In-depth Breast Augmentation Surgery: Essential Knowledge, Types of Silicone, Augmentation Techniques Before Deciding
Breast Augmentation is one of the most popular cosmetic surgeries worldwide, including in Thailand. With continuously advancing medical technology, the procedures, safety, and results are now much more reliable than in the past.
However, breast augmentation is not just about choosing the size or brand of silicone. It is a surgery that requires understanding of body structure, breast base, skin elasticity, and safety at every step. Those considering breast augmentation should know these important facts before deciding to ensure beautiful, proportionate, and long-term safe results.
What is Breast Augmentation and Who is it Suitable For?
Breast augmentation is a surgical procedure to increase size, change the shape of the breasts, or restore chest balance by inserting silicone (Breast Implant) into the breast area. The implant can be placed in an appropriate position, either under the mammary gland (Subglandular) or under the chest muscle (Submuscular), depending on the body structure and the patient’s goals to achieve balanced proportions and desired shape.
This surgery is performed under general anesthesia or local anesthesia combined with sedation and typically takes about 1-2 hours per session. It should be done in a medical facility with an anesthesiology team and comprehensive care system.
Who is Suitable for Breast Augmentation?
Breast augmentation is suitable for individuals with the following characteristics:
- 18 years or older with fully developed bodies (in some cases, waiting until 22 years old may be recommended)
- Good physical and mental health with no contraindicated chronic diseases for surgery
- Small breast size and desire to boost confidence in body shape
- Asymmetrical breasts wanting to achieve symmetry
- Sagging breasts after childbirth or rapid weight loss
- Desire to balance body proportions
- Understanding of realistic risks and outcomes without expecting exaggerated results
- Not pregnant or breastfeeding
However, not everyone is suitable for every technique or size. Doctors will always assess the breast base, breast tissue volume, skin elasticity, and overall health before surgery because good breast augmentation is not about the biggest size but about beauty, suitability, and long-term safety.
How Many Types of Breast Silicone Are There and Which Should You Choose?
Currently, there are many types and brands of breast silicone implants, each with different properties and advantages. Choosing silicone requires considering multiple factors together.
Factors to Consider When Choosing Silicone
1. Shape (produces different results)
- Round shape is the most popular, suitable for those who want to increase fullness and an overall beautiful chest line, emphasizing the upper part of the breast (Upper Pole). It is easier to operate and more affordable.
- Anatomical/Teardrop shape is designed to closely resemble the natural breast shape, with a fuller lower part than the upper. It is suitable for those seeking a highly natural look but has a caution that if the implant rotates, the shape may become distorted.
2. Silicone Surface Texture (affects adhesion in the pocket)
- Smooth surface: moves naturally and reduces the risk of wrinkles.
- Textured surface: adheres better to tissue, reducing rotation in teardrop implants. However, recent studies link it to BIA-ALCL (a rare lymphoma associated with breast implants), so detailed consultation with a doctor is advised.
3. Softness and Flexibility (affects natural feel after augmentation)
The softness and flexibility depend on the filling material inside, such as:
- Silicone Gel Implant is the most popular because it feels closest to natural tissue.
- Saline Implant contains sterile saline solution; if the implant ruptures, the body absorbs the saline safely. However, it feels firmer than silicone gel and may show ripples in patients with thin tissue.
- Composite Implant is a mix of silicone gel and saline designed to combine the advantages of both types.
4. Size and Base of Silicone must correspond to the breast base and body frame of the patient.
5. Certification Standards should be FDA-approved silicone.
Mentor and Motiva: Popular Silicone Brands
Currently, the two leading and trusted silicone brands among doctors are Mentor and Motiva, each with distinct features and models.
The key guideline is to choose silicone that truly suits the patient’s body, not just by brand name. Each brand has different softness and feel. Patients should personally feel the implants and decide together with their doctor, not rely solely on online reviews, as the sensation and results depend on each individual’s body.
How to Choose the Silicone Size? Which Size is Suitable?
One of the most common questions is how many CCs to augment? In reality, size selection should not be based solely on CC volume. Silicone size is usually measured in cc (or mL), indicating the volume of silicone, not bra cup size. Increasing by 150-200 cc generally increases about one cup size, but actual results depend on many factors.
Factors to Consider When Choosing Silicone Size for Breast Augmentation
- Breast Base Width is the main indicator of which silicone size fits the body’s base structure.
- Body width and overall proportions to ensure the new breasts are balanced with the body.
- Skin elasticity and how much the skin can accommodate.
- Thickness of existing breast tissue to assess silicone coverage.
- Lifestyle and regular activities such as exercise or daily routines.
How Risky or Dangerous is Choosing a Very Large Silicone Size?
Choosing silicone too large for the body to handle may cause problems such as:
- Unusual tightness or pain
- Thinning skin, visible or palpable implant edges
- Faster breast sagging than expected
- Unnatural shape
The best size is the one that looks good on you and is safe long-term, not the biggest size. It is recommended to consult a doctor for suitability assessment and to try feeling the actual silicone.
At the Cosmetic Surgery Center, Phyathai 3 Hospital, we offer FDA-approved breast silicone from several leading brands for patients to try. Patients can consult doctors and receive design simulations to help decision-making before surgery.
Breast Augmentation Surgery Techniques: Types with Pros and Cons
Breast augmentation surgery includes different silicone placement techniques and surgical approaches. Doctors will evaluate and recommend the most suitable technique for each individual.
Silicone Placement Techniques
1. Technique 1: Above the Muscle (Subglandular)
- Advantages: Relatively quick recovery, suitable for those with sufficient existing breast tissue.
- Disadvantages: If breast tissue is thin, implant edges may be visible or palpable more easily.
2. Technique 2: Under the Muscle (Submuscular)
- Advantages: Better coverage of implant edges, suitable for those with little breast tissue.
- Disadvantages: Initial post-op period may feel tight and require longer recovery.
3. Technique 3: Dual Plane (Combination of Two Layers)
- Implant placed partly under muscle and partly under breast tissue.
- Provides both natural appearance and good support.
- This technique is currently very popular.
Surgical Approaches (Incision Locations)
1. Transaxillary Incision (Armpit)
- Advantages: No direct scar on the breast; scar hidden in the armpit, suitable for those concerned about breast scars.
- Disadvantages: Requires high surgical skill; implant positioning control can be more complex.
Currently, endoscopic techniques are used to improve accuracy in creating the implant pocket.
2. Inframammary Incision (Under the Breast Fold)
- Advantages: Good access for precise implant placement, suitable for many techniques including revision cases.
- Disadvantages: Scar under the breast fold, but generally hidden in the crease and fades over time.
Suitable for those who want precise implant placement and prefer no armpit scars.
Choosing the technique depends on breast structure and patient goals individually, as there are some limitations that require doctor consultation before deciding.
Important Things to Know About Breast Augmentation
Before deciding on breast augmentation, there are many important aspects to understand thoroughly to prepare both physically and mentally.
When Will You See Results After Breast Augmentation?
After surgery, patients will immediately see size changes. However, the true results gradually become clearer over time.
- Immediately after surgery: Breasts will be swollen, tight, and may be positioned higher than normal.
- 1-3 months: Swelling reduces and breasts look more natural.
- 3-6 months: Implants settle and shape becomes more defined.
The time to see clear results varies by individual, technique used, and post-op care.
How Long Does Breast Augmentation Last?
High-quality silicone implants today are designed to last 10–20 years or more, with some brands offering lifetime warranties. However, this does not mean no maintenance or follow-up is needed.
Factors Affecting Longevity of Results Include
- Type and quality of silicone used
- Surgical technique and precision
- Post-operative self-care
- Long-term weight changes
- Pregnancy and breastfeeding
- Aging and skin changes
Initially, patients should follow up with their doctor as scheduled. If abnormal symptoms occur such as unusual pain, hard breasts, shape changes, or asymmetry, they should promptly return for examination.
How to Prepare Before Breast Surgery?
- Stop smoking at least 4-6 weeks before surgery
- Avoid alcohol and get sufficient rest
- Avoid medications that thin the blood such as aspirin, vitamin E, and some painkillers
- Inform the doctor about chronic diseases, current medications, allergies, supplements, and surgical history
- Undergo basic health checks as recommended, such as blood tests and mammograms (in some cases)
- Arrange for a caregiver and transportation for surgery day and post-op
Post-Operative Care After Breast Augmentation
- Wear a support bra as recommended by the doctor
- Avoid heavy lifting and strenuous exercise
- Avoid raising arms high or vigorous movements initially
- Take all prescribed medications
- Keep the wound clean and avoid soaking or swimming until fully healed
- Attend follow-up appointments and watch for abnormal signs such as swelling, redness, increased pain, fever, or discharge. Contact the hospital immediately if these occur.
Where is the Best Place for Breast Augmentation for Safety?
Breast augmentation is a major surgery with long-term effects on the body. Therefore, before deciding, safety and medical standards must be the primary considerations. Important criteria to check before deciding include:
- The surgeon must be a specialist with experience
- An anesthesiologist must closely monitor throughout the surgery
- The medical facility or hospital must meet international standards
- Silicone must be genuine, verifiable, and guaranteed
- There must be a system for post-operative care and follow-up
At the Cosmetic Center, Phyathai 3 Hospital, we have a ready team of doctors, modern equipment, and a comprehensive safety care system before, during, and after surgery.
FAQ: Common Questions About Breast Augmentation
Q: Does it hurt during augmentation or surgery?
A: There is no pain during surgery because it is performed under general anesthesia by a specialist anesthesiologist. The patient is fully asleep throughout the procedure. However, after waking up, there may be tightness, pressure, or soreness in the chest area for the first 2-3 days. Doctors will prescribe pain relief and provide appropriate care to ease symptoms.
Q: Does it hurt after surgery? How many days does the pain last?
A: Tightness, fullness, or sharp pain when moving is most noticeable in the first 2-3 days and gradually improves within 7 days. The pain level depends on the surgical technique (e.g., submuscular placement may feel tighter than subglandular), implant size, and individual body condition.
Q: How many days should I stay in the hospital? How long should I take off work?
A: Generally, it is recommended to stay in the hospital for 1 night for close nursing care and safety monitoring after anesthesia. For work leave, allow about 5-7 days for recovery for typical office jobs. For physically demanding jobs or heavy lifting, the doctor should assess based on individual work type.
Q: Can people with chronic diseases (diabetes, hypertension, heart disease) undergo surgery?
A: Some patients can, but only after thorough evaluation. Patients must inform the doctor of all medical history and medications in advance to assess heart, lung, blood pressure, and blood sugar levels to ensure they are within safe limits before anesthesia.
Q: Why do some people have uneven breasts or tilted implants after augmentation? What are common post-op problems?
A: Asymmetry or deformity after surgery can result from three main factors:
- Pre-existing structure: Unequal breast base, chest bones, or breast tissue on both sides.
- Technique and surgery: Uneven pocket dissection for implant placement or implant displacement due to muscle pressure.
- Body response: Capsular contracture causing hardening or distortion of the implant, as well as complications like hematoma or infection.
Detailed anatomical assessment by a specialized plastic surgeon before surgery and strict adherence to post-op care instructions can greatly reduce these risks.
Summary: Before Deciding on Breast Augmentation, Safety Comes First
Good breast augmentation requires detailed evaluation of body structure, choosing the right silicone and technique for each individual, and surgery in a facility with standards, anesthesiology team, and comprehensive post-op care. Those interested in breast augmentation should prioritize safety and long-term results over size alone.
Dr. Dulyanat Aranyapal
Specialist Surgeonin Plastic and Reconstructive Surgery
