Breast implants: choosing the volume, the shape and the technique
Choosing breast implants is not choosing a cup size. Volume, shape, position and the surgical approach are four separate decisions, and they are made at the consultation from measurements of your own body.
Here is what each one involves, what your anatomy allows and what it does not, and what you will be asked at the consultation. The procedure itself, the stay and the recovery are on our breast augmentation page.
The key points
- The volume you can have is limited by your anatomy, not by your preference.
- Shape and position are decided after a physical examination.
- An implant is not for life. Replacement is part of the plan from the start.
- Implants and fat transfer do different things and are not interchangeable.
- You try sizers at the consultation, which is worth more than any photograph.
1. Volume: what is actually possible
Three things set the limit.
The width of your chest and of the breast base. This is the main constraint. An implant wider than your breast base does not sit properly, and no amount of wanting changes that.
The thickness of your tissue. It determines how much the implant will be covered and how visible its edges may be.
The elasticity of your skin. It determines how much the skin can accommodate without being overstretched.
At the consultation you try sizers inside a bra, which is the only reliable way to see a volume on your own body. Bring photographs of results you like rather than a cup size: the relationship between volume in cc and cup size varies between manufacturers and between bodies, so a letter tells the surgeon very little.
One thing worth knowing before you decide: the regret people report most often is having gone too large for their frame.
2. Shape: round or anatomical
Round implants give more fullness in the upper pole. They are symmetrical, so if one rotates it makes no difference to the result.
Anatomical implants, sometimes called teardrop, are thinner at the top and fuller at the bottom. If one rotates, it shows, and correcting it means a second procedure.
Neither is better. Which suits you depends on your anatomy and on what you want, and in practice it is the sizing rather than the shape that produces a natural result.
3. Where the implant sits
Retroglandular, between the breast tissue and the pectoral muscle. Recovery is generally more straightforward, and it requires tissue thick enough to cover the implant.
Retromuscular, under the pectoral muscle. Better coverage where the tissue is thin, at the cost of a few more uncomfortable days at the start.
This is an anatomical decision, taken by the surgeon after examining you.
4. The approach: where the scar will be
The inframammary fold. The most commonly used approach, and the one that gives the most precise control over where the implant sits.
Around the areola. The scar blends into the edge of the areola, which works when the areola is wide enough.
Through the armpit. No scar on the breast at all. It is the most discreet and the most technically demanding, and it does not suit every case.
5. Implants or fat transfer?
| Implants | Fat transfer | |
|---|---|---|
| Volume gain | Significant, decided in advance | One to two cup sizes |
| Material | Silicone gel implant | Your own fat |
| Feel | Firmer | Softer |
| Follow-up | Monitoring, and replacement at some point | Stable, but changes with your weight |
| Price | €2,500 | €2,700 |
Part of the transferred fat is always reabsorbed, which is why lipofilling gives a moderate gain and why the result is judged months later rather than weeks.
6. If your breasts are also sagging
An implant adds volume. It does not lift a breast that has dropped — a larger implant in a sagging breast produces a larger sagging breast.
Where there is ptosis, the operation is a breast lift combined with implants, at €2,750 rather than €2,500. The degree of ptosis is graded by the surgeon at the consultation, and it is not something you can assess from a mirror.
7. An implant is not permanent
This is the part most often skipped, and it should be part of the decision rather than a surprise later.
Implants have a limited lifespan. There is no fixed number of years: it depends on the type of implant and on your own situation. A young patient may keep the same implants for several decades, or may not.
Imaging follow-up is carried out according to medical recommendations, to check the implants are intact.
Replacement should be anticipated rather than feared. It costs €2,600.
Breast screening changes. Mammography has to be adapted when implants are present, and you must tell whoever is performing the scan. This matters for the rest of your life, not just the first year.
You are given an implant card after the procedure, with the reference of what was placed. Keep it somewhere you will find it in fifteen years.
8. The risks
In the early period: haematoma, infection, healing problems, asymmetry, changes in nipple sensation.
Related to the implant itself: malposition or rotation, which matters particularly with anatomical implants; rippling, where the edge of the implant becomes visible through thin tissue; and silent rupture, which is one of the reasons imaging follow-up exists.
In the longer term: capsular contracture, where the tissue around the implant tightens; and a rare lymphoma associated with certain textured implant surfaces.
Implants carry CE marking, which means the device is traceable and you can identify exactly what was placed. That is what the implant card is for.
9. What is decided at the consultation, and not before
An opinion given remotely, from photographs, is a first orientation. It is not a plan.
The physical examination is what determines the volume, the shape, the position, the approach and whether you need a lift as well. Four of those five cannot be assessed from a photograph.
Procedures are performed by Dr Taher Djemal, Dr Abir Ben Ouaghrem and Dr Walid Saidane at Myron International Clinic in Tunis.
10. Prices
- Breast augmentation with implants: €2,500
- Breast lift with implants: €2,750
- Breast fat transfer: €2,700
- Implant replacement: €2,600
These cover the consultation, the procedure, the anaesthetic, CE-certified implants, the post-surgical bra, transfers and post-operative follow-up. Flights are at your own expense. The full list is on the prices page, and a personalised quote reaches you within 24 to 48 hours.
Frequently asked questions
Can I choose my own volume?
Within limits. The surgeon establishes the range that works with your anatomy, and you choose within it using sizers. A volume outside that range is not withheld from you — it would not sit correctly.
Which shape gives the most natural result?
It depends on your anatomy, and the honest answer is that sizing matters more than shape. A well-sized round implant looks more natural than a badly sized anatomical one.
Will I be able to breastfeed after breast augmentation?
In most cases, yes. Tell your surgeon at the consultation if you are planning a pregnancy, because it may influence the approach and the position chosen.
How long do implants last?
There is no fixed figure, despite what you may have read. It depends on the type of implant and on your situation, and replacement is anticipated rather than scheduled.
Can implants be removed without being replaced?
Yes. Depending on what your tissue looks like afterwards, that may be combined with a lift or with fat transfer.
Do I need a mammogram before the procedure?
That depends on your age and your medical history, and your surgeon will tell you.
Getting an opinion on your own case
ServiHealth organises and coordinates medical stays in Tunisia. Send us photographs and a description of what you have in mind for a first opinion within 24 to 48 hours. The volume, the shape, the position and the approach are decided by the surgeon at the consultation.
You can request a quote, or read how one patient approached two procedures two years apart in her account of the pathway.
