Breast or Buttock Fillers in Ankara, Turkey

In modern aesthetic surgery, the most effective way to provide permanent and safe volume enhancement in the breast and buttock areas is the autologous fat transfer method, also known as fat injection, where the person’s own tissue is used. While silicone implants continue to be the gold standard in patients with high volume loss, the regenerative power of adipose tissue stands out especially in buttock shaping (BBL) and in creating a natural breast contour. Although hyaluronic acid-based temporary fillers offer a safe alternative for small touch-ups, permanent synthetic fillers are not considered a medically reliable option due to the high complication risks they carry. A successful body contouring process is based on surgical planning that prioritizes biological compatibility.

What Are Breast or Buttock Fillers?

Breast or buttock fillers are aesthetic procedures applied to enhance body contours and add volume. In these procedures, hyaluronic acid-based filler materials or the patient’s own fat tissue are generally used. Filler applications preferred as an alternative to surgery offer a shorter recovery time. Before the procedure, the person’s anatomical structure and expectations are evaluated to determine the appropriate technique. The application must be performed by a specialist physician.

Why is volume restoration a fundamental aesthetic need in body contouring?

One of the main reasons why the silhouette you see in the mirror changes over the years is not only the loss of skin elasticity but also the reduction or displacement of the supporting tissue under the skin, namely the fat pads. Those full, smooth and soft transitions we see in a youthful face or body are actually the result of this volume under the skin.

The concept we call “volume restoration” in plastic surgery is the art of compensating for this loss. However, there is a very fine line here. The goal should not be to tighten the skin as if inflating a balloon. The goal is to mimic the youthful form of that area by giving volume in the correct anatomical locations and in the correct amount. The breast and buttock areas are very different from small areas such as the lips or cheekbones on the face. Here we are not talking about milliliters but about volumes of hundreds of cubic centimeters. When restoring such a large volume, how the material we choose will interact with the body is the most critical decision for your health. If the tissue quality has deteriorated, simply tightening the skin is not enough; the inside must also be supported with a high-quality material.

Why are filler procedures performed with our own fat biologically the safest?

In the medical world, the term “autologous” means that a tissue taken from a person’s own body is used again for the same person. Fat transfer, also called lipofilling, is accepted today as the “gold standard” of aesthetic surgery. The simplest and strongest reason for this is: Your body recognizes what belongs to itself and embraces it.

Unlike synthetic materials produced in laboratories, which always have the status of “foreign” no matter how compatible they are, your own fat tissue carries no risk of allergy. The body does not reject it, does not try to imprison it in a capsule, and does not start a war against it. However, seeing fat tissue only as a simple filling material would be a great injustice to it. The fat we transfer contains miraculous repairers called “adipose-derived stem cells.” These cells not only create volume where they go but also increase blood circulation there, stimulate collagen production, and visibly improve the quality of the skin. In other words, when we transfer fat, we are actually administering a vitality injection to that area. This “regenerative” effect is a biological superiority that no synthetic filler possesses.

How much of the transferred fat cells remain permanent?

In our consultations with patients, this is the most common and most justified concern we hear. The answer to the question “Doctor, will these fats melt away?” is both yes and no. Understanding this process correctly is very important for managing your expectations.

Fat transfer is somewhat like an organ transplant. When we move fat cells taken from the abdomen or waist area to the breast or buttocks, these cells must be nourished by the blood vessels in their new location in order to survive. In the first few months after the procedure, unfortunately some of the transferred fat cannot receive sufficient nourishment and is absorbed by the body. Scientific data and our clinical experience show that on average the following amount of the transferred fat remains permanent:

• 50 percent
• 60 percent

This remaining 60 percent becomes the native tissue of that area. In other words, it does not disappear after one year like a temporary filler; as long as you do not gain or lose weight, it remains with you for life. Because we surgeons know about this loss, we inject slightly more volume than planned during the operation. Thus, when the swelling subsides and the fats that could not survive are eliminated from the body, exactly the fullness we want remains.

Can fat injection replace silicone in breast augmentation?

This subject is one of the most debated yet also one of the most misunderstood topics in aesthetic surgery. To speak honestly, fat injection is not a one-to-one alternative to silicone implants; rather, it is the remedy for a different patient group.

If you dream of a very prominent breast appearance with a very full cleavage and an increase of several sizes, fat injection may not make you happy. This is because the amount of enlargement we can achieve in a single session with fat tissue is limited. There is a physical rule called tissue pressure; if you compress more fat than necessary into one area, those fats cannot be nourished and die. Therefore, with fat we can achieve on average a “cup,” meaning one size increase in the breast.

However, if naturalness is the most important thing for you, if you do not want a foreign object such as silicone in your body and you say “no one should understand that I had surgery,” fat injection is an excellent option. When you touch it, you will not feel a prosthesis in your hand, only your own soft tissue. There is no concern about scars because no incision is made; we work only through needle holes.

Suitable candidates for this procedure are generally:

• Those whose breasts have slightly emptied after breastfeeding
• Those who have asymmetry between their breasts
• Those who have sufficient body fat
• Those who want only slight fullness

What is hybrid breast aesthetics and what problem does it solve?

With the development of technology and techniques, we no longer have to say “all or nothing.” Hybrid breast augmentation is a rational method that combines both the strength of silicone and the naturalness of fat, and it is a method I frequently use.

Think especially of patients who are very thin, have a bony chest cage, and have very thin subcutaneous tissue. When we place only a silicone implant in these patients, the edges of the implant may become visible from the outside or a wavy appearance called “rippling” may occur. In addition, that “cleavage” groove between the two breasts may appear very separated. In the hybrid method, we first place the implant to provide volume, then camouflage the surface and surroundings of the implant with the patient’s own fat.

Here the fat tissue acts like a quilt. It softens the artificial transitions of the implant, fills the cleavage area, and ensures that when you touch it you feel soft tissue instead of silicone. In other words, the volume inside comes from silicone, while the outer touch and appearance come entirely from you.

What kind of transformation does fat tissue create in the Brazilian Butt Lift (BBL) procedure?

BBL, which has been the most popular aesthetic operation in recent years, is actually a misunderstood procedure. People perceive it only as “enlarging the buttocks.” However, BBL is a “proportion” surgery. Just like a sculptor chiseling stone, we shape the body.

The secret of beautiful buttocks is not only the projection at the back but the angle that projection creates with the waist. In the BBL procedure, we first slim the waist by removing excess fat from the waist, back, and abdomen areas. In this way, the buttocks become more prominent even before we touch them.

Then we transfer these removed fats to specific areas of the buttocks.

The aim here is not only to enlarge the buttocks backward. It is also to fill the hollows on the sides called “hip dips,” giving the buttocks a rounder and more feminine form. It is to fill the upper pole to make the buttocks appear more lifted. The amount of fat used is much higher than in the breast. 300, 400, sometimes even 500 cc of fat can be injected into each buttock. The result obtained is body contours that are curvy, athletic, and in an hourglass form.

How are life-threatening risks prevented in buttock fillers and BBL surgeries?

We should not avoid discussing this; aesthetic surgery is serious work and every surgery has risks. BBL is a procedure that has come to the agenda in the past with some unfortunate events. However, the medical world has learned very important lessons from these events, and today we apply very strict safety protocols.

The buttock region has a complex structure containing large veins called “gluteal veins.” The greatest risk is the accidental injection of fat into these veins or into deep muscle tissue. If this happens, fat particles can travel to the lungs and cause embolism (blockage). However, this risk is now a “controllable” risk.

Today, the rules we apply for a safe BBL and never compromise on are:

• Injection only into the subcutaneous layer
• Never entering the muscle
• Using thick and blunt-tipped cannulas
• Continuous control of the cannula tip

In addition, with the help of technology we can now perform injections under ultrasound guidance. When we place the ultrasound probe on the skin, we can see where the vessels are and in which layer the cannula is advancing on the screen. This transforms the procedure from being performed “blindly” to something like driving with navigation and increases safety by more than 90 percent. In skilled hands and when the rules are followed, BBL is a safe procedure.

Are ready-made hyaluronic acid-based fillers logical for the breast and buttocks?

Not everyone may want surgery or may not have enough fat to be removed with liposuction. In such cases, “ready-made fillers” come to the agenda. Here we are talking about two different worlds: one is safe but limited Hyaluronic Acid (HA) fillers, and the other is permanent synthetic gels that we definitely do not recommend.

Let us first talk about the safe option, HA fillers. Think of a much denser version of the filler you have applied to your face. Hyaluronic acid is a substance that already exists in our body, retains water, and dissolves over time.

The advantages of HA fillers for the breast and buttocks are:

• Not requiring an operating room
• No recovery time
• Providing instant results
• Being dissolvable if not liked

However, there is another side of the coin: cost and permanence. These fillers dissolve within 12-18 months. Dozens of boxes of filler are required to fill large areas such as the breast or buttocks, which raises the cost to astronomical levels. For this reason, it is much more logical to use HA fillers not to enlarge the entire breast or buttocks but rather for small touch-ups, to close “hip dips,” or to correct asymmetries.

Why are permanent water-based fillers (Aquafilling, etc.) dangerous?

This is the part where, as a physician, I must warn the most. Please, please stay away from substances marketed under names such as “non-surgical breast enlargement,” “5-year permanent water-based filler,” “Aquafilling,” and “Los Deline.”

These substances have a “hydrophilic gel” structure and most contain synthetic polyamide. The body can never dissolve these substances. The problem is that these substances do not biologically integrate with the body; they move freely between tissues. When first applied, everything may look wonderful. However, after 3 years, 5 years, or even 10 years, your body may react to it.

The complications we encounter include:

• Severe infection
• Tissue necrosis
• Non-healing discharge
• Migration of the filler
• Chronic pain

Once this substance becomes infected, antibiotics cannot reach it. Surgical removal of the gel is extremely difficult because it has infiltrated into the tissues, like jelly filling the pores of a sponge. Protecting our patients from the long-term risks of these substances is our primary duty. Short-term convenience should not turn into a long-term nightmare.

Do breast fillers prevent radiological imaging and cancer screening?

In women’s health, the principle of “first, do no harm” comes before everything else. While performing breast aesthetics, we must not risk future breast cancer screenings.

After fat injection, some fat cells that cannot receive nourishment may die and form hardness called “fat necrosis.” These dead fat tissues may calcify over time. In the past, there was concern that these calcifications seen on mammography could be confused with precancerous lesions. However, modern radiology has advanced greatly in this regard.

An experienced breast radiologist can distinguish whether the whiteness seen on mammography is fat necrosis (benign) or a suspicious tumor (malignant). Fat necrosis has a characteristic appearance; it generally looks hollow, like an eggshell.

Nevertheless, there are some things we ask from our patients to reduce the risk to zero:

• Mammography before the procedure
• Regular annual check-ups
• Preservation of previous films

Thus, the radiologist can say, “This image was present last year as well, it is a trace related to the surgery,” and save you from unnecessary biopsy stress. In those who have a strong family history of breast cancer, it is most appropriate to make this decision together with oncologists.

How do smoking and lifestyle affect filler success?

Aesthetic surgery is a team effort, and the most important player on this team is you. We perform the surgery, but it is your body that preserves the result. The number one enemy that undermines the success of fat transfer is smoking.

The nicotine in cigarettes constricts the smallest capillaries in the body. However, the fat cells we transfer need oxygen coming from those capillaries in order to survive. In a patient who smokes, these vessels are closed, so most of the transferred fats die from “starvation.” Not only volume loss occurs, but the dead fats can also turn into hardness and cysts.

For this reason, following these rules is vitally important:

• Complete cessation of smoking
• Balanced nutrition
• Being at an ideal weight
• Control of chronic diseases

You should stop smoking at least 4 weeks before surgery and absolutely must not smoke during the postoperative period. This is not only an aesthetic recommendation but a medical necessity.

What should patients expect during the postoperative recovery process?

Since breast or buttock volume restoration concerns a large area of the body, the recovery process requires some patience. Bruising and swelling in the areas where liposuction is performed (usually the abdomen, waist, and legs) are completely normal. You may feel soreness in those areas as if you had done intense exercise.

Your most important helper after surgery is “compression garments,” meaning corsets. These corsets allow the skin to adhere to its new place and reduce swelling. We generally recommend wearing them day and night for 3-4 weeks.

For BBL (buttock filler) patients, the situation is a bit more specific. Pressure should not be applied on the transferred fats. Therefore, we recommend the following positions to our patients during the first 3 weeks:

• Lying face down
• Lying on the side
• Standing

When you need to sit, you should use special BBL pillows that leave the buttocks suspended and transfer the load to the thighs. These restrictions may seem a bit challenging, but they are definitely worth the sacrifice for the permanent and beautiful result you will achieve. Returning to work is usually possible within 1-2 weeks, but it is necessary to wait 6 weeks before starting heavy sports.