Breast aesthetics are surgical operations that chosen by patients who are dissatisfied with the appearance of their breasts, providing a comfortable and rapid recovery process with high patient satisfaction after the operation. Breast aesthetics are also used for reconstructive surgical procedures such as breast reconstruction. For example, breast reconstruction surgery can be performed for women who have undergone partial or total removal of the breast due to breast cancer.

The main breast surgeries include:

BREAST AUGMENTATION

Also known as 'Augmentation Mammoplasty,' breast augmentation surgery aims to add volume to breasts that have not reached the ideal size due to aging, sudden weight loss, post-pregnancy shape distortion, or reduced size. This surgery can address mild sagging, but for significantly sagging breasts, simply placing implants may not lift them as desired. In such cases, breast augmentation surgery may need to be combined with a breast lift. Women seeking this surgery are expected to be physically healthy, not breastfeeding, not pregnant, and beyond the adolescent age. Candidates are those who feel their breasts are smaller than desired, or those who have lost volume in their breasts due to aging, weight loss, pregnancy, and breastfeeding, or those who perceive asymmetry in their breasts. 

The most commonly used form of breast implants consists of a medical silicone shell filled with medical silicone gel. Although implants filled with serum are produced, they are generally less preferred due to a less natural feel and the risk of serum leakage. Modern implants come with various features such as shapes and volume distributions (round/anatomic-drop shape), surface characteristics (smooth/textured), and the quality of silicone gel content (low, medium, or high profile, light, progressive gel).

Anatomical (teardrop-shaped) implants promise more volume in the lower part and a softer transition towards the upper part. Generally, the gel inside is more solid. There is a risk of the implant rotating within the pocket where it is placed. This situation can result in an unnatural appearance, and surgical intervention may be required to correct it.

Round implants can create more fullness in the upper part of the breast. This outcome can be finalized with a look that can be requested or avoided according to the patient's preference. Due to their structure, there is no possibility of shape distortion by rotating. Implants incorporating progressive gel technology are round in shape but promise an anatomical appearance over time as the gel shifts.

Smooth implants are the softest and provide a very natural feel. They can be inserted through very small incisions. The capsule formed around the implant is usually the tightest and thickest around smooth implants. In very thin patients, it may be visible from the outside and can cause folding.

Textured implants adhere more tightly to the surrounding tissue with the connective tissue they trigger, limiting their movement and rotation within the created pocket. Over time, textured implants may result in a less thick and less rigid capsule around the implant. There is a perception that there is a connection between the depth of the texture and a type of lymphoma associated with implants (BIA-ALCL: Breast Implant-Associated Anaplastic Large Cell Lymphoma). As a result, macro-textured implants have been withdrawn from the market.

Light implants promise up to 30% less weight compared to standard implants due to nano air spheres in the gel content. While breast augmentation surgery is mostly completed without issues, like any surgery, it carries general and specific risks that patients need to be aware of. Risks related to anesthesia, bleeding in the surgical area, seroma (fluid accumulation), infection, and the risk of visible scarring are applicable to this surgery as well.

Capsular contracture around the implant leading to pain and deformity, rupture of the implant casing causing the gel portion to mix into the capsule or tissues, persistent pain, changes in nipple sensation, visible implants through the skin, and changes in implant position are among the main complications specific to breast augmentation surgery.

Recently, a type of lymphoma associated with implants (BIA-ALCL: Breast Implant-Associated Anaplastic Large Cell Lymphoma) has been identified. Additionally, a range of symptoms, from skin rashes to joint pain and chronic fatigue, has been intermittently linked to implants. In light of all this information, patients should understand that the likelihood of carrying implants throughout a lifetime is not the same for every patient. Besides the risks mentioned above related to implants, shape distortions may develop due to factors such as illness, aging, weight changes, etc. Patients should comprehend that surgeries may be required to replace or remove one or both implants. It is crucial for patients not to neglect regular check-ups as recommended by their doctor and to be aware that, in necessary situations, imaging methods such as ultrasound or MRI may be utilized in addition to clinical evaluations. 

In aesthetic surgery, scars are created in areas that are hidden, such as on folds, in the shadows, or in less noticeable regions. Breast augmentation surgery is no exception. The most commonly preferred incisions for breast augmentation are made around the dark-colored areola surrounding the nipple and on the crease underneath the breast. Alternative methods include incisions in the armpit or navel. The placement of the incision is one of the crucial factors discussed in the preoperative consultation; the type of implant, desired enlargement amount, patient expectations, and the surgeon's experience determine the incision's location. 

According to surgical technique, implants are placed in pockets prepared either above the pectoral muscle and behind the breast gland (subglandular, prepectoral) or between the pectoral muscle and the ribs (subpectoral). The planned location of the implant pocket is also a significant topic in the preoperative consultation; the type of implant, desired enlargement amount, the patient's body and breast structure, skin quality, patient expectations, and the surgeon's experience are determinative in pocket placement. 

The duration of hospital stay after breast augmentation surgery usually does not exceed one night. In some cases, drains may be used to remove fluid and potential bleeding. Special dressings and postoperative bras are commonly used, and the duration of their use may vary depending on the technique and implant type. Depending on the surgeon's preference, short-term use of pain relievers and antibiotics may be recommended after the operation. Pain generally diminishes quickly, and the need for pain relief usually disappears on its own within a few days. Shower permission is usually granted 48-72 hours after surgery. The return to activities such as sports, massage, and heavy physical activity typically varies depending on the surgical technique and the surgeon's preference, but an average of three weeks is often required for a complete return to normalcy.