Breast augmentation with implants: types of techniques, results and safety

Breast augmentation with implants is one of the most frequently performed aesthetic procedures in the world. It not only changes appearance but also has a strong effect on a woman's self-confidence and inner comfort. The procedure allows correction of the size, shape and symmetry of the breasts through the placement of silicone implants.

At Royal Plastic Clinic, established specialist Dr. Stefan Komitski performs this surgical intervention according to the highest medical and aesthetic standards.

In this article we look at the main types of implants, the techniques used to place them, the results you can expect, and how to ensure a safe and successful outcome.

Breast augmentation is a surgical intervention in which implants are placed in the breast area to achieve greater volume where there is a congenital lack of volume, or to restore it after childbirth, breastfeeding, or weight loss. The operation can also be combined with a breast lift (mastopexy) when there is loose skin and soft tissue. Overall, a more harmonious breast shape is achieved and any existing asymmetry is corrected.

By filling:

• Silicone implants — filled with cohesive gel that resembles natural breast tissue and holds its shape under pressure. The most popular choice for a natural feel.
• Saline implants — filled with saline solution, which is absorbed by the body in the event of rupture and breast deformation. Less commonly used in Europe.

By shape:

• Round implants — add volume mainly to the upper part of the breast. Suitable for patients who want a more pronounced, "lifted" effect.
• Anatomical (teardrop-shaped) — mimic the natural slope of the breast, with greater volume in the lower part. Preferred for patients with a less developed bust.
• Ergonomic (round in diameter, but with a dynamic gel) — these combine the advantages of the two types above while reducing their drawbacks: there is no risk of breast deformation if an anatomical implant rotates, they provide sufficient volume in the upper pole, and at the same time they can achieve maximally natural results. This type is currently the most widely used in practice.

By surface:

• Smooth — less sense of firmness, but a higher risk of movement. Rarely used, mainly in reconstructive cases, and placed submuscularly.
• Textured — more stable positioning and fixation within the pocket.
• Micro-textured — the surface used in modern implants. It makes them both stable in fixation and gentle on surrounding tissue, with a dramatically lower risk of developing what is known as capsular contracture.

At Royal Plastic Clinic, Dr. Komitski uses established implant brands with proven quality.

Pre-operative consultation

The first and most important step is the individual consultation. During the appointment, Dr. Komitski listens to the patient's wishes, performs an examination, and takes the necessary measurements. Together with the patient, the appropriate implant model, shape and volume are chosen. The need for an additional intervention — most often a lift (mastopexy) — is also discussed if there is sagging (ptosis).

You will also be scheduled for mandatory pre-operative tests: blood count, coagulation, ECG, and other specific consultations and tests depending on your individual case. Patients receive detailed instructions on diet, medication, and behaviour in the days before the intervention.

Choice of placement technique

There are several main approaches:

• Subglandular position — above the muscle, under the mammary gland;
• Submuscular (subpectoral) position — under the chest muscle, preferred for slim patients for a more natural result;
• Dual-plane — a combined technique offering an optimal balance between natural appearance and stability.

Incisions

The incision can be made:

• at the base of the breast;
• around the areola;
• in the armpit crease.

The procedure is performed under general anaesthesia and takes around 1.5 to 2 hours. Afterwards, the patient remains under observation at the clinic for post-operative infusion, antibiotic and pain-management therapy.

After the operation, a special compression bra is worn to keep the breasts stable and support proper healing. Pain is controllable with medication and subsides within a few days. Swelling and mild discomfort are normal during the first week.

Key recommendations after the operation:

• Avoid lifting heavy objects for at least 4 weeks;
• Wear a medical bra for a minimum of 4–6 weeks;
• Sleep mainly on your back with the upper body slightly elevated;
• Avoid overheating (saunas, hot baths, sunbeds);
• Attend follow-up check-ups with the surgeon.

Most women return to work after 7–10 days, depending on the physical demands of their job.

Results are visible almost immediately, but the final volume and shape settle after around 1–2 months, once the swelling has completely subsided. Implants typically hold their shape for many years. Modern implants do not need to be replaced periodically, but an annual check-up to monitor their condition is recommended.

📌 Important: With proper care and no complications, most implants can remain in place for over 10 years.

Although breast augmentation is a routine operation, it carries certain risks that must be clearly explained and managed by the surgeon.

Possible complications include:

• infection;
• capsular contracture (hardening around the implant);
• change in nipple sensitivity;
• slight implant displacement due to improper recovery.

Rare but serious:

• textured implants and the risk of BIA-ALCL (a rare type of lymphoma — explained in detail during the consultation).

Choosing certified implants and an experienced surgeon such as Dr. Komitski is the best prevention against such situations.

Ideal candidates:

• are in good general health;
• do not smoke, or have stopped smoking at least a month before the operation;
• have realistic expectations;
• are not pregnant or breastfeeding.

If you have any doubts, a consultation at Royal Plastic Clinic will help you make an informed decision.

The price of the operation depends on the choice of implants, the complexity of the case, and whether an additional intervention — most often a lift — is required. You'll find current prices here: procedure prices.

To book a consultation with Dr. Stefan Komitski, you can reach us at:

• email: info@royalplasticsurgery.eu
• phone: +359 888 533 824
• or through the online contact form

Breast augmentation with implants is a safe, well-studied and effective procedure that combines medical expertise with an artistic approach. At Royal Plastic Clinic, Dr. Stefan Komitski approaches every case with precision and individual attention, to deliver a result that is both aesthetic and safe.

If you are considering breast augmentation, trust a team with proven experience and a modern approach. Take the first step towards the change today.