BREAST AUGMENTATION
Breasts are one of the most defining features of a woman’s body, as they express her femininity and sensuality. This is why breast augmentation is the procedure that most profoundly enhances my patients’ overall well-being long before it affects their physical appearance. This procedure allows you to increase the size and fullness of your breasts using next-generation implants, as well as correct their shape and improve their overall appearance.
Breast augmentation is recommended when you feel that your breast size is not in harmony with the rest of your body, and you wish to feel more confident in different types of clothing and swimwear. My approach combines a refined aesthetic sense, always guided by the pursuit of elegance and natural beauty, with advanced surgical expertise focused on carefully analyzing your proportions and anatomical features.
“In this regard, I would like to introduce you to a key concept that underpins my approach to breast surgery: the so-called FOOTPRINT.”
I use this term to describe the level at which your breast sits on the chest wall. Some women have a high footprint (high breast position) and a relatively short distance between the collarbone and the upper edge of the breast. Others have a footprint that begins much lower on the chest wall (low breast position) with a greater distance between the collarbone and the top of the breast. The breast footprint cannot be changed, not even through surgery; however, we can refine the shape of the breast within its natural position. Placing a breast implant can slightly lift the upper edge, making a low breast appear somewhat higher, especially when adjusting the implant projection. Some patients say they would like larger implants because they believe bigger implants sit higher on the chest. Unfortunately, the opposite is true. Larger implants tend to settle lower and are more affected by gravity over time.
UNDERSTANDING THE PROCEDURE
Most patients are primarily concerned with improving the size of their breasts, but during consultations. I evaluate many other factors beyond size. These include breast shape, chest contour, skin quality, nipple and areola position, the height of the inframammary fold, and the amount of natural tissue available to cover an implant. I always consider your body and breasts as a whole to avoid results that look exaggerated or unnatural.
It is important to understand that there is no single correct way to perform breast augmentation.
During your consultation, we will review the different types of implants, along with the benefits and characteristics of each option. We all have unique physical features and tend to perceive ourselves subjectively. What you see in the mirror can differ significantly from what appears in photographs, so an objective assessment by an experienced surgeon is essential in determining the shape and size that will best enhance your body. It is also common for some patients to present with sagging of the breasts, known as breast ptosis, along with dissatisfaction with their breast size. Although some breast implants are designed to create a subtle visual lift, depending on the technique used, they alone cannot truly correct skin laxity. In such cases, I recommend combining the procedure with a breast lift, known as a mastopexy, to achieve more stable and desirable results.
Looking at the surgical techniques in more detail, implants can generally be placed behind your breast tissue in a subglandular position, behind the chest muscle in a submuscular position, or using the dual-plane technique. The latter is an evolution of the submuscular technique, in which the implant is partially positioned under the pectoral muscle, covering the upper and central portions of the implant while leaving the lower portion free in a subglandular position. Where tissue thickness allows, I prefer the subglandular approach, which typically results in less postoperative pain, a lower risk of unnatural implant movement with muscle contraction, and helps prevent the so-called “double bubble” deformity. For very thin patients, I usually opt for the dual-plane technique, which provides greater coverage in the upper pole for a more natural result, reduces long-term visibility and palpability of the implants, and, in some cases, gently lifts mildly sagging breasts.
I most often place the incision in the inframammary fold, which consistently provides excellent results. This approach allows greater flexibility in creating the breast pocket while preserving your gland’s potential for breastfeeding and avoiding interference with the nipple. The inframammary incision is also practical and strategic, especially given the likelihood of future revision or implant replacement procedures. Other options include the periareolar or transaxillary approaches, which I use less frequently due to higher risks and potential drawbacks.
Every patient has unique features and expectations, which is why there is a wide variety of breast implants available in different styles, shapes, sizes, textures, volumes, heights, and projections. Carefully selecting the right combination of these characteristics ensures a natural, personalized, and harmonious result for each procedure. In my practice, I use all types of breast implants, both silicone and polyurethane, ranging from anatomical implants, which provide greater fullness in the lower pole, to round or ergonomic implants, which also enhance the upper pole while naturally following the breast’s movement. Modern cohesive silicone gel implants are encased in a solid silicone shell. They are extremely safe, and in the rare event of traumatic rupture, the gel does not leak outside the shell. Implant shells may be smooth, textured, with a rough surface that prevents rotation by adhering more firmly to surrounding tissue, or nano-textured, with a softer shell that also reduces how easily the implant can be felt through the skin. In recent years, polyurethane implants have been introduced. Their even rougher surface significantly lowers the risk of capsular contracture, an unwanted reaction in which the tissue capsule surrounding the implant becomes excessively hard. These implants adhere more securely to surrounding tissues, which can make them appear more fixed if not used appropriately with the correct surgical technique. It is also worth mentioning hybrid or composite breast augmentation, which uses both implants and fat harvested from the patient’s own body to achieve the desired breast size and shape. This approach optimizes volume and symmetry while producing an even more natural, personalized result.
“The choice of surgical technique and specific implant is always determined based on each patient’s unique anatomy and personal goals.”
FOR A MORE CONSCIOUS CHOICE
Good candidates for breast augmentation are healthy, non-smoking patients who wish to increase the size and fullness of their breasts. As with any surgical procedure, being in good health is essential for proper healing and to minimize potential risks and complications. If you are allergic to any medication, have a health condition affecting blood circulation, or have a history of breast cancer surgery, it is important to discuss this with me to ensure your safety. If you are interested in enhancing breast volume but are already satisfied with the overall size, you may find greater benefit from a breast lift, which reshapes and firms your existing breast tissue. It is important to remember that breast augmentation primarily addresses breast size and shape rather than their position on the chest. The procedure enhances fullness in the upper pole and breast tissue but will not lift loose or excess skin. If you wish to increase volume while also lifting breasts that show signs of sagging, you may require a breast lift with implants. Regardless of your starting point, my goal is to achieve a beautiful and visually pleasing result that suits your body, lifestyle, and personal preferences. Many of my patients are active and prefer to avoid an overly artificial appearance. During the consultation, I will walk you through the available options and provide a realistic understanding of the results we can achieve, helping you choose the implant that is best for you. We will start with a clear discussion of your goals, including what you like most and least about your breast size. This will be followed by a comprehensive consultation, including photographic analysis and body measurements, to help us fully understand your anatomy. In both my clinical and surgical practice, I use state-of-the-art technology to tailor the procedure precisely to you. Achieving the best results for each patient means carefully balancing the natural qualities of the skin and breast tissue while selecting the optimal implant type and shape. Every patient is unique, and there is no one-size-fits-all solution.
You may be a good candidate for breast augmentation if you want to feel more confident in your appearance, both with and without clothing. Perhaps you have noticed that, no matter what bra you wear, the upper part of your breasts lacks fullness. Maybe you struggle to find clothing or swimwear that flatters your décolletage, or you feel that your breasts are not in proportion with the rest of your body. These concerns can leave you feeling self-conscious or uneasy in fitted outfits, swimwear, or during intimacy. If this sounds familiar, it may be the right time to meet and explore together the best approach for your physical and emotional transformation. With professionalism and empathy, I always strive to put myself in your shoes to determine whether breast augmentation is the right choice for you and to help you regain confidence and the indescribable sense of well-being that comes from feeling comfortable in your body. I believe that open communication is essential for understanding what matters most to you and for setting healthy, realistic expectations for the procedure’s results. Nipple sensitivity is generally well preserved, particularly when the surgery is performed through the inframammary fold. In some cases, temporary hypersensitivity may occur, but it typically resolves on its own without any intervention. Studies have also shown that breast augmentation alone does not affect the ability to breastfeed. Placing an implant through the inframammary fold preserves the milk ducts leading to the nipple. However, over the course of their lives, women may experience changes in breast size and shape due to pregnancy and breastfeeding. These changes can potentially alter the results of the procedure, sometimes making a revision necessary. In contrast, a breast lift, with or without implants, may reduce your potential for breastfeeding.
For the best results, it is important to be in good physical and mental health. In some cases, it may be wise to postpone breast augmentation until the timing is right. For instance, if you are currently losing weight or have not yet had children, you might choose to wait until these life stages are complete to avoid changes in your newly enhanced breasts due to weight fluctuations or pregnancy. Your personal commitments and lifestyle are also important factors to consider. Although recovery from this procedure is generally straightforward, it is essential to allow yourself enough time to heal completely. I usually tell my patients it takes about two weeks to resume most normal activities, while avoiding heavy lifting or upper-body strain. Returning to sports, more intense workouts, or gradually lifting heavier weights typically takes four to six weeks. If you cannot allow enough time for a full post-operative recovery, I recommend postponing the procedure to minimize the risk of complications and ensure a faster, smoother healing process.
The final results will not be visible immediately. In the first few days after surgery, it is common to experience swelling and occasional bruising, along with a tight sensation in the breasts, which can be easily managed with pain relief medication. At this stage, the implants have not yet settled, and the breasts are not fully rounded. You will need to wear a supportive compression bra continuously for 6-8 weeks following the procedure. After 6 weeks, the initial sutures begin to dissolve, and the implants start to settle. Between 3-6 months after surgery, as the swelling subsides, the final shape of the breasts becomes visible and well-defined. After around 2 years, once the scar tissue has softened, the breasts reach their definitive form. Depending on individual needs, I often recommend a course of lymphatic drainage massages to reduce any residual fluid, soften the tissues, and help prevent capsular contracture. Additionally, as with other surgical procedures, I highly recommend physiotherapy or osteopathic rehabilitation. This helps restore postural balance, relieve back or neck pain caused by prolonged limited mobility, and address connective tissue tension from scarring. It also helps prevent hypertrophy and adhesions, supporting the proper restoration of tissue elasticity and function. Finally, it is important to note that the presence of implants does not interfere with breast screening. Routine mammograms and ultrasounds can be performed safely without any risk or complications.
The long-awaited day has finally arrived! To help you feel calm and confident throughout the experience, here is what to expect step by step:
• Arrival at the clinic – Our nursing staff will welcome you, guide you through check-in, and provide you with a surgical gown.
• Confirmation of details – All your personal and medical information will be carefully reviewed to ensure your safety and peace of mind.
• Meeting with the surgeon – Before the procedure, you will meet with the doctor again to review the details of the surgery, confirm the implant size, and mark the surgical lines on your body.
• Consent and safety – You will sign the consent forms, and through multiple identity and procedure checks, you can be confident that you are in safe hands.
• The procedure – You will then enter the operating room, where the team will provide the highest level of professional care.
• After the procedure – Once the surgery is complete, the surgeon will update your family or support person, reassuring them about the outcome.
• Short stay – In some cases, after evaluation by the doctor, you may not need to stay in the clinic overnight. Once you feel ready, you can go home the same day. Before leaving the clinic, you will receive your medications along with detailed post-operative instructions, including a soft post-surgical bra (similar to a sports bra) to support your breasts during the initial healing period.
• Overnight stay – You will leave the clinic after spending one night in care. Before leaving the clinic, you will receive your medications along with detailed post-operative instructions, including a soft post-surgical bra (similar to a sports bra) to support your breasts during the initial healing period.
Breast augmentation is a relatively short procedure, usually lasting 60-90 minutes. Added to this are the initial anesthesia phase and the final recovery and monitoring period, all designed to ensure your safety and comfort. In other words, your total time in the operating room will be slightly longer, but throughout the entire process, a highly skilled team will be by your side, caring for you every step of the way.
At Elisà Plastic Surgery, your comfort and peace of mind are our top priorities. One of our main goals is to provide an almost entirely pain-free experience from start to finish, which is why we place great importance on anesthesia. Our team of anesthesiologists uses state-of-the-art techniques, including targeted local blocks, to ensure maximum comfort, reduce post-operative pain, and minimize the risks associated with general anesthesia. The main sensation you may notice is a mild pressure in the chest area, caused by the increased volume, especially when lying down. At the end of the procedure, a long-acting local anesthetic will be administered directly to the surgical area to provide lasting comfort during awakening. You will also be fitted with a soft, supportive bra, designed to relieve pressure and help you maintain a comfortable posture from the start. In the days following surgery, you may experience mild discomfort or tenderness in the treated area, especially with movement. This is completely normal and can be easily managed with topical therapies and pain medication.
Gentle daily activities: can be resumed within the first few days, paying attention to how your body feels.
Driving: recommended only after at least 2-3 weeks, once you are pain-free and able to move safely.
Sports and more intense activities: wait 4 weeks before resuming exercise, avoiding sudden movements or heavy lifting.
Supportive bra: essential for 4-6 weeks, to support your breasts and promote proper healing.
A gradual, targeted approach is key to returning to your routine safely, comfortably, and smoothly.
After the procedure, a regenerative dressing will be applied to support tissue recovery. During the first few days, it is important to avoid strenuous activity, excessive sweating, and sudden movements of the chest and arms. You should also avoid lifting heavy objects for about 1 month. Scars can be treated with specialized products containing silicone or exosomes, following the protocol prescribed by Dr. Elisa Bolletta, once the wounds are dry, fully healed, and well-closed. The compression garment should be worn for 4-6 weeks. Showering or bathing is allowed only after the sutures have been removed, typically 15-20 days post-surgery. Keep in mind that the results evolve over time. Initially, the breasts may appear fuller and more lifted, gradually softening and taking on a natural shape over approximately 4 months.
All surgical procedures carry some risks, even when performed with the highest standards of care and safety. In breast augmentation, the most common complications include minor bleeding, infection, temporary changes in sensation, or asymmetry. Over time, a capsular contracture may develop, which is a hardening of the scar tissue around the implant, or very rarely, implant rupture, although modern implants come with a lifetime guarantee. In some situations, a follow-up procedure may be needed to replace or remove the implant. Scars, in rare cases, can also be more noticeable than anticipated. Some patients report general, non-specific symptoms, such as fatigue, muscle aches, or difficulty concentrating, that are currently being studied internationally under the term “Breast Implant Illness (BII)” and may be linked to the presence of an implant. While BII is not currently recognized as a formal medical diagnosis, it describes a range of symptoms reported by some patients that are still under scientific investigation. These cases are rare but important to understand. My goal is to guide you with transparency and responsibility, ensuring that your decision is fully informed and that the benefits of the procedure outweigh any potential risks.
Breast augmentation is not just a technical procedure; it is a personal choice that requires careful listening, precision, and balance. The foundation of a successful result begins during the consultation, where we assess your shape, proportions, and style together to ensure the implant integrates seamlessly with your body. The surgery is generally quick, with a short recovery period, while the results continue to evolve over several months until they reach their final, natural appearance. Personalization is key. Every breast is unique, and my goal is to guide you toward a result that reflects your femininity with harmony and authenticity.
The care process does not end in the operating room. Post-operative check-ups are essential for supporting you closely as you progress toward the end result. The first visit occurs a few days after surgery to assess wound healing and remove the initial dressings. Follow-up appointments at 1-2 weeks allow us to monitor your recovery and guide you through the daily care routine. Around the first month, we review your progress together as the breast shape softens, swelling decreases, and the results start to take form. Follow-up appointments are scheduled at 6 weeks, then at 3 and 6 months, to ensure everything is progressing smoothly. The final visit, 1 year after surgery, allows us to assess the fully matured scar and the settled results, showing their natural, final appearance. Your care will continue beyond this stage, with ongoing support to ensure balanced, long-lasting, and dependable results. Each check-up is designed not only for your safety but also for your peace of mind, providing consistent, personalized, and thoughtful support that is part of the Elisà Plastic Surgery experience.
Your procedure is performed by Dr. Elisa Bolletta, supported by a team of specialized assistants, anesthesiologists, and nurses. Each team member works in perfect harmony to ensure your safety, comfort, and a natural, refined result.
