Breast augmentation is one of the most requested cosmetic procedures in the world, but it is also one where the gap between a good outcome and an extraordinary one comes down almost entirely to the surgeon’s planning. Implant selection, profile, pocket placement, incision approach, and how the surgery accounts for each patient’s existing tissue all shape the final result — and every one of those decisions is made before the first cut. A breast augmentation that looks effortlessly natural years after surgery was designed that way from the consultation, not assembled in the operating room.

Dr. John Anastasatos performs breast augmentation at his Athens, Greece practice with the depth of surgical planning and international aesthetic sensibility his patients have come to expect. Board certified by the American Board of Plastic Surgery and a Fellow of the American College of Surgeons (FACS), he delivered a plenary lecture on endoscopic breast surgery at the Pan-Hellenic Congress of Plastic, Reconstructive and Aesthetic Surgery — a directly relevant academic credential given that endoscopic augmentation through the armpit is among the techniques he offers. Named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World and recognized as a Castle Connolly and U.S. News & World Report Top Doctor, Dr. Anastasatos has been featured across Reuters, the Boston Globe, FOX News, ABC, NBC, Forbes, LA Confidential, Vogue Greece, and Elle Greece, including his appearance on the plastic surgery series Nip/Tuck. His dual practice in Beverly Hills and Athens serves as an international referral center, drawing patients from across Europe, the Middle East, and the United States for the combination of American board-certified training and refined European aesthetic judgment that defines his approach to breast surgery.

Understanding Breast Augmentation

Breast augmentation uses implants — or in some cases autologous fat — to increase the size, improve the shape, or restore lost volume of the breasts. Patients pursue the procedure for a range of reasons: congenital under-development, asymmetry, volume loss after pregnancy or weight reduction, or simply the desire for proportions that feel more balanced with the rest of their figure. The right surgical plan depends on what a patient is starting with and what she wants to end with — and that is the work of the consultation, not the operating room.

Dr. Anastasatos’s approach emphasizes patient participation in size selection. During pre-operative visits, patients try on different implant sizes so the final choice reflects their preference rather than the surgeon’s. He believes the patient should select the breast implant size — not the surgeon.

Choosing the Right Size and Shape

Beyond size itself, two additional decisions shape how a breast augmentation looks: implant profile and implant shape.

Profile refers to how far the implant projects from the chest wall — essentially, how much “perkiness” it creates. Moderate profile implants produce a more natural look that reads as subtly enhanced rather than obviously augmented. High profile implants project further forward and create more dramatic projection. Dr. Anastasatos shows patients both profiles during consultation to help them decide what matches their aesthetic goals.

Shape refers to whether the implant is rounded or anatomic (teardrop-shaped). Round implants produce a fuller upper pole, while anatomic implants more closely mimic the natural slope of the breast. The right choice depends on the patient’s existing anatomy and the look she is seeking.

Implant Material Options

Dr. Anastasatos offers several implant types at the Athens, Greece practice, with selection guided by each patient’s anatomy and preferences.

Saline Implants

Saline implants consist of a silicone shell filled with sterile saltwater. They are filled after insertion, which allows for smaller incisions, and any leak is harmlessly absorbed by the body.

Silicone Gel Implants

Silicone gel implants are pre-filled with a cohesive silicone gel designed to feel similar to natural breast tissue. Modern cohesive gel implants maintain their shape even if the shell is compromised.

Polyurethane-Coated Implants

Available in Europe, polyurethane-coated implants consist of a cohesive silicone implant covered by a shell of silicone and polyurethane. This implant type was previously available in the United States but was discontinued over concerns about cancer that were identified in mice but never proven in humans. Many patients at the Athens practice appreciate having access to this option, which offers distinct characteristics not available in the U.S. market.

Surgical Approach and Incision Options

Dr. Anastasatos offers multiple incision approaches based on what suits each patient’s anatomy and preferences. Incision choice affects both visible scarring and recovery.

Trans-Umbilical Breast Augmentation (TUBA)

The TUBA approach places the breast implants through an incision in the belly button, leaving no visible scars on the breasts themselves. It is also the quickest augmentation procedure. Only saline implants can be placed through the TUBA approach because they are filled after insertion.

Endoscopic Breast Augmentation Through the Armpit

Endoscopic augmentation places the implant through an incision in the armpit, also leaving no visible scars on the breasts. Dr. Anastasatos’s plenary lecture on endoscopic breast surgery reflects his specific expertise in this minimally invasive technique, which is particularly appealing to patients who prioritize preserving the breast from any incision at all.

Inframammary Fold Incision

The incision is placed along the natural crease beneath the breast, allowing direct access to the implant pocket. This remains one of the most common approaches because it hides the scar in a natural skin fold and provides the surgeon with precise control over pocket creation.

Peri-Areolar Incision

Placed along the lower border of the areola, this incision takes advantage of the natural color transition between areola and surrounding skin to conceal the scar within an already pigmented border.

Implant Placement Options

Where the implant sits in relation to the pectoralis major muscle affects both appearance and feel.

Sub-Glandular (Over the Muscle)

The implant is placed over the pectoralis major muscle and under the breast tissue. This approach can provide additional lift for patients with mild sagging and allows the implant to enhance the existing shape of the breast directly.

Sub-Muscular (Under the Muscle)

The implant is placed beneath the pectoralis major muscle. This approach produces a more natural upper-pole slope, is often preferred for thinner patients with less existing tissue, and provides additional coverage of the implant edge.

Dual-Plane (“Half-Over, Half-Under”)

A hybrid approach where the implant is partially under the muscle and partially under the breast tissue. This approach is essentially a sub-muscular placement with additional coverage adjustments for patients whose anatomy benefits from both planes.

“Breast augmentation is a conversation before it is a surgery. The time I spend helping a patient understand profile, shape, placement, and material — and helping her try on different sizes until she finds what genuinely reflects what she wants — is what separates a result she loves from one she simply lives with. The patient should leave my office knowing exactly why her plan was designed the way it was.” — Dr. John Anastasatos

Why Patients Choose Breast Augmentation

Patients pursue breast augmentation for reasons that are often a mix of physical, aesthetic, and personal. Common motivations include:

• Congenital Under-Development: Breasts that never developed to the desired size during puberty and feel out of proportion with the rest of the figure.
• Post-Pregnancy Volume Loss: Breasts that deflated after pregnancy and breastfeeding, losing fullness even when the rest of the body has recovered.
• Post-Weight-Loss Changes: Volume loss after significant weight reduction that leaves the breasts disproportionately small for the new body.
• Breast Asymmetry: Correcting noticeable size differences between the two sides by augmenting one or both breasts.
• Clothing Fit: The desire for clothing — tops, dresses, swimwear — to fit the way the patient has always wanted it to.
• Aesthetic Balance: A goal of proportion and balance across the whole body rather than focus on one dimension alone.

What to Expect From Breast Augmentation

Breast augmentation is performed under general anesthesia and typically takes one to two hours. Most patients return home the same day. A surgical bra supports the breasts during the first four to six weeks. Sleeping on the back and avoiding chest exercise are required during early healing. Most patients return to desk-based work within five to seven days, resume light activity at two weeks, and are cleared for full exercise — including chest-focused workouts — at approximately six weeks. The final shape continues to refine as implants settle into their pockets over three to six months in a process often described as “drop and fluff.”

Frequently Asked Questions About Breast Augmentation

How do I choose the right implant size?

Size is highly personal and depends on your frame, existing tissue, lifestyle, and aesthetic goals. Dr. Anastasatos has patients try on different sizes during pre-operative visits, so the final choice reflects your preference rather than a number on a chart.

Saline, silicone, or polyurethane — which should I choose?

Each has distinct characteristics. Saline offers smaller incisions and simpler monitoring. Silicone gel offers a more natural feel. Polyurethane-coated implants — available at the Athens practice — have specific shell characteristics not available in the U.S. Dr. Anastasatos reviews the properties of each during consultation based on your anatomy and priorities.

Will my scars be visible?

Incision placement determines scar visibility. TUBA and endoscopic approaches leave no scars on the breasts. Inframammary and peri-areolar incisions place scars in naturally concealed locations. All scars fade significantly over twelve to eighteen months with proper care.

Can I breastfeed after breast augmentation?

Many patients retain the ability to breastfeed after augmentation, particularly with techniques that preserve the nipple-gland connection. If future breastfeeding is a priority, this is factored into incision and placement decisions during consultation.

How long do breast implants last?

Modern implants are durable, but they are not considered lifetime devices. Many patients keep their original implants for ten to fifteen years or longer without issue. Replacement or revision may eventually be appropriate, and regular monitoring is part of long-term care.

Will I need a breast lift at the same time?

If your breasts already have significant sagging (ptosis), augmentation alone will not lift them — a combined breast lift with implants is often more appropriate. Dr. Anastasatos evaluates both the volume question and the position question during consultation.

Why Choose Dr. Anastasatos for Breast Augmentation

• Endoscopic Breast Surgery Authority: Plenary lecturer on endoscopic breast surgery at the Pan-Hellenic Congress — a specific credential for the minimally invasive technique offered at the Athens practice.
• Board-Certified and FACS: Certification by the American Board of Plastic Surgery and Fellowship in the American College of Surgeons reflect rigorous, verified training.
• Patient-Driven Size Selection: Patients try on different sizes during pre-operative visits; Dr. Anastasatos believes the patient selects her implant, not the surgeon.
• Full Spectrum of Implants and Techniques: Saline, silicone, and polyurethane options combined with TUBA, endoscopic, inframammary, and peri-areolar approaches — all tailored to individual anatomy.
• Top 10 International Recognition: Named by The Luxe Insider as one of the Top 10 Plastic Surgeons in the World with Los Angeles Plastic Surgery honored among the Top 10 Cosmetic Clinics globally.
• International Referral Practice: Offices in Beverly Hills and Athens serve patients from across Europe, the Middle East, and the United States with coordinated care throughout the journey.

Schedule Your Breast Augmentation Consultation in Athens, Greece or Beverly Hills

Having a highly qualified plastic surgeon who specializes in breast augmentation can make a significant difference in the results. If you are considering breast implants, a breast lift or even a reduction, contact the clinic of Dr. John Anastasatos in Athens, Greece, or Beverly Hills, CA, to schedule a consultation.

Dr. John Anastasatos serves patients from all over the world at his Athens office including: