Choosing the right implant for breast augmentation is not based solely on the desired cup size. Chest width, existing breast tissue, skin quality, asymmetry, and lifestyle are evaluated together. Implant selection, placement, and incision location are planned according to these measurements. In patients with thin tissue coverage or where certain contour transitions require additional support, a hybrid approach combining a breast implant with fat transfer may be considered. No breast implant is guaranteed to remain problem-free for a lifetime; capsular contracture, infection, implant displacement, and the potential need for future revision surgery should be discussed openly during the consultation.
Breast augmentation surgery aims to increase breast volume and create a breast contour that is more balanced with the patient’s body.
Surgery may be considered in patients with naturally limited breast volume, volume loss following pregnancy or weight changes, or noticeable differences in volume between the two breasts.
However, the goal is not to use the largest possible implant in every patient.
Breast width, chest-wall anatomy, existing tissues, and the patient’s desired appearance are evaluated together to plan a result that is proportionate to the rest of the body.
Adult patients who wish to increase their breast volume and whose general health is suitable for elective surgery may be evaluated for breast augmentation.
Existing breast tissue, skin quality, breast and chest-wall anatomy, nipple position, asymmetry, and the patient’s expectations are important factors when determining suitability.
Breast augmentation may also be considered in patients who have experienced volume loss following pregnancy, breastfeeding, or significant weight changes.
However, when significant breast sagging is present, an implant alone may not be sufficient, and a breast lift (mastopexy) may need to be considered as part of the surgical plan.
Not every concern involving breast volume or shape can be addressed with an implant alone.
In some patients with significant sagging, attempting to lift the breast simply by using a larger implant may not be an appropriate approach.
Surgery may need to be postponed or may not be recommended in patients whose general health significantly increases the risks of surgery or anesthesia, those with active infections, or those with conditions that may negatively affect wound healing.
Patients who desire breasts that are significantly larger than their anatomy can safely accommodate, or who expect perfectly symmetrical breasts after surgery, require careful discussion of expectations and anatomical limitations.
A breast augmentation consultation should not focus solely on the question, “How many cc do you want?”
Chest width, breast-base dimensions, the thickness of existing breast tissue, skin quality, nipple position, the inframammary fold, and existing differences between the right and left breasts are evaluated.
The patient’s height, body proportions, and lifestyle are also part of the planning process.
The desired appearance is equally important. Whether the patient prefers a more natural transition or more pronounced upper-pole fullness should be discussed during the consultation.
Based on these evaluations, not only implant volume but also implant width, projection, and shape are considered.
There is no single implant or surgical technique that is appropriate for every breast augmentation patient.
Implant selection is based on the patient’s anatomical measurements and desired appearance.
Placement options in relation to the pectoral muscle and surrounding tissues may be considered according to the amount of existing breast tissue and the patient’s anatomy.
The incision location is also individualized. The inframammary fold is one of the commonly used incision sites, but the appropriate approach is determined for each patient.
The fundamental principle is:
First, determine the anatomy and the desired result. Then select the implant.
The implant should be adapted to the patient—not the patient to the implant.
Hybrid breast augmentation combines a breast implant with the patient’s own fat tissue.
The implant provides the primary volume and projection, while fat transfer may be used to soften specific contour transitions or provide additional tissue coverage.
In appropriately selected patients with thin existing breast tissue, fat transfer may help make implant edges less noticeable.
The fat is generally harvested from the abdomen, waist, or another suitable area using liposuction, processed, and then transferred in controlled amounts to the required areas.
However, a hybrid approach is not necessary for every breast augmentation patient.
Breast augmentation is generally performed under general anesthesia in an appropriately equipped operating-room setting.
The duration of surgery may differ between standard implant augmentation and hybrid surgery combining an implant with fat transfer.
Before surgery, the patient’s medical history, current medications, previous operations, and necessary tests are reviewed to create an individualized surgical and anesthesia plan.
Swelling, tightness, and tenderness in the breasts can be expected after breast augmentation surgery.
During the early postoperative period, implant position and breast appearance should not be considered the final result. As swelling decreases and the tissues adapt around the implants, breast shape gradually changes.
The timing of return to work and normal daily activities varies according to the surgery performed and the patient’s individual healing process.
Returning to heavy lifting, strenuous exercise, and particularly activities that place significant stress on the chest muscles should be planned gradually under medical guidance.
If hybrid breast augmentation has been performed, healing of the areas from which fat was harvested is also part of the recovery process.
An incision is required to place a breast implant.
The location of the incision depends on the surgical technique. In suitable patients, it may be positioned within a natural anatomical area such as the inframammary fold.
The appearance of scars changes over time and is influenced by the patient’s individual wound-healing characteristics.
It cannot be guaranteed that surgical scars will become completely invisible.
Temporary or permanent changes in breast or nipple sensation may also occur following surgery.
Breast augmentation is not a risk-free procedure.
In addition to bleeding, hematoma, infection, wound-healing problems, scar-related concerns, asymmetry, and sensory changes, there are complications specifically associated with breast implants.
These may include:
Rare but important diseases and complications associated with breast implants should also be discussed before surgery according to the type of implant being considered.
Some complications may require implant removal, implant replacement, or another revision procedure.
The two breasts are naturally not completely identical.
Differences in the chest wall, breast base, nipple position, and existing breast tissue are evaluated before surgery.
Breast augmentation may help reduce noticeable asymmetries, but mathematically perfect symmetry cannot be guaranteed.
Breast tissues also continue to change over time due to pregnancy, breastfeeding, weight fluctuations, gravity, and natural aging.
For this reason, the surgical result is not static.
Long-term follow-up is important for patients with breast implants.
During early postoperative appointments, the incision sites, swelling, implant position, and wound healing are evaluated.
Over the longer term, changes involving both the breast tissue and implants should continue to be monitored.
Depending on the type of implant and the individual patient’s circumstances, imaging or other follow-up examinations may be recommended.
Having breast implants should not be considered a situation in which no further follow-up will ever be necessary.
What implant size is right for me?
Cup size or implant volume in cc alone does not determine the appropriate implant. Breast-base width, chest-wall anatomy, existing tissue coverage, skin quality, and the desired appearance should all be evaluated together.
Does a larger implant create better cleavage?
Not necessarily. Cleavage is influenced by several factors, including existing breast anatomy, chest-wall structure, the natural distance between the breasts, implant characteristics, and tissue quality. Selecting an implant beyond the patient’s anatomical limits may increase the risk of certain complications.
Breast implants or fat transfer—which is better?
The two techniques have different purposes and can provide different degrees of volume enhancement. An implant may be appropriate for some patients, fat transfer for others, while a hybrid approach combining both may be considered in suitable patients.
What are the advantages of hybrid breast augmentation?
In suitable patients, hybrid augmentation can combine the volume provided by an implant with the contour refinement offered by fat transfer. It may be particularly useful for softening certain transitions or providing additional coverage in patients with thin tissues.
Does all of the transferred fat remain permanently?
No. Some of the transferred fat may be absorbed by the body during the healing process. Long-term fat survival varies from person to person, and a specific percentage cannot be guaranteed.
Do breast implants last a lifetime?
Breast implants are not devices that can be guaranteed to remain problem-free for life. However, this does not mean that an implant without problems must automatically be replaced after a predetermined number of years. Long-term follow-up is important.
Can I breastfeed with breast implants?
Many patients are able to breastfeed after breast augmentation. However, surgical technique, individual anatomy, and other factors may affect breastfeeding capacity. Patients planning future pregnancies should discuss this during the consultation.
Do breast implants interfere with breast cancer screening?
The presence of breast implants should be taken into consideration during breast imaging. Patients should inform the radiology team that they have implants when undergoing mammography or other imaging studies. Routine breast screening appropriate for the patient’s age and individual risk factors should continue.
If the implants are removed, will my breasts return to how they looked before surgery?
Not necessarily. Changes in the skin and breast tissue over time, implant size, the duration the implants have been in place, pregnancies, and aging can all affect the appearance of the breasts after implant removal.
Could I need another operation after breast augmentation?
Yes. Changes involving the implant or breast tissue may require revision surgery, implant replacement, or implant removal in the future.
A consultation with Dr. Atilla Fesli can be arranged in Antalya or Doha for breast augmentation or hybrid breast augmentation evaluation.
The purpose of the consultation is not simply to choose an implant volume.
Breast and chest-wall measurements, existing breast tissue, skin quality, asymmetries, and the patient’s desired appearance are evaluated to determine whether an implant is appropriate, which implant characteristics may be considered, and whether fat transfer could contribute to the surgical plan.
The right question in breast augmentation is not simply, “How many cc?”
The appropriate volume should be considered in relation to your body, existing breast tissue, and the appearance you want to achieve.
The goal is not simply to create larger breasts, but to plan a balanced, individualized result that is harmonious with the patient’s body.
Dr. Atilla Fesli
Natural. Balanced. Still You.
Op. Dr. Atilla Fesli
Doha, Qatar
Plastic and Aesthetic Surgery in Doha, Qatar
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