Breast Augmentation Surgeries

Breast augmentation can be performed in two ways: 1) breast implants, 2) fat transfer (fat injection). In some cases, a combination of both methods is used.

In practice, the more commonly performed method is breast augmentation with implants (prostheses). Since these implants contain biocompatible silicone, many people refer to them as “breast silicone.” In our clinic, we select and use FDA- and CE-approved implants based on the patient’s body type and needs, considering the implant brand, size, and surface characteristics. There is a lot of correct and incorrect information circulating about breast augmentation with implants. Here, we will answer common questions on these topics.

Who Is Eligible for Breast Augmentation Surgery?

We perform this procedure on women who are over 18 years old and do not have a medical condition that would prevent surgery.

How Is It Performed?

An incision is made along the inframammary fold (the crease under the breast), and a pocket is created beneath the breast tissue. The breast implant is inserted through this incision and placed into the prepared pocket.

What Does Placing the Implant Under or Over the Muscle Mean? Which Is Better?

Breast implants are primarily placed in one of two planes: 1) between the breast tissue and the muscle, 2) under the muscle.

The layers of the breast area from superficial to deep are as follows: skin, breast tissue, pectoral muscle, ribs. Under the breast tissue lies the “pectoralis muscle,” which is a relatively large and strong muscle. The most important factors in deciding which implant to place and in which plane are the amount of existing breast tissue and the degree of breast sagging. In women with very little breast tissue, we place implants under the muscle both to provide additional volume and to reduce the implant’s visibility and palpability from the outside. We also know that the risk of “capsular contracture” (the formation of a firm capsule around the implant) is lower when the implant is placed under the muscle compared to over the muscle. The disadvantages of under-muscle placement are that the surgery can be slightly more painful than over-muscle placement, and in the long term the implant may move with muscle activity (this is called animation).

What Is Mia Femtech?

MiaFemtech is a breast augmentation method developed with a minimally invasive approach, focusing on fast recovery and a natural appearance. The procedure is performed under local anesthesia with light sedation; it does not require general anesthesia.

Through an approximately 2–2.5 cm transaxillary (underarm) incision, the implant is placed using a specialized injector system. There is minimal intervention to breast tissue, muscles, and vascular structures.

This technique is designed especially for patients aiming for a 1–2 cup increase, who want a scar-free breast appearance and wish to return to social life in a very short time. With Diamond Shape SmoothSilk Ergonomix2 implants, the breast can achieve a highly natural look and feel.

The implant volume used is typically up to 195 cc, helping achieve results that match body proportions. One of the most important advantages of Mia Femtech is that the vast majority of patients can return to daily life the same day, and the recovery process is extremely comfortable. No scar remains on the breast; the underarm incision mark usually fades quickly.

What Is Preservé?

Preservé is an advanced surgical approach centered on preserving breast tissue and anatomical structures. In this technique, specialized equipment such as the Motiva Channel Separator and an Inflatable Balloon is used to place the implant with minimal trauma to tissues.

Preservé is suitable not only for breast augmentation, but also for combined augmentation with lifting, implant exchanges, asymmetry corrections, and cases that require individualized planning.

This method allows for a wider range of implant options, and volume increases of up to 4 cup sizes may be achieved. The choice of anesthesia can be planned as local anesthesia + sedation or general anesthesia, depending on the patient’s needs. In primary breast augmentation procedures, the surgical time is approximately 20–30 minutes on average.

Preservé™ is compatible with advanced implant technologies such as SmoothSilk® Ergonomix2®, TrueMonobloc+®, ProgressiveGel Ultima®, BluSeal+®, SuperSilicones®, and Zen RFID. This enables stable, tissue-supported, and aesthetically strong results in the long term. Recovery time is fast in augmentation-only cases; however, if additional procedures such as lifting or revision are performed, the recovery period may be somewhat longer.

Mia vs. Preservé Comparison

Purpose and Scope

Mia is designed for primary breast augmentation, with a minimally invasive technique and a focus on rapid recovery. Preservé, on the other hand, is a broader surgical approach that includes augmentation as well as lifting, revision, and personalized combined procedures.

Implant and Volume Options

With Mia, the goal is up to 195 cc and a 1–2 cup increase. With Preservé™, a broader range of volumes is available, and augmentation of up to 4 cup sizes is possible.

Recovery Process

With Mia, returning to social life usually happens the same day or within a very short time. With Preservé™, recovery is fast in primary augmentations; in combined procedures, the process may be somewhat longer.

Patient Profile

Mia is ideal for patients who want scar-free breast aesthetics, natural results, and a quick outcome, and whose breast sagging is minimal. Preservé is preferred for patients who want a tissue-preserving approach, those planning a larger volume increase, or those who require a combined procedure with lifting.

Conclusion

Mia Femtech is an ideal primary breast augmentation method for patients who seek fast recovery, a minimal incision, and natural results. Preservé is an advanced surgical approach that preserves tissue integrity, offers personalized solutions, and can address more comprehensive aesthetic needs.

Both methods are supported by Motiva technologies and, when performed by expert hands with appropriate patient selection, can provide safe, long-lasting, and aesthetically satisfying results.

Placing the implant over the muscle—meaning in the plane between the breast tissue and the muscle—is also used in cases where the breast is sagging, as it can provide a better tightening and lifting effect. However, capsular contracture is encountered more frequently with implants placed over the muscle, and revision rates are higher.

What Are Textured and Smooth Surfaces? What Is the Difference? Which Is Better?

Breast implants contain a silicone gel on the inside, and on the outside there is a durable shell that surrounds the silicone. This shell is the surface that comes into contact with our internal tissues after implantation. Because of the capsular contracture issue mentioned above, over the years manufacturers developed textured-surface implants in an effort to reduce this risk. Indeed, when placed in the plane between the breast and the muscle, textured implants used to lead to lower rates of capsular contracture.

However, newer information and studies began to report that textured breast implants may be associated with a rare type of cancer. This condition was defined as “Breast Implant-Associated Anaplastic Large Cell Lymphoma (BIA-ALCL).” Around the world, textured-surface breast implants have started to be banned in various countries. In our clinic, we have continued not to prefer textured implants, which we have not used for a long time, and we believe they will likely be banned in Turkey soon as well.

On the other hand, no such cases have been reported with smooth-surface implants. When placing smooth implants, we generally prefer the under-muscle plane to reduce the risk of capsular contracture.

In short, we believe that implants with a smooth surface should be used.

What Are Anatomical (Teardrop) and Round Breast Implants? What Is the Difference? Which Is Better?

Round breast implants are symmetrical implants that contain an equal amount of silicone gel throughout, and they are the most commonly used type of implant.

Anatomical (teardrop-shaped) implants are designed so that when placed under the breast, they provide less volume in the upper part and more volume in the lower part. They were developed to mimic the natural breast shape; however, we do not prefer this type of implant in our clinic. The reason is that the area we most often want to enhance is the upper portion that appears in the décolletage. In anatomical implants, the upper part is thinner, so it cannot provide the level of volume we want in that area.

Whether we place round implants in the submammary plane or under the muscle, we observe that they provide the desired natural upper pole fullness much better. Of course, teardrop-shaped anatomical implants are also a type that many colleagues use and have experience with. However, in our clinic we prefer round, smooth-surface implants because we believe they provide more natural and more desirable results. We also more often prefer to place these implants under the muscle.

How Is the Size of the Breast Implant Determined?

The size of the implant is determined based on the patient’s body type, preferences, and whether those preferences align with realistic expectations. Fundamentally, by body structure we mean the breast base. The breast base is the footprint area the breast covers on the skin, and it defines the space where the implant will sit. In women with a narrow chest, smaller-base implants are placed, while in those with a wider chest, wider-base implants are preferred. As the implant base widens, the implant volume needed to achieve the desired projection (height) also increases. In summary, the first factor that determines implant volume is body structure.

The second factor is the patient’s desired size. Some patients state that they want only a slight increase and prefer it not to be noticeable. Some want a medium size, and others prefer a larger size. Certain patients may want a size that does not align with reality and would be far beyond a natural look. We approach such requests cautiously, and in many cases we do not perform overly exaggerated augmentations. However, we decide on small, medium, or large implant options during consultation, discussing the patient’s wishes, concerns, and expectations. This decision phase is important, because once an implant is placed, changing it requires another surgery.

Can Breast Implants Be Placed Through the Armpit?

Yes, breast implants can be placed through an incision in the armpit. However, this is not a commonly preferred method for several reasons. First, the scar remains in the armpit and is often more noticeable in daily life compared to a scar hidden under the breast. Second, bleeding control—which is very important in breast implant surgery, since even minor bleeding can increase future capsular contracture rates—cannot be achieved as effectively with the armpit technique compared to the inframammary approach. Third, implants generally cannot be placed under the muscle through the armpit. Although there are publications reporting under-muscle placement via the armpit, this only makes the surgery more difficult and does not provide a meaningful benefit.

What Type of Anesthesia Is Used for Breast Implants? What Are the Recovery and Discharge Times?

The procedure is performed under general anesthesia or under local anesthesia supported by sedation.

Patients are discharged the same day or the next day. On the third day, bandages are removed and the patient is instructed to wear a special medical bra. This bra is used for one month. Avoiding physical activity is recommended for the first 7–10 days. The most important point is to avoid putting strain on the arms. Especially if the implant is placed under the muscle, arm movements need to be limited to support a faster and more comfortable recovery. By one month, patients have typically returned fully to their normal daily lives.

What Is the Surgical Scar Like in Breast Implant Surgery?

After surgery, it takes about one year for the scar under the breast to reach its final appearance. Along the breast fold, a scar of approximately 3 to 5 cm remains depending on the implant size. During healing, these scars first form a crust, then become pink, and over the months they gradually fade to match the skin tone. We do not encounter scar-related problems frequently in breast implant surgery. The final scar is typically an average of about 4 cm, hidden in the breast fold and similar in color to the surrounding skin.

Do Breast Implants Prevent Breastfeeding?

This procedure does not harm the milk glands or ducts, and therefore it does not prevent breastfeeding.

Can a Breast Implant Rupture?

Older-generation breast implants had weaker shell durability, so in the past it was common to hear reports such as “her silicone ruptured.” However, modern implants are produced using nano-surface technologies, and they do not rupture even if a truck drives over them. In other words, this is no longer something to be feared.

Last Updated Date: 20.11.2025