Breast Enlargement

Breast enlargement surgery is one of the most common procedures in the field of plastic surgery The surgery was first performed at the beginning of the last century. In the initial years in which the breast enlargement was performed, implants of various types were used, including ivory and paraffin, but all of these were eventually rejected by the body. Only by the 1960s were silicone implants first used; and since then, until the present time, it is the most common material used in breast enlargement. Medical research conducted over the years has proven that the silicone implants are safe and pose no health risk.
The course of the actual surgical procedure has undergone many changes related to the nature and shape of the implant structure and in terms of our understanding of how and where it is best to place the implants in the breast. At the same time, the vast medical experience amassed from these surgeries has enabled us to perform this procedure with a very high degree of safety, which has made the surgery very popular.

What the implant is made of?

The implant is comprised of salt water or silicone. Use of the silicone implants is more common. These implants are wrapped in an outer shell made of silicone and contain silicone gel. The gel we currently use is more viscous than in the past, so that if there is a tear in the implant’s outer shell, the silicone gel does not leak into other areas but remains in place.

The size and selection of the implants

The implant can have an anatomic or circular shape. When we reach the stage of selecting the implants, there is a discussion that takes into account both the plastic surgeon’s recommendation and the patient’s wishes, based on the implant’s anatomical fit in relation to the body structure. The degree of compatibility of the implants to the body is related to the patient’s physical characteristics, such as height, weight and diameter of the chest. A short woman with a narrow chest will not enjoy having large implants. It is important to know that large implants will lead to premature sagging (ptosis) due to their weight.

Who is suitable for breast enlargement surgery and what is the desired age?

Breast enlargement surgery is suitable for women whose breasts have stopped growing and whose breasts are small as a result of a lack of full development of the breast or whose breasts are not symmetrical, or women whose breasts have begun to sag primarily due to pregnancies and breast feeding, or simply women who would like a to have bigger breasts.

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Who is not suitable for breast enlargement surgery?

Those who have unrealistic expectations or who have significant risk factors such as heavy smokers are not suitable for the surgery. Patients who have undergone radiation in the chest area are not suitable for breast enlargement above the muscle. Patients with sagging breasts (ptosis) are not suitable for breast enlargement, they will have to first undergo a breast lift, together with the enlargement.

Prevalence of the Surgery

Breast enlargement surgery is one of the most common procedures in the field of plastic surgery. In the U.S. alone, 2 million breast enlargements were performed between 1963 and 1988. Since that time the numbers are constantly on the rise.

Doctor, how long will the surgery last?

The surgery should serve as a solution for many years. Although the implant manufacturers offer a lifetime warranty, you will probably have to replace the implants every 10 to 15 years.

Preparations before the breast enlargement surgery

Routine blood tests are required. In women over the age of 35, mammography is recommended (primarily among women who have not had any breast exam up to that point). If there are any cysts in the breast, they must be assessed using imaging before the surgery is performed. It is recommended that you stop smoking and stop taking anticoagulants.

The Method

The surgery is performed under general anesthesia and lasts about one hour. There are a number of methods of inserting the implants, through the fold under the breast, through the areola and through the armpit. Another method is to go in through the navel, which is only suitable for salt water implants. During the surgery, an incision is made, through which a pocket is created, above or below the muscle. After the pocket is created, we will use a sample implant to determine the right size implant for the breast. After the right size is determined, the permanent implant is inserted into the pocket. The pocket is sewn and the breast is bandaged with a pressure bandage or a sports bra, which you will have to wear for a month following the surgery.

Above or below the muscle?

There are differences of opinion as to the position of the implant. It is customary to say that half of the surgeons prefer placing the implant above the muscle and the other half below the implant. The table below presents the advantages and disadvantages of the different implant positions.

Subject of the discussion

Incidence of capsular contracture

Folds and wrinkles resulting from the implant

Mammography and other imaging methods

Appearance of the implant

Damage to the muscle

For sagging breasts

Pain following surgery

Above the muscle


More visible

Less accurate (however, better precision can be achieved with MRI)

The outline of the implant is more visible in a small breast

Doesn’t exist in this position

This is the right position


Below the muscle

Less (the implant is covered by the muscle and so the stiffening is felt less)

Less visible

More accurate

The implant is less visible in a small breast



Hospitalization Days

The patient can generally go home the same day, a few hours after the surgery.

Doctor, how long will it take to recover and when will I see the final result?

Recovery lasts about one week to 10 days and you must wear a sports bra for about one month.

Does the surgery hurt?

Generally, there is a feeling of pressure in the chest that lasts for a few days following the surgery. As the edema dissipates, the pressure is reduced.
Side Effects and Complications

As in any surgery, there is the possibility of complications or side effects. However, in breast enlargement surgery, these complications are more prevalent. Among the complications:

1. Bleeding – takes place in one percent of all patients. If necessary, the blood is drained.

2. Infection – This complication is rare (happens in one in every 1,000 patients). If the implant or the area of the surgery becomes infected, the implant will have to be replaced. An infection may lead to the rejection of the implant by the body.

3. A leak or tear in the implant.

4. Capsular Contracture – the capsule is the connective tissue that contains the implant and separates it from the breast. Capsular contracture may lead to the crushing of the implant and induration of the breast. This phenomenon is reported in the literature at a prevalence of 5% of all cases.

5. Implant folds – In patients with thin skin, the implant folds are sometimes visible.

Will a breast enlargement surgery lift the breasts?

Since we add weight in a breast enlargement surgery, we cannot lift a sagging breast, on the contrary, there may be significant sagging as a result of the additional weight.

Does breast enlargement change the shape of the breast?

Breast enlargement surgery only enlarges the breast, i.e. the breast will look the same in terms of its shape prior to the surgery, just bigger. For example, the surgery will not cause an areola/nipple that is positioned on the side of the breast to move toward the middle.

Is there a connection between silicone and breast cancer or other connective tissue diseases?

The answer is no. In light of the many studies published on this subject, silicone does not constitute a risk for breast cancer or other connective tissue diseases. In 1999, the American Medical Academy determined “since more than 1.5 million adult women of various ages are carrying silicone implants in their breasts, some of these women are expected to develop cancer, connective tissue diseases, neurological diseases, or other systemic complaint or conditions. Evidence suggests that such diseases are no more common in women with breast implants than in women without them.”


Despite the long list of possible complications related to breast enlargement surgery, this surgery is one of the safest and most common surgeries. The surgery will lead to better balance and proportion between the size and structure of the patient’s breasts and the rest of her body.