Breast augmentation aims to increase breast volume and size with the implantation of breast implants
It is one of the most requested cosmetic surgery procedures, thanks to the remarkable, very natural results achievable with the latest techniques and the high quality of modern implants.
Breast augmentation is in high demand among women with naturally small breasts and those who, after pregnancy or weight loss, have experienced a significant reduction in breast volume, leaving the breasts looking emptied and flattened.
Breast augmentation can also improve breast volume asymmetry by using tailored implants.
The result is very natural because the implant is placed deep, not within the mammary gland—specifically beneath all breast tissue. In practice, your natural breast tissue fully covers the implant. This positioning is key to achieving a natural feel: the implant sits deeply, hidden by the full thickness of glandular tissue.
Prof. Bracaglia, thanks to extensive experience and attention to detail, has refined breast augmentation techniques published in international scientific journals and shared with colleagues via the U.S. National Institutes of Health and National Center for Biotechnology Information.
How to choose the breast implant
The type of implant and its position are selected after carefully evaluating the breast’s volume and shape, and the target outcome.
The types of implants
Breast implants can be round, anatomical (teardrop), or ergonomic—the latter adapts dynamically with posture.
Profiles may be low to high (i.e., more or less projection from the chest), with a base that can be wide, medium, or narrow. Volume is chosen according to the desired increase. Modern implants feel very similar to natural breast tissue and blend in convincingly.
Biocompatibility and reliability
Implants are filled with ultra-pure, medical-grade silicone gel sealed within a silicone shell that is solid yet flexible and soft. A key feature of current implants is a consistency very similar to natural breast tissue.
Over the past 40 years, the FDA and numerous international institutes have conducted large studies to assess the biocompatibility of medical-grade silicone breast implants—with consistently favorable results.
Silicone breast implants are the most extensively monitored implants worldwide, having been placed in tens of millions of women in advanced healthcare systems.
Latest-generation shells often feature nano/micro-textured surfaces—tiny, velvety reliefs that enhance biocompatibility and acceptance. Thanks to these technologies, capsular contracture (the body’s normal scar capsule tightening) is seen more rarely. New implants also undergo rigorous quality controls to maximize reliability.
One of the most notable advances is ergonomic implants that adapt their shape with posture, giving a very natural look.
Choosing the implant volume
Volume depends on many parameters. Chest width and the existing breast volume are crucial: the final size equals your natural volume plus the implant volume.
Previewing your result
Sizer bra test
A practical way to preview your outcome is to wear a bra fitted with trial sizers of different volumes until you reach the look you prefer.
This test also conveys the actual weight of implants before surgery. For example, a 200 cc implant weighs ~200 g, helping you sense the added weight—another useful factor in decision-making.
CRISALIX virtual reality simulation
With CRISALIX, you can better understand what to expect using 3D/VR previews of different implant types and sizes.
These images help you approach surgery calmly and well-informed. You can preview the final look based on your chosen implant on a monitor or through VR headsets (e.g., Oculus).
Choosing the technique and the placement plane
The placement plane varies by patient and depends on:
Breast gland size | Body thinness | Chest shape | Selected implant volume
A thorough consultation with your plastic surgeon is essential to review all aspects and choose the most suitable plan together.
Retroglandular placement
In women with normal or higher body fat, implants are usually placed retroglandularly—above the pectoralis major. Here the subcutaneous tissues often provide adequate coverage to conceal the implant visually and to the touch.
Partial submuscular “Dual Plane” technique
In very thin women, the subcutaneous layer may be too thin to cover the implant well. Adding muscular coverage by placing the upper pole under the pectoralis major offers additional concealment.
Only the upper pole (the cleavage area) goes beneath the muscle, which is the part most in need of coverage. The remainder stays deep under the gland, similar to retroglandular placement.
The Dual Plane approach combines the benefits of submuscular and subglandular placement: it is widely used and recommended in thinner patients to improve implant coverage.
This yields very natural results, with a softer, less visible upper pole and additional coverage from skin, gland, and pectoralis muscle.
Partial submuscular “Triple Plane” technique
In thin women—or normal-weight women with very small glands—the Dual Plane may not fully mask the lower edge near the inframammary fold, where tissues are thinner.
The Triple Plane technique adds precious coverage to the lower pole at the inframammary fold.
Additional coverage is achieved using the connective/muscular fascial plane of the serratus in the lower chest. This layer is elevated centrally to cover the implant’s lower edge, further concealing it visually and to palpation.
How breast augmentation surgery works
Duration, anesthesia, and stay
Breast augmentation is performed under general anesthesia. It lasts about 1 hour and typically requires one overnight stay.
Scars
Scars are usually small and discreet. They may be placed along the lower areolar border, in the inframammary fold, or in the axilla—according to preference.
From an aesthetic standpoint, the least visible access is often the lower areolar border, right at the transition between darker and lighter skin. Periareolar incisions usually heal very inconspicuously, and any minor visibility can be camouflaged with medical tattooing.
Post-operative course
During week 1, avoid driving and wide arm movements; essential daily activities are allowed.
After week 1, you can resume driving and normal physical activity. After one month, you may return to sports such as tennis, gym, and swimming.
Wear a supportive bra continuously for the first 4 weeks. After one month, you can switch to a regular bra.
Over the years, perform regular self-exams and attend clinical follow-ups to monitor both breast tissue and implants.
Possible complications
Complications are uncommon and manageable. They can occur early or later and include:
- Hematoma
- Infection (very rare)
- Implant displacement
- Implant hardening (capsular contracture, rare)
- Implant rupture after trauma (very rare)
FAQ
Do you want to know more about breast augmentation?
Read here first.
Yes. Volume can be increased with autologous fat transfer (lipofilling). The technique, pioneered by S. Coleman, has been used for many years to enhance overall breast volume or selectively (e.g., medial fullness or upper-pole augmentation).
Autologous fat can also improve asymmetries in size or shape.
Fat is harvested from an area of abundance using minimally invasive, micro-cannula liposuction, then purified and micro-grafted into the breast. The procedure is performed under sedation as a Day Hospital case.
Autologous fat augmentation is increasingly used, including in patients with prior breast surgery.
For thin patients with small or regressed breasts (after pregnancy or weight-loss), where extra lower-pole coverage improves contour and reduces implant palpability and animation deformities.
Modern implants are very durable and have no fixed “expiry date”, but should be monitored over time (e.g., ultrasound). Gradual wear can occur with years of chest/arm movement.
Replacement is typically simpler than primary surgery because the anatomical planes were created during the first operation. It is often performed as a Day Hospital procedure.
Yes. Round implants add more upper-pole volume; anatomical (teardrop) implants create a very natural slope. Ergonomic implants adapt with posture and are among the most natural-looking options.
A feeling of fullness/tightness is common for a few days. Pain is typically absent or mild and short-lived.
Yes. Wear a supportive bra day and night for the first month. After that, you can return to normal bras and routines.
Absolutely. Just inform the radiologist you have implants so they can tailor the exam appropriately.
No. Modern implants are fully sealed and contain no valves that could fail or leak during flights.
Medical-grade silicone has a high degree of purity and is more cohesive than older generations of implants.
No. Breastfeeding remains possible because the mammary gland’s ability to produce milk is not affected—the implant sits deep, behind the gland.
Before surgery, you and your surgeon can preview sizes with the CRISALIX VR system and by trying a special bra with different sizers. These methods provide a reliable idea of the final result and how your silhouette will change.
After breast development is complete and stable—generally from age 18.
No. Implants do not alter your genetic or familial predisposition to breast cancer.
Yes. Continuous advances have led to more natural shapes and feel, alongside high biocompatibility and reliability.
