What is it and how is it done?
Preserve is the name of a tissue-sparing, minimally invasive technique that focuses on how the implant pocket is prepared in breast augmentation. In conventional breast augmentation, the space for the implant is usually created by cutting tissue with surgical instruments and sealing bleeding vessels with cautery. With the Preserve technique, the aim is to create the space the implant needs by gently separating the tissue layers instead of cutting them, preserving the internal support structures of the breast, the nerves and the chest muscle as far as possible.
Three instruments specific to the technique are used for this. A channel dissector is introduced through the small incision and opens a narrow tunnel in the plane where the implant will sit. An inflatable balloon dissector is placed in this tunnel; when it is inflated in a controlled way, it pushes the tissues apart and creates a pocket matched to the size of the chosen implant. An insertion sleeve then allows the implant to slide into the pocket through the small incision with little contact with the skin. The incision is usually made in the crease beneath the breast.
Because the surgical disruption of tissue is kept limited, the Preserve technique can be performed in suitable patients under local anaesthesia with sedation instead of general anaesthesia, and the patient can go home the same day; this way of operating without an overnight hospital stay is called day-case breast augmentation. The technique is not suitable for everyone, however. It is generally preferred for women having breast augmentation for the first time who have enough breast tissue to cover the implant, no significant sagging and a medium-sized implant in mind. For implant exchange, correction of sagging at the same time, a wish for large implants or very thin tissue, conventional breast augmentation techniques are more appropriate.
At the practice in Nişantaşı, Prof. Dr. İlker Yazıcı assesses the thickness of the breast tissue, the width of the breast base, skin elasticity and the position of the nipple, and the intended volume is discussed together using 3D imaging and simulation. Whether the Preserve technique is suitable is decided on the basis of this examination; if it is not, conventional breast augmentation or, if needed, breast lift options are explained. Although the technique is different, a silicone breast implant is still placed, so the implant-related risks and the need for long-term follow-up are the same as with conventional breast augmentation.
What are the aims?
- To preserve breast tissue, nerves and the chest muscle by preparing the implant pocket through separation rather than cutting.
- To increase breast volume in proportion to the body through a small incision.
- In suitable patients, to perform the operation as day surgery under local anaesthesia with sedation.
- To limit pain and swelling after surgery and allow an early return to daily life.
Who is it suitable for?
- Women considering breast augmentation for the first time who have not had breast implants before.
- Women with breast and soft tissue thick enough to cover the implant.
- Women without significant sagging whose nipple position is suitable.
- Women who can reach their goal with a medium-sized implant that suits the width of the breast base.
- Women whose breasts have finished developing, who are at least 18 and whose general health allows surgery.
- Women found suitable for local anaesthesia with sedation who can have someone with them on the first night after day surgery.
When is it postponed or not recommended?
- Previous breast implants; implant exchange and revision operations generally fall outside the scope of this technique.
- Significant sagging that needs a breast lift.
- A wish for large implants, or breast tissue too thin to cover the implant.
- Structural differences such as tuberous breasts that need additional correction of the breast base or shape.
- Pregnancy, breastfeeding, an unexplained breast finding or a health problem that rules out surgery.
Alternatives
- Conventional breast augmentation
- The widely used method, with placement under the muscle, over the muscle or in a dual plane, which covers a wider range of implant sizes and is also used for implant exchange.
- Breast augmentation with your own fat
- Provides a limited increase in volume without an implant; part of the injected fat may be absorbed, and more than one session may be needed.
- Breast lift (with or without an implant)
- If the main problem is sagging, a breast lift that raises the breast is a more suitable option.
The process step by step
- 1
First contact
You can send photos of your breasts and a short description of your concerns by WhatsApp or e-mail, or call the practice. This information gives you a general idea of the options and helps plan the examination; the medical assessment and the decision, including whether the technique suits you, take place at the examination in Nişantaşı.
- 2
Examination and measurements
At the practice in Nişantaşı, Prof. Dr. İlker Yazıcı assesses the breast tissue and measurements; implant size and the suitability of the technique are discussed using 3D imaging and simulation.
- 3
Preparing for surgery
Blood tests, an age-appropriate breast ultrasound or mammogram and an anaesthetic assessment are carried out; the type of anaesthesia (local with sedation, or general) is confirmed at this stage.
- 4
Day of surgery
The pocket is prepared through a small incision with the channel dissector and balloon dissector, and the implant is placed using the insertion sleeve; the operation usually takes 1–2 hours, and suitable patients go home the same day.
- 5
Check-ups and follow-up
The wound is checked within the first week; breast examinations and imaging follow-up for the implant continue over the following months and years.
Recovery timeline
Day of surgery
Once the sedation has worn off and the necessary checks have been made, suitable patients go home the same day with a companion. There is a feeling of tightness and pressure in the chest; the prescribed painkillers are used.
Days 1–3
A support bra is worn and short walks are taken. For most people, pain and swelling gradually ease; avoid lifting anything heavy with your arms.
Week 1
The first check-up takes place. Most people return to desk work and light daily tasks at this stage.
Weeks 2–4
Swelling reduces noticeably, and light exercise such as walking can be increased. Scar care begins.
Weeks 4–6
After a check-up, sport and heavy lifting are resumed gradually.
Months 3–12
The implant settles into place, the breast shape softens and the scar continues to fade. In the following years, regular breast check-ups and imaging follow-up for the implant continue.
Risks and possible complications
Every surgical procedure carries risks. Your personal risk is assessed in detail at the consultation.
- Reactions to sedation or local anaesthesia; if considered necessary, the operation can be switched to general anaesthesia.
- Bleeding (haematoma), fluid collection or infection; rarely, these may need a further operation.
- Capsular contracture: the capsule that forms around the implant tightening over time, causing firmness, distortion of shape or pain.
- Implant displacement, asymmetry between the breasts, or an implant edge that can be felt.
- Temporary, and rarely permanent, changes in sensation of the nipple and breast skin.
- Implant rupture; because a ruptured silicone implant may cause no symptoms, regular imaging is recommended.
- Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL): a very rare type of lymphoma associated with breast implants; it is usually noticed years later as new swelling or a fluid collection in the breast and can be treated when diagnosed early.
- Thickening or prominence of the incision scar.
What determines the cost?
The fee for Preserve breast augmentation depends on the instruments specific to the technique, the implant used, the type of anaesthesia, whether the operation is done as day surgery and the follow-up plan. Because the technique is only used in patients found suitable, the fee cannot be confirmed before the examination and suitability assessment.
After the examination, you receive written cost information that sets out, item by item, the plan recommended by Prof. Dr. İlker Yazıcı and what it includes. If the Preserve technique is not suitable, separate written information is prepared for the alternative that is recommended.
If you are coming to Istanbul
The practice is authorised by the Turkish Ministry of Health for international health tourism (certificate no. ST-2365); help with accommodation near the clinic and airport transfer can be arranged through authorised partners. Although the operation is done as day surgery in suitable patients, if you are travelling from abroad or from another city, plan to stay in Istanbul for 3–5 days after surgery so that the first check-up can take place. Back home, you stay in touch with the practice by sending photos and messages; if something needs to be examined, a check-up in Istanbul or a visit to a local doctor is arranged. Return visits are usually advised at 1 and 6 months, with exact dates set at the first check-up.
Frequently asked questions
What is the Preserve technique, and how does it differ from conventional breast augmentation?
Preserve is the name of a way of preparing the implant pocket in breast augmentation. In the conventional method, the space for the implant is usually created by cutting tissue. With the Preserve technique, dedicated instruments such as a channel dissector, an inflatable balloon dissector and an insertion sleeve separate the tissues without cutting them, and the implant is placed through a small incision. The aim is to preserve breast tissue, nerves and the chest muscle. A silicone breast implant is still used, and long-term follow-up is the same.
Can Preserve breast augmentation be done as day surgery under local anaesthesia?
Preserve breast augmentation can be performed under local anaesthesia with sedation in suitable patients. Under sedation you are deeply relaxed and often do not remember most of the operation. After being checked, suitable patients go home the same day with a companion. The type of anaesthesia is decided with the anaesthetist according to your general health and the extent of the operation; for some people general anaesthesia may be more appropriate.
Who is the Preserve technique suitable for?
The Preserve technique is not suitable for everyone. It is generally preferred for women having breast augmentation for the first time who have enough breast tissue to cover the implant, no significant sagging and a medium-sized implant in mind, who are at least 18 and in good general health. Smoking should be stopped because it impairs healing, and blood thinners and herbal products should be mentioned at the consultation. Suitability is decided on the basis of the examination and measurements by Prof. Dr. İlker Yazıcı.
Is Preserve breast augmentation painful?
With the Preserve technique you feel no pain during the operation, as it is done under local anaesthesia with sedation or under general anaesthesia. In the first days after surgery there is a feeling of tightness and pressure in the chest, which for most people is controlled with the prescribed painkillers. Because the chest muscle is not cut, the aim is to keep pain limited, but how much pain is felt varies from person to person, and some pain should be expected.
When can I return to work after Preserve breast augmentation, and when does the result settle?
After Preserve breast augmentation, most people return to desk work and daily tasks within a few days to a week. Heavy lifting and sport usually wait 4–6 weeks; when to resume them is decided at a check-up. Swelling goes down over the first weeks, while the implant settling into place and the breast taking on its final shape take several months; the shape usually becomes clear within 6–12 months.
Does the Preserve technique leave a scar?
With the Preserve technique the implant is placed through a small incision, usually in the crease beneath the breast, so the scar is mostly hidden under a bra or bikini. Like any surgical incision, it leaves a permanent scar. The scar can be pink in the first months and usually fades and becomes finer within 12–18 months. Its final appearance depends on skin type, how you heal and scar care.
Is breast augmentation with the Preserve technique permanent?
The Preserve technique still uses a silicone breast implant, so the long-term information about implants is the same as for conventional breast augmentation. Implants are not lifetime devices, but they do not have a fixed expiry date either. Ageing, weight changes, pregnancy and breastfeeding affect breast shape over time. Because a ruptured silicone implant may cause no symptoms, regular ultrasound or MRI checks are recommended, starting a few years after surgery.
Can the Preserve technique be combined with other procedures?
The Preserve technique is designed mainly for a first breast augmentation done on its own. When it is planned together with more extensive procedures such as a breast lift or a tummy tuck, general anaesthesia and conventional techniques are usually needed, and the option of day surgery under local anaesthesia may no longer apply. Whether minor additional procedures can be done in the same session is assessed at the examination, taking into account the total operating time and the anaesthetic plan.
What determines the cost of Preserve breast augmentation?
The cost of Preserve breast augmentation depends on the instruments specific to the technique, the implant chosen, the type of anaesthesia, whether it is done as day surgery and the follow-up plan. Because the technique is only used in patients found suitable at the examination, suitability is assessed first. After the examination, you receive written cost information that sets out, item by item, what the plan recommended by Prof. Dr. İlker Yazıcı includes.
I am travelling to Istanbul for Preserve breast augmentation. How many days should I stay?
Although Preserve breast augmentation is done as day surgery in suitable patients, those travelling to Istanbul are advised to stay for 3–5 days after surgery. During this time the first check-up takes place and your readiness to travel is assessed. An extra day before surgery may be needed for the examination and tests. Return visits are usually advised at 1 and 6 months after surgery.
Last updated: · Responsible for content: Prof. Dr. İlker Yazıcı · info@ilkeryazici.com