Breast enlargement with silicone implants: facts, misconceptions, procedure

You wish for a natural breast enlargement that is not immediately recognizable as an operated breast? With good planning and professional execution, that is possible.

Before and After Photos

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How is a breast enlargement with implants planned?

We plan the breast enlargement using test implants in front of the mirror so that you can see exactly how your enlarged breasts may look. We do not perform computer simulations because they are never as authentic as looking in the mirror. Only after we have jointly selected the size of the implant do we determine the important aspects of the profile (round or anatomical) and the placement of the implants (above or below the muscle).

The most common misconceptions

Breast enlargement with silicone gel-filled implants is one of the most common procedures in aesthetic surgery. Women who wish to undergo breast enlargement should be well informed about the procedure and the possible risks and complications involved.

Patients often confront me with a number of misconceptions. In many cases, I can give reassurance, for example:

Silicone gel-filled implants do not cause breast cancer. However, in recent years, breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) has come into scientific focus, with an estimated likelihood of occurrence between 1 in 1,500,000 and 1 in 3,000,000.
There are no allergic reactions to silicone.
Quality implants do not burst on airplanes.
Quality implants have no limited lifespan and therefore do not need to be replaced after several years.
Silicone gel-filled implants do not interfere with routine mammographic examinations.
The ability to breastfeed is generally maintained after breast enlargement, with only rare exceptions.
It is possible to use B-Lite lightweight implants (approximately 30% lighter than conventional breast implants), which are particularly interesting for physically active women.

Furthermore, before a consultation, you should familiarize yourself with certain details (such as the shape or placement of the implants) so that you can actively participate in the surgical planning.

The shape of the implants

There are round and teardrop-shaped implants, and it is even possible to order custom-made implants. Round implants emphasize the décolleté, while teardrop-shaped implants are also referred to as “anatomical” implants and appear more natural, especially when a pronounced décolleté is not desired.

Round implants
Round implants have an even volume distribution (like a half-sphere).

Teardrop-shaped implants
With teardrop-shaped implants, more volume is concentrated in the lower part.

Where should the implants be placed?

To ensure that a breast enlargement is not immediately recognizable as such, the implant must be completely surrounded by a soft-tissue covering. If the existing breast is not very small (from cup size B), the implant can often be placed above the chest muscle. If the existing breast is rather small (smaller than cup size B), the implant is usually placed under the muscle to ensure better coverage. Both placement options have advantages and disadvantages, which should be discussed with your plastic surgeon.

Breast enlargement with placement of anatomical implants above the muscle, 250 g each side, access via the inframammary fold.

positionierung-implantate-unter-dem-muskel

Breast enlargement with placement of the implants under the muscle. More before-and-after photos of breast enlargement can be found further below.

Which access route?

There are three surgical access routes for breast enlargement: armpit, inframammary fold, and areola.

In contrast to the question of implant placement, this question cannot be answered medically. Each access route has its advantages and disadvantages, which your surgeon should explain to you in detail. Every woman should be free to choose the access route herself, and the surgeon should master all three techniques. Ultimately, what matters most is where the approximately 4 cm long scar will bother you the least.

Every breast enlargement acts like a magnifying glass on the appearance of the breasts. Therefore, minor asymmetries, shape anomalies, and slight positional differences of the nipples become much more noticeable after the procedure than before. Unevenly sized or positioned areolas, for instance, become far more visible after a breast enlargement and should therefore be considered in the surgical plan. Likewise, size differences should be compensated for by using implants of different volumes.

Sagging breasts of a certain size can only be insufficiently lifted through breast enlargement alone. The rule applies: “What sags before, sags afterward as well.” In almost all cases of sagging breasts, a simultaneous breast lift should be considered.

Pregnancy generally has a negative effect on the surgical outcome, as breast sagging can be expected. Significant weight fluctuations can also affect the results of the surgery.

As a wonderful alternative to breast enlargement with implants, a completely natural breast enlargement using autologous fat is highly suitable.

Breast enlargement summarized

Some important facts about breast enlargement with silicone implants

allgemeine-information-zur-brustvergroesserung-silikonimplantate

Before and After Photos

We plan the breast enlargement with test implants in front of the mirror so that you can see exactly how your enlarged breasts may look. We do not perform computer simulations because they are never as authentic as looking in the mirror. Only after we have jointly selected the size of the implant do we determine the important questions of the profile (round or anatomical) and the placement of the implants (above or below the muscle).

Show images

Your consultation appointment

Would you like to learn more about breast enlargement with silicone implants? We are happy to provide you with comprehensive and personal advice; our experience goes back to 1997, and we can look back on over 1,000 procedures! By the way, we were the first to use B-Lite lightweight implants in Austria! Simply click on the button below and schedule your consultation at any time of the day or night, whenever it suits you. If you don’t like using a computer, or if no appointment is available in the near future, you are also welcome to call us: Monday to Friday from 9:00 a.m. to 7:00 p.m., 01/5870000 — I look forward to speaking with you.

Book an Appointment

Breast enlargement with implants: overview

Below is a summary of the necessary steps and preparations associated with the procedure “breast enlargement with implants.”

Initial Consultation

Have you already purchased the book “Breast Enlargement” for 40 euros in our practice or online? Then the initial consultation for an aesthetic surgical procedure such as a nose or chin correction is included. An initial consultation usually lasts about 30 minutes. Without purchasing the book, the fee is 250.00 euros; for a longer and more detailed initial consultation (no fixed duration), I charge 300.00 euros.

Even if you have already had a breast enlargement performed at another practice, are dissatisfied with the result, and would like to seek a second opinion, I am happy to advise you. However, I ask for your understanding that in this case I will charge 300 euros, which will be credited to you in the event of a corrective surgery.

My personal tip for you: Always and fundamentally obtain a second opinion before undergoing a procedure (this is, of course, not included in the book purchase).

Hospital Stay

Inpatient (with overnight stay)

1,500 to 3,500 euros, depending on the duration of the surgery, number of overnight stays, room category (suite, single room, shared room), and hospital.

Anesthesia

The procedure is performed under general anesthesia; therefore, an anesthesiologist must be present during the surgery. The cost for the anesthesiologist varies depending on the duration of the operation, ranging from 600 to 1,200 euros.

Costs

Depending on the duration of the surgery, the surgical fee ranges between 3,500 and 5,500 euros.

Surgery Preparation

Chest X-ray and ECG (not always necessary)
Mammogram
Complete blood count including coagulation, blood group, HIV test, and hepatitis A, B, C

Surgical clearance by a general practitioner or internist

If you are socially insured in Austria and the procedure is medically indicated, the blood tests, mammogram, and X-ray will not incur any additional costs. The same applies to the surgical clearance by an internist or general practitioner who has a contract with the Austrian social insurance providers. In our medical center, there is an internist who is a private doctor (“Wahlarzt”). For private doctors, the insurance covers about 50%–75% of the costs.

For 14 days before the operation, blood-thinning medications (Aspirin, Marcoumar, Vitamin E, etc.) should be discontinued, as they can delay blood clotting. Alcohol and sleeping pills should also be avoided as much as possible, as they reduce blood clotting ability and increase the risk of postoperative bleeding. Smoking should be stopped if possible — nicotine causes constriction of blood vessels, which can lead to wound healing problems.

The surgery is performed under general anesthesia. Therefore, you need the following examinations before the procedure:

Please note that the examinations must not be older than 10 days at the time of surgery.

Please bring the X-ray and all medical reports with you to the surgery appointment.

To ensure smooth admission procedures, you should arrive at the hospital at least 2½ hours BEFORE the operation and refrain from eating for 6 hours and drinking for 4 hours prior to surgery. After completing the admission formalities, you will be taken to your room; if desired, you can receive an infusion to reduce thirst.

For breast enlargement, an overnight hospital stay is to be expected.

Surgery Checklist

Plan the surgery date
Set the surgery date (take vacation/compensatory time or sick leave, arrange childcare if necessary, etc.)
Select implants (size, shape, projection, surface texture) – together with the doctor
Have the preoperative examinations (blood tests, mammogram, X-ray, ECG, surgical clearance) done at least 2 weeks before the operation
Preoperative consultation on the day before the surgery. The findings are reviewed, final details discussed, and the consent form signed.
You will receive a hospital admission form from the assistant, which must be completed and brought to the hospital. Schedule the first follow-up appointment at the practice.
Arrive at the hospital 2.5 hours before the operation – admission formalities. Upon request, a staff member can accompany you and make the waiting time before surgery more pleasant.
Discharge from the hospital usually takes place one day after the procedure. Please do not drive yourself — take a taxi or have someone pick you up.
Plan to rest at home and avoid physically demanding activities.

First follow-up visit (approx. 5–7 days after surgery): replace the tape dressing with a support bra
Second follow-up visit (approx. 10 days after surgery): remove the stitches
Third follow-up visit (approx. 30 days after surgery)

additional follow-ups after two and six months
final follow-up after one year

Implants

1,100 to 2,500 euros, depending on the type (anatomical/round, smooth/textured) and brand of the implant.

Support Bra

After a breast enlargement, the operated breast should be moved as little as possible and optimally supported. Depending on the brand and design, a support bra costs between 60 and 180 euros.

Rounds & Follow-up Appointments

Are included in the surgical fee.

Faq

Below is a summary of the necessary steps and preparations associated with the procedure “breast enlargement with implants.”

Can silicone gel-filled implants cause breast cancer?

No, this question has now been definitively answered. At the 11th World Congress of Plastic Surgeons in Yokohama in 1995, several worldwide studies were presented that examined the connection between breast implants and breast cancer in detail. No correlations could be found in any study; for this reason, silicone gel-filled implants were again approved in the USA by the FDA (Food and Drug Administration).

Is cancer screening made more difficult by silicone gel-filled implants?

No, breast implants are clearly visible in every imaging examination and do not hinder the early detection of breast cancer.

Are there other substances besides silicone gel that have been used to fill breast implants?

For a time, in addition to silicone gel and saline solution, soy oil and starch gel were also used to fill implants. Starch gel proved unsuitable due to volume fluctuations, and soy oil produced toxic degradation products. Therefore, currently, only silicone gel-filled and saline-filled implants are standard. Since saline solution feels significantly less natural compared to silicone gel, silicone gel-filled implants are considered the state of the art.

Do silicone gel-filled implants need to be replaced after several years?

No. ISO 9000 and CE-certified quality products have no limited lifespan and therefore do not need to be replaced.

There are implants with smooth and textured surfaces — which are better?

Until recently, it was believed that implants with a textured surface caused capsular fibrosis less frequently than implants with a smooth surface. However, recent publications show there is no difference. It is confirmed, however, that implants with a textured surface perform at least as well as smooth ones.

Are there intolerances or allergies?

No, neither. The only reaction that can occur is capsular fibrosis, which occurs with a probability of 3–5% and, strictly speaking, is not an intolerance reaction to silicone.

What is capsular fibrosis?

The body reacts to the “foreign object” silicone implant by forming a connective tissue capsule. Ideally, it is delicate, thin, and not palpable. In about 3–5% of cases, the capsule thickens and may contract — this phenomenon is called capsular fibrosis. In rare cases, this can lead to deformation, hardening of the breast, and pain.

How is capsular fibrosis treated?

The hardened capsule is incised multiple times so it can expand again. The implant is then reinserted. This measure is successful in about half of all cases. If capsular fibrosis occurs again, the implant must be permanently removed.

From what age to what age can breast enlargement be performed?

Breast enlargement should not be performed before the age of 18. Growth and breast development should be complete. There is no upper age limit, provided there are no medical or psychological contraindications.

Can breasts be enlarged to any size?

The limiting factors are the width of the chest and the size of the existing breast. As a general rule: the smaller the existing breast and the narrower the chest, the less enlargement is possible. Implants should not extend beyond the edge of the chest and should not overstretch the skin beyond its elasticity limit.

Should implants be placed above or below the chest muscle?

Ideally, implants are placed above the muscle, as this allows them to form a unit with the breast tissue and move naturally with body motion. They are also barely perceptible when healed without complications. To achieve a natural result, however, the implant must be surrounded by a soft-tissue covering. If the volume of a smaller breast is insufficient for this, the implant must be placed under the muscle to ensure sufficient soft-tissue coverage. However, this placement has the disadvantage that the implant moves less naturally and is easier to feel when touched.

There are round and teardrop-shaped implants — which should be used?

That depends partly on the patient’s preference and partly on the planned placement. Round implants emphasize the décolleté, which may be desirable. Teardrop-shaped implants (anatomical implants) are flatter at the top and emphasize the décolleté less. Therefore, they are mainly used when placement under the muscle is planned so that the décolleté does not appear too prominent since the breast muscle adds additional volume. The choice of implant should always be made individually.

There are three possible access routes — which should be chosen?

Whether the implant is inserted through the armpit, the areola, or the inframammary fold, none of these access points is better or worse — each has advantages and disadvantages. Depending on lifestyle, the patient should be free to choose where the scar bothers her least. When performed correctly, all scars are almost invisible. Although the inframammary approach is technically the easiest for the surgeon, they should master and offer all techniques to their patients.

Can breast enlargement also be performed using autologous fat transplantation?

Autologous fat transplantation, especially when combined with stem cell enrichment, is still in its early stages. Currently, the time and surgical effort are still high, and the achievable enlargement is limited to about 250 ml. However, there are no longer medical objections to it, and if a breast enlargement with autologous fat is desired, it can be offered.

Can breast enlargement be performed under local anesthesia?

I advise my patients against it. Under local anesthesia, the discomfort of experiencing the surgery and the risk of stress-related complications outweigh the cost savings. Moreover, general anesthesia today poses only a very low medical risk, and with good postoperative recovery, the hospital can often be left on the same day.

Does breast enlargement affect the ability to breastfeed?

Generally not. In rare cases, breastfeeding ability may be slightly affected.

Does breast enlargement reduce nipple sensitivity?

Generally not. In rare cases, there may be a temporary, and very rarely, a permanent decrease in the sensitivity of the nipples and areola.

What complications can occur?

The most common medical complication is postoperative bleeding, followed by infection. Both are very rare when performed correctly. Result-related complications include asymmetry, implant displacement, implant damage, or rippling. All complications can be treated surgically.

How soon can one resume normal activities after breast enlargement?

If the implants are placed above the muscle, after a few days; if placed under the muscle, recovery may take a bit longer.

What are the long-term results after breast enlargement?

In the vast majority of cases, the implant heals without reaction and the result looks natural. If weight fluctuations and pregnancies are avoided, long-term results are excellent. Depending on implant size, however, breast sagging may occur over time as the tissue loses elasticity and can no longer counteract gravity.

What is a tubular breast, and how can it be treated?

There are two conditions — tuberous deformity and quadrant hypoplasia. In both cases, enlargement with implants alone is usually insufficient, as the limited tissue must be released to make room for enlargement. Fat grafting is excellent, but often 2–5 sessions are required, and vacuum pre-expansion is necessary. These are not routine procedures. To find the right method for breast enlargement and optimization, a specialist must always be consulted.

What methods exist instead of breast enlargement with implants?

More and more women wish for natural and gentle breast enlargement. Implants are often perceived as uncomfortable or bothersome and can also lead to complications. Autologous fat transplantation is particularly suitable for this — it is less stressful for the body and provides the most natural results. A side effect is fat reduction, as the fat is removed from another area.