In short. The decisions behind breast augmentation — implant plane, size, incision, and follow-up — framed as honest trade-offs rather than a sales menu.
Key points
- Implants are placed either behind the breast tissue (subglandular) or behind the chest muscle (submuscular/dual-plane).
- Thin soft-tissue cover argues for the muscle plane, which hides implant edges and lowers visible rippling at the cost of more early discomfort and movement distortion with muscle contraction.
- Size is bounded by the chest width and skin envelope — an implant wider than the breast footprint guarantees visible edges and long-term problems, whatever the requested cup size.
Breast augmentation is one of the most satisfying operations in aesthetic surgery when the decisions behind it are made carefully — and one of the most revised when they are not. In Dr. Mao’s practice the consultation is structured as a series of trade-offs, each explained before any date is booked. This article walks through that framework.
Decision one: is surgery the right answer at all
The first question is not which implant but whether the goal is achievable and stable. Good candidates are adults in good health with fully developed breasts, realistic size goals, and no untreated breast disease. Surgery is deferred around pregnancy and breastfeeding plans where practical, because these change breast shape and volume substantially. A wish to fix a relationship or a life situation with implants is a reason to pause, not to operate.
Decision two: pocket, size, and incision
Tissue decides; preference negotiates
Implants are placed either behind the breast tissue (subglandular) or behind the chest muscle (submuscular/dual-plane). Thin soft-tissue cover argues for the muscle plane, which hides implant edges and lowers visible rippling at the cost of more early discomfort and movement distortion with muscle contraction. Size is bounded by the chest width and skin envelope — an implant wider than the breast footprint guarantees visible edges and long-term problems, whatever the requested cup size. Incisions hide in the inframammary fold (the most versatile), around the areola, or in the armpit; each trades scar location against surgical control. None of these choices is universal, which is precisely the point of a consultation.
The operation and recovery
Augmentation is performed under general anesthesia in hospital and typically takes one to two hours. Most patients return to desk work in one to two weeks and resume full exercise around six weeks. The breasts sit high and feel firm initially, settling into position over three to six months; scars in the fold mature over a year and, like all scars, are permanent although they usually fade well.
What augmentation can and cannot do
It increases volume and can improve upper-pole fullness and modest asymmetry. It does not lift a genuinely drooping breast (that is a different operation, sometimes combined), cannot guarantee identical symmetry, and does not produce a lifetime device. Implants are not lifetime implants: a proportion of patients will need or choose a further operation over the years for replacement, repositioning, or capsular contracture.
Risks worth knowing
Recognized risks include bleeding and hematoma, infection, capsular contracture (tightening of the scar envelope that can distort shape and require revision), implant rupture or deflation, rippling, changes in nipple sensation, interference with mammography that requires adapted imaging technique, and rare associations reported with certain textured devices. These are discussed in consultation with current evidence, not glossed over — an informed yes is the only yes worth having.
Arrange a prompt review if
- One breast swells rapidly or becomes markedly painful in the first weeks — hematoma or infection must be excluded.
- A breast gradually hardens, rises, or changes shape months or years later — this suggests capsular contracture.
- You notice a new lump, skin change, or discharge at any time — implants do not prevent breast disease, and routine screening still applies.
Frequently asked questions
How is the implant plane decided?
By the tissue. Implants are placed either behind the breast tissue or behind the chest muscle, and thin soft-tissue cover argues for the muscle plane, which hides implant edges and lowers visible rippling at the cost of more early discomfort and movement distortion with muscle contraction.
Does breast augmentation lift a drooping breast?
No. It increases volume and can improve upper-pole fullness and modest asymmetry, but it does not lift a genuinely drooping breast, which is a different operation that is sometimes combined with augmentation. It also cannot guarantee identical symmetry between the two sides.
Do breast implants last a lifetime?
No. Implants are not lifetime devices, and a proportion of patients will need or choose a further operation over the years for replacement, repositioning, or capsular contracture. Recognized risks also include bleeding, infection, rupture or deflation, rippling, and changes in nipple sensation.
Risks & Limitations
- Bruising and swelling lasting weeks; after bone surgery, months pass before the final result is visible.
- Scars are permanent. They mature and fade over 6–12 months but never disappear.
- Numbness or altered sensation, which may be temporary or, after bone or nerve work, lasting.
- Asymmetry, under-correction or over-correction; final assessment is made at 6–12 months.
- Infection, bleeding or haematoma, which may need drainage or antibiotics.
- Breathing changes after nasal surgery, which may be temporary or require further treatment.
- Revision surgery carries higher risk and is less predictable than a first operation.
When to Seek Care
- Difficulty breathing or shortness of breath — seek emergency care immediately.
- Rapidly expanding swelling, or a tense, painful, tight area.
- Fever above 38 °C, spreading redness, warmth or pus.
- Bleeding that does not stop with gentle pressure.
- Any sudden change in vision after facial surgery or a facial injection.
References & Further Reading
- American Society of Plastic Surgeons (ASPS) — procedure and safety guidance
- International Society of Aesthetic Plastic Surgery (ISAPS)
- National Institute for Health and Care Excellence (NICE, UK) — relevant guidance
- Cochrane Library — systematic reviews in facial plastic surgery
This page is patient education, not medical advice, and it does not cite individual studies. Discuss your own case with a qualified clinician. To arrange an assessment at Chongqing West District Hospital, see Contact & Consultation.