Breast augmentation is a surgical procedure that increases breast size and improves breast shape using either silicone implants, saline implants, or fat transfer from the patient’s own body. It is one of the most commonly performed cosmetic procedures globally and is done under general anesthesia in one to two hours. The decisions made at consultation, including implant type, size, placement, and incision location, shape the result as much as the surgery itself.

According to Dr. Monisha Kapoor, a trusted plastic surgeon in Delhi, “Breast augmentation is not one standard procedure. The implant type, the placement plane, the incision site, and the size all have to be matched to the patient’s existing anatomy and what they are actually trying to achieve. Getting that combination right at consultation is what produces a natural result rather than an obviously operated one.”

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How Is Breast Augmentation Actually Performed?

The procedure involves several decisions that are made at consultation rather than in the operating room, and each one affects the outcome.

Implant Type
Silicone gel implants are the most commonly chosen option because they feel closest to natural breast tissue. Saline implants are filled after placement, allowing a smaller incision, but feel firmer. Structured saline implants offer a middle ground. Each has different profiles, projection options, and long-term considerations that are discussed based on the patient’s starting anatomy.

Implant Placement
Implants can be placed under the breast tissue directly over the pectoral muscle, or behind the muscle in the sub-muscular plane. Sub-muscular placement tends to look more natural in patients with less existing breast tissue, reduces the risk of visible implant rippling, and is generally preferred for thinner patients. Over-muscle placement suits patients with adequate existing tissue who want a quicker recovery.

Incision Location
The three main incision options are under the breast fold, around the lower edge of the areola, and through the armpit. The breast fold incision is the most commonly used and gives the surgeon the best access and visibility. Areolar incisions are hidden at the colour change but carry a slightly higher risk of affecting nipple sensation and milk ducts. Armpit incisions leave no scar on the breast at all but limit the surgeon’s precision during placement.

The Procedure Itself
Under general anesthesia, the chosen incision is made, a pocket is created in the selected plane, the implant is inserted and positioned, and the incision is closed. The whole procedure runs one to two hours depending on complexity. A compression garment is fitted before the patient leaves and worn for several weeks during recovery.

Full detail on implant options and the procedure approach is on the breast surgery service page.

Who Is a Good Candidate and What Should Patients Know?

Candidacy for breast augmentation is broader than most patients assume, but a few things make a meaningful difference to outcomes.

Good Existing Skin Elasticity
Patients with reasonable skin tone and elasticity get the most natural-looking results. Very thin patients with minimal breast tissue may need sub-muscular placement specifically to achieve a result that does not show implant edges.

Stable Weight
Significant weight changes after augmentation affect how the result looks. Patients should be at or near their stable weight before surgery rather than planning augmentation at a temporary low point.

Finished Having Children
Pregnancy and breastfeeding after augmentation can change the breast shape significantly. Women who plan to have children are not excluded from the procedure, but it is worth having the conversation about timing at consultation.

Realistic Expectations
Breast augmentation changes size and improves shape, but it does not lift significantly sagging breasts. Patients with significant ptosis typically need a breast lift combined with augmentation rather than implants alone. Going into the consultation with reference images and a clear idea of the goal size and shape helps the surgeon plan the right approach.

Patients wanting to understand how breast augmentation compares to other breast procedures can read through the breast reduction blog, which covers what reduction involves and when it is the appropriate choice.

Why Choose Dr. Monisha Kapoor?

Dr. Monisha Kapoor is India’s first woman aesthetic plastic surgeon admitted to the American Society of Aesthetic Plastic Surgery and holds active membership with ISAPS, with 25+ years of practice and over 10,000 procedures. Breast augmentation at her Saket clinic is planned around the patient’s existing anatomy, frame, and goal rather than a standard implant protocol, which is what produces results that look proportionate and natural rather than obviously augmented.

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FAQs

How long does breast augmentation surgery take?
The procedure runs one to two hours under general anesthesia as a day procedure in most cases.

How long is recovery after breast augmentation?
Most patients return to desk work within five to seven days. Strenuous activity and heavy lifting are restricted for four to six weeks.

How long do breast implants last?
Modern implants are not lifetime devices. Most last 10 to 20 years before replacement or removal is considered, though many patients go longer without issues.

Does breast augmentation affect breastfeeding?
Most women with implants can breastfeed, though incision location and placement plane affect the degree of impact. Sub-muscular placement and non-areolar incisions preserve the best breastfeeding potential.

References

1. National Library of Medicine — Breast Augmentation: Techniques, Outcomes and Complications: https://pubmed.ncbi.nlm.nih.gov/28481798/
2. National Library of Medicine — Silicone Implant Safety and Long-Term Patient Outcomes: https://pubmed.ncbi.nlm.nih.gov/26371717/