Choosing to have breast augmentation raises a lot of practical questions, and one of the biggest is how to land on the right breast implant sizes for your frame and goals. Add in decisions about implant type, incision location and placement, and it's easy to see why so many women want a clear, easy-to-understand guide before their first consultation.
Here's what goes into augmentation mammoplasty planning, from implant type through to scarring.
Breast implants come in a handful of core types, and almost all implants used in Australia today are silicone gel, not saline.
Breast implant sizes are measured in cubic centimetres (cc) and chosen based on your chest width, existing breast tissue, skin elasticity and desired outcome, not a bra cup size.
The three main incision sites are inframammary (under the breast), periareolar (around the nipple) and transaxillary (in the armpit), each with different scarring trade-offs.
Implants can sit above or below the chest muscle (or a combination of both), which affects how natural the result looks and feels.
A specialist plastic surgeon will tailor implant type, size, incision and placement to your anatomy during a personalised consultation.
There are a few different types of breast implants on the market, and they're generally grouped by shell texture and shape.
Round implants create fullness across the whole breast, including the upper pole
Anatomical (teardrop) implants taper from top to bottom, mimicking the slope of a natural breast.
Shell surfaces are typically smooth or nano-textured, which affects how the implant sits and how tissue interacts with it.
All medical devices supplied in Australia, including breast implants, must be included on the Australian Register of Therapeutic Goods and meet the Therapeutic Goods Administration's essential safety principles before they can be used. Your surgeon should be able to tell you exactly which implant brand and model they use, and confirm it's currently approved for supply.
Silicone implants are pre-filled with a cohesive silicone gel that maintains its shape and has a texture closer to that of natural breast tissue. Saline implants are silicone shells filled with sterile salt water, usually after they're positioned in the pocket.
Saline implants are rarely used in Australian cosmetic breast surgery these days. Silicone gel implants are the standard choice for augmentation mammoplasty here, largely because of their feel and the way the results tend to hold up over time. If you've read about silicone vs saline implants on an overseas website, it's worth discussing local conventions with your surgeon rather than assuming the same options apply.
Ultimately, the silicone vs saline implants decision in Australia is less about personal preference and more about what's available and recommended here.
Breast implant sizes aren't chosen off a chart the way you'd pick a bra size. They're measured in cubic centimetres (cc), and the right number depends on several things working together:
The width and shape of your chest wall
How much natural breast tissue and skin elasticity you already have
Your lifestyle, posture and any asymmetry between your breasts
The look and proportion you're hoping to achieve
Many surgeons use 3D imaging during consultation so you can preview how different breast implant sizes might translate to your body before any decision is locked in. This tends to give a far more realistic sense of outcome than trying on implants in a bra alone, since it accounts for your existing tissue and frame rather than just volume in isolation.
Where the incision goes affects both how the implant is inserted and where any resulting scar sits. The three incisions most commonly used are:
Inframammary: in the crease underneath the breast. This gives the surgeon direct access to the pocket and is one of the most widely used approaches for both silicone and saline implants.
Periareolar: around the lower edge of the areola, where the scar can blend into the natural colour change of the skin.
Transaxillary: in the armpit, avoiding a scar on the breast itself, though it can be technically more difficult and offers less direct visibility during placement.
Incision choice also depends on implant type, the degree of enlargement you're after and your surgeon's assessment of your anatomy; it's not simply a personal preference. Scarring itself tends to fade over time, though how well it fades depends on genetics, wound care and whether you smoke.
Once the incision is made, the implant is positioned in one of a few pockets:
Subglandular (over the muscle). The implant sits directly behind breast tissue, in front of the pectoral muscle.
Submuscular (under the muscle). The implant sits beneath the pectoral muscle, which can soften the visible edge of the implant and may support more natural movement.
Dual plane. A combination approach, partly under the muscle and partly behind breast tissue, often used to balance coverage with a natural slope at the top of the breast.
Your surgeon will recommend a placement based on how much natural tissue you have, your activity level and the implant type and size you've chosen together. Placement is determined by the implant type and incision, since all three choices work together.
Augmentation isn't always a standalone decision. Some women combine implants with a breast lift (mastopexy) to address sagging as well as volume. Others come to a consultation after weight loss or breastfeeding and are weighing implants against a breast reduction mammoplasty if their concern is more about size and comfort than shape.
If you already have implants and are unhappy with your current size, shape or feel, breast implant revision surgery allows those factors to be reassessed and adjusted.
Every one of these decisions (implant type, breast implant sizes, incision and placement) works together, so they're best worked through simultaneously with a specialist plastic surgeon. A registered surgeon will examine your anatomy, talk through your goals and explain which combination genuinely suits your body, rather than applying a one-size-fits-all approach.
If you're in Cairns or North Queensland and considering augmentation mammoplasty, discover Cairns Plastic Surgery to arrange a confidential consultation and get advice specific to your anatomy and goals.
This article provides general information only and is not a substitute for individual medical advice. All surgery carries risks, and individual results vary. AHPRA Registration: MED0001372020.