissue (milk glands). In other words, there is an anatomical barrier between the implant and the milk ducts, and they do not come into contact with each other. Unless a nipple incision is used, the milk ducts are not cut. Therefore, mothers with implants can safely breastfeed their babies without a significant change in milk quantity or quality. Silicone mixing into breast milk is not supported medically or scientifically.

What long-term risks and complications may occur?

As with any surgical procedure, breast augmentation has its own risks, and it is important to discuss them transparently. Possible long-term complications include:

• Capsular contracture
• Implant rupture
• Asymmetry
• Sensory changes
• BIA-ALCL (a very rare condition)

Capsular contracture, as discussed above, is hardening of the capsule the body forms around the implant. It is the most common reason for revision surgery, but modern technology and surgical techniques have significantly reduced its incidence. Implant rupture can occur due to severe trauma (for example, a seatbelt injury) or very long-term material fatigue. Because modern cohesive gels do not “leak,” rupture typically does not create an urgent life-threatening risk, but implant replacement is required.

BIA-ALCL is a very rare type of lymphoma that arises from the capsule around the implant and is not breast cancer. It typically presents 8–10 years after surgery with sudden swelling (seroma) in the breast. With early diagnosis, removal of the implant and capsule can be curative. Although the incidence is often described as “in the tens of thousands,” not skipping routine annual follow-ups is important. Temporary nipple sensation changes can occur in about 15–20% of patients, but they usually resolve within a few months as nerves recover.

When can you return to sports and physical activity?

For patients who are active in sports, staying inactive can be challenging, but patience is necessary for tissues to heal properly. A general return-to-sport timeline is:

• Walking (can start the next day)
• Lower-body exercises (after week 2)
• Light jogging (after week 4)
• Upper-body and chest exercises (after weeks 6–8)

Light walks in the first days after surgery increase circulation and support healing. However, activities that significantly elevate heart rate should be avoided in the early weeks. Especially if the implant is placed under the pectoral muscle, returning to sports that heavily use the chest muscles—such as push-ups, pull-ups, tennis, or swimming—should be delayed for at least 6 weeks, ideally 2 months.