Breast Augmentation Types: Implants & Placement

The key to a satisfying breast augmentation is not choosing the "best" implant - it's choosing the right implant for your body. Every decision (type, size, shape, placement, incision) should be made based on your anatomy, tissue characteristics, and aesthetic goals. A competent surgeon will guide these decisions using measurements, imaging, and experience - not a one-size-fits-all approach.

The sections below cover the four choices every patient makes: implant type, shape, placement plane, and size. If you are still deciding whether surgery is appropriate for you, review the general plastic surgery candidacy criteria first, and see our breast augmentation cost guide for pricing and package structure.

Are You a Candidate for Breast Augmentation?

Augmentation is an elective operation, so good candidacy is about health, stability and clear motivation as much as anatomy. Most surgeons look for the following before recommending surgery.

• Physical maturity and stable weight: Breast size shifts with weight and hormones, so a stable weight gives a more predictable, lasting result.
• Good general health: No active infection, well-managed chronic conditions and no untreated bleeding disorder. Your surgeon will review your full medical history.
• Not pregnant or breastfeeding: Surgeons advise waiting until well after breastfeeding ends, so that breast tissue and volume have settled.
• Realistic, self-directed goals: The best outcomes come from patients who want the change for themselves and understand that implants enhance proportion rather than deliver perfection.
• Willingness to monitor implants long term: Implants are not lifetime devices, so candidates should be comfortable with ongoing self-checks and periodic imaging.

If you are unsure whether the timing is right, review the general plastic surgery candidacy criteria with your surgeon.

What Are the Main Types of Breast Implants?

Silicone Gel Implants

Silicone gel implants are the most popular choice worldwide - accounting for approximately 85% of all breast augmentations - due to their natural feel, as noted by the ASPS. Silicone implants contain a cohesive silicone gel that closely mimics the feel of natural breast tissue. They are pre-filled by the manufacturer in a range of volumes and profiles.

• Standard cohesive gel: Soft, natural feel. Most popular option.
• Highly cohesive ("gummy bear"): Form-stable - maintains shape even if the shell is cut. Firmer feel, less natural movement. Best for anatomical shapes.
• Ergonomic (responsive gel): Newer technology. Firm when standing (maintains shape), soft when lying down (natural spread). Combines advantages of both categories.

Saline Implants

Filled with sterile saltwater after insertion. The shell is silicone; the filling is saline. Advantages: adjustable volume during surgery, immediate detection of rupture (the implant deflates visibly and the saline is harmlessly absorbed). Disadvantages: slightly less natural feel, visible rippling in thin-tissue patients.

Round vs Anatomical (Teardrop) Shape

Round implants distribute volume evenly and add upper pole fullness and cleavage. Anatomical or "teardrop" implants carry more volume in the lower pole, producing a natural slope and a more subtle result; they are typically made from highly cohesive gel so the shape stays stable. Shell surfaces come in smooth, micro-textured, and nano-textured finishes.

Silicone vs Saline: A Side-by-Side Comparison

Both implant types are widely used and each carries clear trade-offs. This table summarizes the practical differences your surgeon will walk you through.

Should Implants Go Over or Under the Muscle?

Submuscular (Under the Pectoralis Muscle)

• Better coverage of the implant (reduces visible edges and rippling)
• Lower capsular contracture rate
• Better mammogram imaging (implant separated from breast tissue)
• More natural appearance in thin patients
• Longer recovery (muscle involvement) and animation deformity (implant moves when flexing chest muscles)

Subglandular (Over the Muscle)

• Faster recovery (no muscle manipulation)
• No animation deformity
• Better for patients with adequate breast tissue coverage
• Higher capsular contracture risk
• More visible implant edges in thin patients

Dual-Plane (Hybrid)

The most versatile and commonly used approach in 2026. The upper portion of the implant sits under the muscle; the lower portion under the gland only. Provides the coverage benefits of submuscular placement with the natural shape of subglandular - minimizing animation deformity.

How Do You Choose the Right Implant Size?

Cup size is a meaningless measurement for implant selection. Cup sizes vary between bra manufacturers by up to 200cc. Instead, sizing should be based on:

• Breast base width: The distance across your breast determines the maximum implant diameter. An implant wider than your base creates lateral overhang and unnatural results.
• Tissue thickness: Thin tissue (pinch test <2cm) requires submuscular placement and moderate sizing. Thicker tissue offers more flexibility.
• Desired profile: Low profile (wider, less projection), moderate (balanced), high profile (narrower base, more projection), or extra-high profile.
• 3D imaging: Modern consultation uses Crisalix, Vectra, or similar 3D simulation to visualize approximate results before surgery.

Most augmentation patients choose between 250-400cc. Going larger is not always better - oversized implants create more complications (capsular contracture, bottoming out, stretch marks) and age poorly.

How Safe Is Breast Augmentation?

Breast augmentation has been the most commonly performed cosmetic surgical procedure worldwide for over a decade, according to ISAPS. That does not make it minor surgery, and the honest version of the safety picture has four parts: the common complications, the rate of further surgery, two rarer things regulators now require surgeons to discuss, and what implants do to breast screening.

The Common Complications

• Capsular contracture: scar tissue tightening around the implant, making the breast firm, distorted or painful. Reported in roughly 2-5% of patients over ten years, lower with submuscular placement. Severe cases need further surgery.
• Infection: around 1-2%. An infection that does not settle on antibiotics usually means the implant has to come out and go back in months later.
• Implant rupture: the risk rises with the age of the implant rather than staying flat, and silicone rupture is usually silent - you feel nothing. A ruptured implant should be removed and replaced, which is why imaging surveillance matters.
• Changed nipple sensation: common in the first months and usually recovering. In a minority it is permanent, either numbness or uncomfortable hypersensitivity. This is rarely given the weight it deserves before surgery.
• Asymmetry, rippling and malposition: some difference between the two sides is normal; a noticeable one may need revision. Rippling shows most in thin tissue.

The Number Worth Knowing: Further Surgery

In the manufacturers' own ten-year follow-up studies, somewhere between a fifth and a quarter of primary augmentation patients had further surgery within that decade - for contracture, rupture, size change, malposition, or a lift as tissue aged. That is the figure to plan around, and it matters more when you have travelled, because a revision usually means flying back. Establish before you book what happens clinically and financially if a complication needs treating, and what the clinic's revision policy actually covers. Wholecares does not underwrite any of that; the partner hospital's written quote and its complication cover define it.

BIA-ALCL and Other Implant-Associated Cancers

BIA-ALCL is a cancer, and the acronym hides that. Breast implant-associated anaplastic large cell lymphoma is a type of non-Hodgkin lymphoma - a cancer of the immune system rather than breast cancer - that develops in the scar capsule around an implant. It is rare. How rare is genuinely uncertain: published estimates range from roughly 1 in 300 to 1 in 30,000 depending on the implant surface and the registry, and quoting only the reassuring end of that range would be misleading. Almost all reported cases involve textured implants, and the most heavily textured devices were withdrawn from the market in 2019.

What matters practically is that it is usually treatable when caught early, and that it shows up late - typically years after surgery - as persistent swelling of one breast, or a lump. If one breast swells months or years after everything had settled, that needs investigating rather than waiting out. Regulators including the MHRA and the FDA require this to be part of the consent conversation, and have also reported squamous cell carcinoma and other lymphomas arising in implant capsules - rarer still, and under active surveillance.

Breast Implant Illness

Some people with implants report fatigue, joint and muscle pain, brain fog, rash and other systemic symptoms, a cluster commonly called breast implant illness. It is not a formally defined diagnosis and research has not established a causal mechanism, but regulators no longer treat it as nothing: the FDA requires it to appear in implant labelling and in the patient decision checklist, and some patients report improvement after explant. A provider who dismisses the question outright is not giving you the current regulatory position.

Implants and Breast Screening

Implants obscure some breast tissue on a mammogram. Extra displacement views are used to see around them, and screening remains possible and worth attending, but the picture is not identical to a breast without implants. If you are in or approaching the NHS Breast Screening Programme, tell the screening unit you have implants when you book so they can plan the views. Implants also change what a self-examination feels like, which is worth learning from your surgeon rather than working out alone.

For a fuller picture of what can go wrong in aesthetic surgery and how partner clinics manage it, see our guide to plastic surgery risks and complications.

Common Misconceptions About Breast Implants

• "Implants must be replaced every ten years." The old ten-year rule is not evidence-based. Implants are replaced based on a clinical indication such as rupture or contracture, not an arbitrary date.
• "Bigger implants always look better." Oversized implants strain the tissue, age poorly and carry more complications. An implant matched to your base width looks proportional and holds up better over time.
• "Implants make breastfeeding and screening impossible." Neither is impossible, but neither is unaffected either. Most people who want to breastfeed after augmentation can, though not everyone, and an incision around the areola puts the ducts and nerves at more risk than one in the breast crease - say so at consultation if future breastfeeding matters to you. Mammograms work with extra displacement views, but implants do obscure some tissue, so tell the screening unit you have them.
• "A silicone leak is an emergency." It is not an emergency - modern cohesive gel is form-stable and tends to stay within the capsule rather than spread - but nor is it something to leave. A ruptured implant should be removed and replaced, and because silicone rupture is usually silent, finding it depends on imaging rather than on how you feel.
• "Cup size is how you order implants." Cup size is inconsistent between brands. Surgeons plan in terms of base width, tissue thickness and profile instead.

What Does Recovery After Breast Augmentation Look Like?

• Day 1-3: Compression bra, rest, moderate discomfort (worse with submuscular). Prescribed pain management.
• Week 1: Return to light activities. No lifting >5 kg.
• Week 2-3: Most patients return to sedentary work.
• Week 4-6: Progressive return to exercise. Implants begin to "drop and fluff" (settle into natural position).
• Month 3-6: Final position achieved. Implants soften and look natural.

Wearing the compression bra as instructed and following the clinic's scar-care protocol has a direct effect on the final result; our recovery and aftercare guide covers the details that apply across procedures.

Breast augmentation is performed by board-certified plastic surgeons at partner hospitals, using CE-marked implants. A coordinated package typically brings together consultation, 3D sizing, surgery, hospital stay, compression garments, and 12-month follow-up, with what it covers set out in the written quote issued by the partner hospital.

Breast Enlargement and Implants in Turkey

Breast enlargement is the term used in the UK and much of Europe for the same operation described here as breast augmentation, and Turkey is one of the destinations patients most often consider for it. None of the clinical decisions above change with the destination - implant type, shape, placement plane and base-width sizing are still chosen from your measurements rather than from a price list, and the same premium implant brands are used. What travel changes is logistics and structure, which is why breast surgery in Istanbul is normally quoted all-inclusive - about €2,600-€4,300 across the Turkish market for an augmentation, and €3,000-€4,750 for a reduction or uplift - covering consultation, surgery at a partner hospital, hotel, transfers and follow-up. That is a market range rather than a Wholecares price - Wholecares coordinates surgery within that market and confirms your own figure only after your measurements and 3D sizing consultation, which is free. If you are comparing quotes across countries, compare on a like-for-like basis using the cost factors below.

What Influences the Cost of Breast Augmentation?

Pricing reflects several choices and cannot be reduced to a single number. Reviewing these factors helps you understand a quote and compare options fairly on a like-for-like basis.

• Implant type and manufacturer: Different implant materials and makers sit at different price points.
• Surgical complexity: Placement plane, whether a lift is combined with augmentation, and any revision work all affect operating time.
• Anesthesia and facility fees: licensed partner hospitals with full surgical teams carry their own costs.
• Imaging and planning: Consultations that include simulation and detailed measurement add value and cost.
• Aftercare included: Compression garments, follow-up visits and ongoing support all form part of the total.

Questions to Ask Your Surgeon

Bring these questions to your consultation so you can compare recommendations with confidence:

• Based on my measurements, what implant type, profile and size do you recommend, and why?
• Do you advise placement over or under the muscle for my tissue thickness?
• Which incision location suits my anatomy, and where will the scar sit?
• How will we monitor the implants over time, and what would prompt a revision?
• Which complications are most relevant to my case, and how are they handled?
• Can I preview my likely result with imaging before I commit?
• What does aftercare and follow-up involve once I return home?