Non-surgical breast augmentation, also called breast filler, is the injection of a filler material into the breast to add volume. It is done under local anesthetic through small entry points. No surgery is involved, but it is still an injection procedure with its own risks.

The established methods for enlarging or lifting the breasts are surgical: breast implants, breast lift surgery and transfer of a person’s own fat. Filler should not be thought of as a replacement for these methods.

Filler in the breast carries risks that differ from other body areas: the breast is regularly screened for cancer, and filler may affect that screening. Using filler for breast enlargement is debated in many countries, and some health authorities have issued warnings about it. A decision is made only after a detailed examination and the necessary tests, with the risks discussed openly.

Breast filler is not suitable for everyone. If the breasts are large, noticeably sagging or need lifting, a plastic surgeon’s assessment of surgical methods is recommended. Filler may be considered only in limited situations:

• After weight loss: A reduction in breast volume after losing weight.
• After breastfeeding: Loss of fullness once breastfeeding has ended.
• Mild volume difference: A slight difference in volume between the two breasts.

Even then, suitability is decided at examination, based on the breast tissue, test results and your medical history. A family history of breast cancer, any previous breast surgery and breast implants must always be mentioned.

The volume filler can add is limited. It does not raise sagging tissue, change the position of the nipple or improve stretch marks; for those, see stretch mark treatment. For filler types in general, see dermal fillers.

Breast health is assessed first. If you have not had a recent breast ultrasound or mammogram, or have a breast finding under follow-up, these tests are requested, and nothing is planned until the results are reviewed.

1. The area is marked, the skin is cleaned with an antiseptic solution and sterile conditions are set up.
2. Local anesthetic is applied to the entry points.
3. The filler is placed in controlled amounts in the planned area with a fine cannula.
4. The volume of both sides is compared during the procedure and the amount is adjusted if needed.
5. The entry points are closed and the area is checked.

A doctor carries out the procedure under sterile conditions at the clinic in Nişantaşı, Istanbul; it usually takes 45–50 minutes. Tell your doctor beforehand about your medications, especially blood thinners, and supplements. Swelling means the result is judged at a follow-up visit, not straight away.

Swelling, tenderness and bruising may appear and usually ease within a few days to a few weeks. Desk work can often be resumed soon, but avoid heavy lifting and work that strains the arms for a while. To help the filler settle:

• Supportive bra: Wear a supportive bra, such as a sports bra, for about a month.
• Sleeping position: Avoid lying on your front or on the treated area in the early period.
• Heat: Stay away from Turkish baths, saunas and steam rooms for about 10 days.
• Massage: If your doctor advises it, massage the area with the cream provided for about 2 weeks.
• Exercise: Return to exercise that works the chest and arm muscles only with your doctor’s approval.

If you notice new firmness, redness, increasing pain, discharge or fever in the breast, contact your doctor without delay. Skin quality on the chest is assessed separately; see neck, décolletage and hand treatments.

These risks should be understood before any decision:

• Effect on imaging: Filler can be seen on mammograms, ultrasound and MRI. It may make images harder to interpret and complicate breast cancer screening follow-up.
• Firmness and lumps: Filler can collect in one spot and form a lump that can be felt, which may need further tests to assess.
• Asymmetry and migration: Filler may shift away from the planned area over time.
• Infection: It can appear early or months later and requires treatment.
• Reaction to the filler: The body may form an inflammatory reaction or a capsule around the filler.

If a complication develops, the filler may need to be dissolved or removed. Hyaluronic acid-based fillers can be dissolved with an enzyme, but in some cases a surgical procedure may be needed.

If you have had breast filler, tell the radiologist and your doctor before every mammogram, ultrasound or MRI. Keep up with your regular breast screening even after filler.