Breast augmentation (augmentation mammoplasty) is an aesthetic plastic surgery aimed at correcting proportions and breast position in order to achieve the desired volume and contours.
For a plastic surgeon, augmentation is not just a technical increase in breast size, it is an art, a delicate and meticulous work with anatomy, aimed at eliminating imbalance, with the task of creating luxurious, natural proportionality.
Who is breast augmentation indicated for?
Breast augmentation is an aesthetic surgery that not only changes contours but also improves quality of life. Indications can be physiological (objective) and psychological (subjective):

• Asymmetry – if there is a disproportionality of more than one size (in practice, the left breast is usually larger than the right), this is an objective indication for augmentation. In this case, implants of different sizes are used;
• Micromastia – underdeveloped mammary glands;
• Loss of elasticity, age-related changes – in this case, augmentation is combined with a lift to eliminate ptosis (tissue sagging);
• Involution of the mammary glands after pregnancy and lactation – the breast becomes “empty”, tissues lose tone and volume; transplanted implants help restore anatomy, fullness, and previous contours;
• Tubular breast deformity – a congenital developmental feature in which the breast base is narrowed and the gland takes on a cylindrical “tube-like” shape; only implants can help form correct proportions;
• Reconstruction after surgeries or injuries – most often after oncological conditions, mastectomy (complete removal of the breast), lumpectomy (partial excision of the gland, organ-preserving surgery), or severe mechanical injuries (thermal burns).

The most important indication is a conscious desire for change.
Types of implants
Correct determination of implant parameters and individual volume calculation is the most responsible planning stage. There is no “best” implant — there is one that is ideal for a specific patient.
Modern implants are high-tech multilayer products designed for permanent implantation. When choosing an implant, the following characteristics are considered:
1. Shape

• Round (hemispherical) – symmetrical contour, pronounced fullness of the upper pole, push-up effect and emphasized cleavage;
• Anatomical (teardrop-shaped) – closely mimic natural breast shape, with fullness focused in the lower pole and a flatter upper pole.

2. Implant shell texture

• Smooth – used rarely, soft to the touch and invisible under thin skin;
• Textured – porous surface that adheres to surrounding tissues, reducing implant displacement and capsular contracture risk;
• Microtextured – combines softness and smoothness with reliable fixation.

3. Profile / projection
Regulates implant thickness. Even with the same size, results will differ.

• Medium height – standard size;
• Reduced height – suitable for shorter patients with a wide chest;
• Full height – for tall, slender patients with a long chest;
• Conical shape – wide base with sharp projection (“peak”), creates pronounced projection.

4. Filler

• Cohesive silicone gel of varying density – the gold standard of modern plastic surgery;
• Lightweight filler – silicone gel with hollow microspheres (borosilicate), reducing weight by 30%;
• Hydrogel – based on a natural polymer (carboxymethylcellulose).

Types of implant placement access
Implants are placed using three main techniques:

• Submammary (inframammary) – incision under the breast fold, full visualization and control, suitable for any implant size and shape. The scar is hidden in the natural fold (4–6 cm) and fades over time;
• Periareolar – incision along the lower edge of the areola. Allows implant replacement and correction of the nipple-areola complex. Has limitations with small areola size and future breastfeeding considerations;
• Axillary – incision in the armpit (3–4 cm). The breast tissue is not involved, leaving no scars on the breast. Performed with endoscopic equipment. Suitable for patients with good initial anatomy and minimal asymmetry.

How does augmentation take place?
Breast augmentation is not only surgery but a clear sequence of steps:

• In-person consultation and measurements, anatomy analysis, implant selection;
• Preoperative examinations to identify contraindications;
• Consultation with an anesthesiologist;
• Lifestyle adjustments before surgery.

Surgical stages:

1. Marking in a vertical position;
2. General anesthesia;
3. Antiseptic preparation;
4. Tissue incision;
5. Key surgical stage;
6. Suturing and sterile dressings.

Recovery
Key recovery rules include:

• Wearing compression garments;
• Antiseptic wound care;
• Avoiding physical strain;
• Using prescribed ointments;
• Avoiding UV exposure;
• Maintaining stable weight;
• Sleeping on the back with elevated head;
• Taking prescribed medications;
• Avoiding smoking, alcohol, heat exposure, and hypothermia;
• Physiotherapy if indicated.

Restrictions are adjusted only after follow-up examinations.
Final result
The final result is assessed after 6–12 months, when tissues fully regenerate, breasts take correct position and contours, and circulation and nerve endings recover.
Modern plastic surgery today is not about artificiality, but about inner comfort. Gentle breast augmentation techniques help achieve impressive, natural results, where the new shape feels like the only correct one.

Breast Lift with Implants (Augmentation Mastopexy)
Breast lift with implants (augmentation mastopexy) is a popular plastic surgery procedure that simultaneously (in one operation) solves two fundamental tasks – restores the breast to the proper anatomical shape (eliminates ptosis – sagging) and restores lost volume.
What is ptosis?
Ptosis refers to the aesthetic sagging of soft tissues, determined by the vertical vector from the nipple to the inframammary fold. It is divided into three main degrees:

1. Nipple is lowered no more than 1 cm below the inframammary fold;
2. Nipple is 1–3 cm below the fold;
3. Nipple is more than 3 cm below the fold or located at the very base of the gland projection.

In addition to the main degrees, there is pseudoptosis, where the areola maintains its anatomical position, but the breast itself is lowered.
Visually, ptosis can be identified by several factors:

• Striae, stretch marks on the breasts;
• Upper part of the bra cup remains empty when wearing a bra;
• Skin irritation;
• Loss of rounded shape with nipple displacement toward the inframammary fold.

Who is suitable for combined lift and implant placement?
Combined breast lift and augmentation is most relevant for patients who have finished breastfeeding or have experienced rapid weight loss.
In such cases, tissue structures are overstretched, elasticity is reduced, and if only implants are used, the breasts may sag further. It is important to lift and remove excess skin while using implants to restore volume.
Other indications for augmentation mastopexy include:

• Previous breast surgeries;
• Hormone production deficiencies;
• Congenital morphological features – asymmetry;
• Chronic skin inflammation under the breasts;
• Skin hypotonia related to age;
• Desire to change the location and proportions of the breasts.

How to prepare
To perform a lift with implants, it is necessary to strictly follow preparation steps:

• Consultation with a plastic surgeon for a comprehensive analysis of breast condition, tissues, anatomy, body type, and determination of implant size and shape – round (symmetrical radius) or anatomical (flattened on top, full lower pole);
• Laboratory and diagnostic tests to detect hidden contraindications and assess current health (CBC, ECG, chest X-ray, ultrasound, hormone tests, hidden infections, etc.);
• Mandatory consultation with an anesthesiologist to determine anesthesia method and dosage. If research is inconclusive or comorbidities are present, additional consultations with specialists may be required (gynecologist, endocrinologist, mammologist);
• Lifestyle changes (quitting smoking, alcohol, certain medications, avoiding sun exposure, etc.).

Before the combined operation, a pregnancy test must be performed independently (if positive, the operation is postponed until at least six months after breastfeeding).
How the operation is performed
Mastopexy with augmentation requires detailed analysis of the breast condition and selection of implant placement technique:

• Subfascial – under the fascia covering the pectoralis major;
• Dual-plane – upper part of the implant under the muscle, lower pole under the gland;
• Submuscular (subpectoral) – under the pectoralis major;
• Subglandular – behind the mammary gland.

The most stable implant position is under the pectoralis major and its fascia.
Two main surgical techniques are used for lift with implants:

1. Periareolar – incision along the areola contour, removal of excess soft tissues, implant placement under the pectoralis major, nipple repositioning to correct anatomical location. Effective only for mild ptosis.
2. Anchor (T-shaped) – the most effective, stable, and predictable technique. Incision from the areola to the inframammary fold with lateral extensions, forming an inverted T. Can correct any degree of ptosis and associated tissue deformities, with full visual control.

Other techniques include J-shaped and vertical lift, but they are less effective and may require repeat procedures as the result may be unstable and the breast may sag again.
Step-by-step of a simultaneous operation

1. Marking in vertical position;
2. General anesthesia;
3. Antiseptic preparation;
4. Incision according to markings;
5. Main stage – removal of excess tissue, nipple repositioning, implant placement;
6. Suturing and sterile dressings.

Recovery
The first month after lift with implants is the most critical. Patients should strictly follow the surgeon’s instructions:

• Sleep on your back with an elevated headrest; avoid sexual activity;
• Treat sutures with antiseptic;
• Wear compression garments continuously, removing only for hygiene;
• Take prescribed medications and apply regenerative and moisturizing creams;
• Avoid UV exposure;
• Do not smoke or drink alcohol;
• Avoid preoperative weight fluctuations;
• Do not injure the chest area;
• Avoid hypothermia and exposure to high temperatures (hot baths, sauna);
• Avoid swimming in pools or open water.

After suture removal, physiotherapy may be indicated – lymphatic drainage, magnetotherapy, microcurrents, etc.
Pregnancy should be avoided for 6–12 months after the operation, as tissues are regenerating, lymphatic and blood circulation are restored, and the breasts acquire correct contours and proportions.
Final result
The final result is best assessed after six months when the breasts have reached their anatomical position. The effect is long-lasting but depends on age, lifestyle, and care.
Advantages of a single-session procedure
Augmentation mastopexy requires only one consultation, one preparation, one anesthesia, and one recovery period, saving time and resources. Additional benefits include:

• Individual breast architecture;
• Stable long-term result;
• Creation of a full, ideal upper pole;
• Comprehensive breast rejuvenation;
• Universal procedure;
• Predictable outcome;
• Restoration of psychological comfort and self-confidence.

Combined augmentation and lift solve a complex problem in a single step, providing a regal, natural-looking result. In many cases, the outcome is even better than before pregnancy or other causes of ptosis, and it lasts for many years.

Reduction mammoplasty is the surgical reduction of large (hypertrophic) breasts by excising excess fat and glandular tissue.
Reduction is aimed not only at improving aesthetics but also at radically eliminating somatic discomfort and physical discomfort.
When should you consider breast reduction?
Large breasts are not only an aesthetic issue but also increase the risk of developing oncological conditions, as it can be difficult to conduct examinations such as ultrasound or mammography due to the volume of tissue.
Patients most often seek the procedure with specific complaints, which may include:

• Intertrigo in the inframammary fold, chronic dermatoses due to excessive sweating and friction;
• Chronic pain in the back, lumbar region, or shoulders;
• Excessive load on the cervical spine;
• Macromastia (gigantomastia) – large breast weight and volume;
• Breathing difficulties when lying down, leading to sleep problems;
• Kyphosis, posture issues;
• Difficulty finding suitable bras or clothing;
• Severe ptosis (sagging), asymmetry.

Reduction mammoplasty may also be a secondary procedure if a patient wishes to reduce naturally large volumes.
Who cannot undergo breast reduction?
Breast reduction is a complex, extensive operation, and like any surgery, has contraindications:

• Blood clotting disorders;
• Oncological pathologies;
• Age under 18;
• Psychiatric disorders;
• Decompensated diabetes mellitus;
• Renal, cardiovascular, or liver failure;
• Pregnancy or breastfeeding;
• Obesity (high BMI);
• Viral respiratory infections;
• Tendency to form atypical (hypertrophic, keloid) scars;
• Hypersensitivity to anesthesia components;
• Infections or purulent foci in the décolleté area.

How to prepare for surgery
The main step is a preoperative examination, including history, complaints, visual assessment of the breasts – evaluation of tissue structure, detection of nodules or suspicious areas, symmetry analysis, anthropometry, and photo documentation.
The plastic surgeon is responsible for the technical aspects of reduction, but patient discipline forms the foundation for smooth recovery and an aesthetically pleasing result. Preparation also includes:

• Full medical check-up according to guidelines to detect contraindications and assess overall health (CBC, coagulation, hidden infections, hormone tests, ultrasound, mammography, chest X-ray, ECG, etc.);
• Consultation with an anesthesiologist to determine anesthesia type and dosage. Additional specialist consultations may be required if indicated;
• Lifestyle modifications (avoiding UV exposure, smoking, alcohol, certain medications, etc.).

How is reduction performed?
Reduction mammoplasty can be performed using one of the following techniques:

• Periareolar – not effective for large-volume breasts;
• Vertical;
• Anchor (T-shaped) – universal technique, tissues are excised in an inverted T shape from the areola to the inframammary fold with lateral extensions along natural lines. This technique provides predictable, stable results, suitable for any type of gynecomastia or combined defects. It allows modeling imperfections, removing excess tissue, performing a lift, and repositioning the nipple and areola.

In addition to reduction, breast size can be reduced while placing implants. Although it may seem paradoxical, after surgery, the breast without an implant will be soft and pliable, taking a teardrop shape.
If an implant is placed, the following changes occur:

• Full upper pole and enhanced cleavage (décolleté area);
• Stability of new shapes and proportions – the implant acts as an internal support;
• More predictable long-term results.

Combined reduction and augmentation is technically complex and precise. Typically, a small-volume implant is selected to avoid overloading the tissues and to create a stable framework for new proportions.
What to expect during recovery
The effectiveness of reduction mammoplasty largely depends on proper rehabilitation and strict adherence to recommendations, which may include:

• Wearing compression garments continuously, removing only for hygiene;
• Treating sutures with antiseptic;
• Avoiding hypothermia and high-temperature exposure (sauna, hot bath);
• Avoiding smoking (including vapes) and alcohol;
• Sleeping only on the back with head elevation;
• Avoiding sudden preoperative weight fluctuations;
• Avoiding chest and shoulder overstrain, heavy lifting, and intense physical activity;
• Taking prescribed medications and using regenerative and moisturizing ointments;
• Wearing comfortable, breathable clothing with buttons;
• Avoiding sexual activity.

It is important to understand that results develop gradually. Full recovery takes several months. Initial results can be observed after 2 months, and complete healing and stabilization of tissue structures occur over 6–12 months, when final outcomes are assessed.
Expected results
Reduction mammoplasty provides both aesthetic transformation and physical relief:

• Relieves spinal pressure, improves breathing, increases comfort for skin and movement – immediate effects;
• Balances volume, eliminates asymmetry, repositions nipple and areola, creates a new silhouette proportional to body type – aesthetic benefits;
• Restores psycho-emotional balance, eliminates complexes, and enhances overall quality of life.

Reduction is not just removal of excess volume – it provides physical relief, psycho-emotional well-being, and restores harmonious, flawless breast architecture.

Finding the right plastic surgeon requires a conscious, well-considered decision – it is not just about finding someone to perform the desired procedure, but a partner-mentor, an expert in transformation. The basis for choosing should be proper qualifications and total trust.
The choice of surgeon affects not only the aesthetics of your upcoming procedure but also your health, psycho-emotional state, and long-term quality of life.
Tips on what to look for when choosing your surgeonEducation
A truly competent specialist holds a medical degree from a university, has completed residency in general surgery and plastic surgery (or retraining), and should have specialist accreditation or a valid certificate.
Documents can be requested:

• Personally at the clinic from the administrator (check the information board);
• On the official clinic website in the doctor’s profile;
• Verified online via government registries – Rosobrnadzor, FIS FRDO, FRMR, Roszdravnadzor; professional status can be confirmed in the ROPREH registry (Russian Society of Plastic, Reconstructive, and Aesthetic Surgeons).

Experience in the specialty
Experience and success often correlate with age but are essential, especially for the specific procedures you seek. The surgeon should possess unique techniques and skillful combinations for your desired operation.
Scientific publications and teaching experience also indicate that the specialist is recognized in the professional community and contributes to modern medical standards.
Continuing education
Plastic surgery is a rapidly evolving field. To master advanced methods, a professional surgeon must engage in continuous education by participating in international congresses, conferences, and practical master classes.
Ongoing skill improvement and study of innovative techniques allow the surgeon to ensure patient safety and deliver modern aesthetic results.
Clinic
Choosing a clinic is as important as choosing the surgeon; it is the foundation of your well-being. The clinic should be equipped with modern equipment, inpatient facilities, have a valid medical license, certifications for used materials, anesthesia equipment, etc.
The clinic should have an official website where you can review the portfolio of the surgeon you are interested in.
Before-and-after photos
During consultation, ask to see before-and-after photos or videos relevant to your case. “Try on” these results mentally to see if they suit you, paying particular attention to long-term results – 6–12 months after the procedure.
Honesty and behavior during consultation
A plastic surgeon may also refuse to perform a procedure (for example, if the operation is based on a trend unsuitable for your anatomy). At the initial consultation, a competent surgeon acts as a medical expert, prioritizing safety, health, comfort, and harmonious results over profit.
When patients cannot clearly express their wishes or decide on the correction technique, only a qualified specialist will guide them.
The surgeon should clearly and accessibly explain all key points about the procedure and study your personal information:

• Review your medical history and current complaints;
• Clarify the reasons and goals for the planned procedure;
• Conduct a thorough examination of the area to be operated – analyze tissue condition, perform tests, samples, etc.;
• Explain correction options suitable for your situation, how they will be performed, and realistic expected results;
• Review the preparation process – necessary tests, examinations, self-preparation, and additional specialist consultations if needed;
• Not push additional services, procedures, or guarantee 100% results;
• Provide a full cost estimate for the surgery;
• Offer psychological support and show empathy;
• Inform you of all risks and potential complications along the path to self-improvement.

A competent specialist is tactful, stress-resistant, asks clarifying questions, pays attention to details and preferences, and respects the patient’s dignity.
Psychological contact
During consultations and examinations, you should feel comfortable asking even “silly” or awkward questions. If there is pressure or neglect, this is not your doctor. You and your surgeon should form a unified team working toward the same goal and listening to each other.
If after the consultation you feel relief and clarity about your upcoming procedure, rather than doubt or discouragement, you have chosen the right specialist for you.

The temporal lift is a minimally invasive plastic surgery procedure aimed at lifting the upper third of the face – the outer corners of the eyes, forehead, temple area, and eyebrows.
This procedure harmonizes the face and corrects age-related changes to enhance aesthetic appearance. The correction can restore an open, refreshed look to the upper third of the face while maintaining maximum naturalness. It can also be combined with other rejuvenating procedures and treatments (blepharoplasty, cheek lift, botulinum therapy, etc.).
Who is it suitable for?
Endoscopic forehead and temple lifting is a localized rejuvenation of the upper third of the face. It helps eliminate imperfections such as:

• Loss of cheekbone definition – flattening;
• Horizontal and vertical wrinkles, skin folds in the forehead and temple areas;
• “Crow’s feet” around the eyes;
• Drooping of the upper eyelids;
• Decreased tone or ptosis of soft tissues – sagging of the eyebrows, cheeks, outer eye corners, and forehead;
• Minor asymmetry of the eyebrows;
• Nasolabial folds;
• General rejuvenation of the upper face.

The optimal age for endoscopic forehead and temple lifting is between 30–45 years.
Techniques
Temporal lifting is performed using two main surgical methods:

1. Open (classical, diagonal) technique – incisions of 2–4 cm are made parallel to hair growth in the temple region, 2–3 cm from the hairline. Lifting is performed diagonally upward and outward, targeting the outer corner of the eye and the lateral third of the eyebrow.
2. Endoscopic technique – using endoscopic video equipment, small punctures (3–5) are made in the hair-bearing area. The endoscope (a hollow tube with light sensors and a camera) projects the image onto a screen, allowing full visualization of even hard-to-reach areas.

• This method does not require tissue excision or tension; tissues are only repositioned and fixed in the desired position, allowing extensive correction of the forehead and temple zones.

Preparation
A consultation with a plastic surgeon is required to:

• Identify complaints and collect medical history;
• Conduct a visual examination (come with clean skin, without makeup or skincare products) – facial expressions tests, tissue analysis, structural assessment, and photo documentation from multiple angles;
• Agree on the lifting technique.

Following the consultation, preparatory steps include:

• Laboratory and diagnostic tests (standard checklist provided during the consultation);
• Anesthesiologist consultation to determine anesthesia type and dose, with additional specialist consultations if any doubts arise;
• Lifestyle adjustments (avoid UV exposure, harmful habits, certain medications, etc.).

Procedure
The endoscopic forehead and temple lift typically follows this sequence:

1. Skin cleansing from sebum and impurities;
2. Marking;
3. Antiseptic disinfection of the operative field;
4. Anesthesia;
5. Creating access according to the chosen method;
6. Performing the key surgical steps – repositioning, lifting, and fixation of tissues in their new anatomical position;
7. Suturing (for classical method) and sterile dressing application.

Recovery
Active rehabilitation usually lasts 7–14 days, during which strict adherence to the following rules is required:

• Disinfect puncture sites and sutures with antiseptic;
• Wear a compression bandage;
• Apply cold compresses in the first days (ice packs wrapped in cotton or sterile gauze for 10–15 minutes several times daily, avoiding direct pressure on incisions and sutures);
• Avoid sudden head movements, tilting, physical activity, or lifting;
• Take all prescribed medications;
• Avoid makeup and skincare products;
• Avoid hypothermia and high temperatures;
• Avoid sun exposure;
• Sleep on your back with head elevated;
• Abstain from harmful habits;
• Avoid excessive facial expressions.

After 2–4 weeks, some restrictions are eased or lifted entirely. Final results are assessed after complete tissue healing, typically 1–3 months post-procedure.
The results of temporal and forehead lifting can last 5–10 years (up to 5 for classical and up to 10 for endoscopic), depending on age, self-care habits, and physiological features.
Benefits of Temporal Lift
Endoscopic temporal lifting provides noticeable rejuvenation without radical changes to facial features. Additional advantages include:

• Gentle surgical technique;
• Minimally visible or invisible scars;
• Short, comfortable recovery;
• Accessibility;
• Long-lasting rejuvenation;
• Versatility in upper face rejuvenation;
• Natural appearance.

Endoscopic temporal lifting is not just a correction of dermal changes – it harmoniously restores the face’s natural tone and freshness, while boosting self-esteem and psycho-emotional well-being.