In this interview, we speak with Dr. Ergin Er about modern aesthetic surgery and the key aspects of breast augmentation. The discussion covers implant selection, surgical techniques for placement, as well as potential risks and long-term outcomes. Special attention is given to the methods currently used in breast surgery and the factors that influence patient safety and recovery.
Dr. Ergin Er is a plastic, reconstructive, and aesthetic surgeon with more than 30 years of experience, practicing in Istanbul. Throughout his career, he has performed over 10,000 aesthetic procedures and has received national and international scientific awards. His main areas of expertise include rhinoplasty, breast augmentation, liposuction, and facial rejuvenation. In his work, Dr. Er focuses on precision, safety, and achieving natural and harmonious results for each patient.
The interview was prepared by Maria Chabdaeva, Director of the international company Beauty by Experts Medical, which assists patients in receiving treatment from leading plastic surgery specialists.
- Good morning, Dr. Ergin Er. Thank you very much for meeting with us today, for your long-term cooperation, and for all our happy patients.
Good morning. Thank you.
- Could you please tell us more about yourself? What do you do in your medical practice, and what types of surgeries do you perform?
I received my medical education in Ankara, and then completed my residency at a military medical academy. During this period, I performed many reconstructive and aesthetic surgeries. After finishing my residency, I spent one year in the United States for a postdoctoral research and clinical fellowship to further improve my skills in aesthetic and plastic surgery. For the past 23 years, I have been working in private practice, mainly in aesthetic surgery.
- What kind of residency did you do in the United States?
It was not a residency. I had already completed my residency earlier. In the United States, I completed a postdoctoral fellowship focused on research in reconstructive and aesthetic surgery. I also attended specialized courses in aesthetic surgery and learned techniques in breast augmentation, liposuction, and rhinoplasty from American surgeons. I observed surgeries and participated in some of them. This significantly improved my skills. As I mentioned, I have 23 years of experience in aesthetic surgery.
- Which surgeries do you enjoy performing?
My specialization is aesthetic surgery, so it is difficult to say that I prefer specific procedures. If I had to mention the most common ones, they are breast augmentation and rhinoplasty, as these are the most in-demand procedures. I also perform facial surgeries such as facelift and neck lift, but these are less frequent. Most patients come for nose correction or breast augmentation.
- Regarding breast augmentation, which implants do you use?
There are two main implant brands in the world that are considered safe. We only work with well-tested and reliable implants. I mainly use Mentor, one of the oldest and most well-known brands. We also use Motiva implants. These are the two brands I work with. In terms of shape, I prefer round implants.
- Why do you prefer round implants?
Because anatomical or teardrop-shaped implants are associated with a risk of complications. They can be placed above or below the muscle, and they may shift over time, which is normal. However, if a teardrop implant rotates, it causes breast deformation that needs correction. When they first appeared, they were considered more natural, but this is not always true. In my practice, teardrop implants are used in about 5% of patients, while 95% choose round implants because they are safer. Due to gravity, a round implant naturally takes on a teardrop-like shape over time and always looks natural.
- Do you use B-Lite implants?
B-Lite? What is that?
- They are lightweight implants from a German brand.
We do not have these implants in our market, so I have no experience with them.
- What is the maximum implant size you use?
The larger the implant, the higher the risk of complications in the future. Large implants are not always the best option, but in some cases patients do require a larger volume.
We evaluate chest dimensions and breast anatomy. Within these limits, we choose implants according to the patient’s wishes, aiming for the largest safe size. When a large implant is used, it is placed under the muscle for a more natural result.
It is also important to inform patients that a large implant means more weight and long-term considerations. In my practice, I have placed a 1050 ml implant, which is one of the largest in the world. This was a patient who previously had 800 ml implants and requested an increase to 1050 ml. It was her conscious decision.
- What breast size does that correspond to?
Very large. It is hard to believe, but it is truly a very large breast size. Personally, I prefer implants between 300 and 350 ml, which provide a sufficient volume. In that case, the breast looks very natural, and the risk of future complications is minimal.
- You mentioned that implants can sag. How often does this happen, and what can be done in such cases?
If this happens, the only solution is to replace the implant and perform a breast lift to reposition the breast.
- So it is not possible to do a small lift without replacing the implant to raise the breast?
There is no such thing as a small lift. A breast lift involves at least a vertical incision, and sometimes an additional horizontal one. For a long-lasting result, it is important to remove skin flaps of about 5–6 cm, since the breast naturally loses some firmness over time.
- If we perform a lift, do we need to change the implant?
Yes. During a breast lift, we usually replace the old implant with a smaller one, because some skin and tissue are removed to reshape and lift the breast. Therefore, the implant is typically reduced by 1–2 sizes.
- In what percentage of cases does this happen?
In my practice, it has been no more than 2%, although I have seen such cases with other surgeons. It is a manageable situation — everything can be corrected and improved. The only downside is that additional scars remain on the breast.
- Patients sometimes request nipple correction. Do you reduce nipples?
There is a common misconception here. The nipple and the areola are different structures.
- The areola is the brown area around the nipple?
Yes. During breast lift or reduction, we also reduce the areola. We follow an aesthetic standard: the ideal areola diameter is about 4.2 cm. During surgery, we adjust it to this size.
- Is areola reduction a difficult procedure?
No, it is not a complex procedure. However, over time, the areola may slightly stretch again and return closer to its previous size within 6–12 months.
- How do you place breast implants?
That is a very good question. Many patients rely on online information and say: “It is better to place the implant under the muscle so it won’t sag.” But this is not entirely correct.
- What is the correct approach?
Traditionally, implants are placed under the breast tissue. Placing them under the muscle is not fully natural because an additional pocket is created.
We use submuscular placement only in patients with very little natural breast tissue. In this case, the implant is not completely under the muscle — the upper part is covered by the muscle, while the lower part remains under the breast tissue.
- How does this mechanism work?
The muscle is relatively small and covers only the upper part of the implant, which helps create a more natural look in patients with small breasts. That is why this technique is used only in selected cases.
- Are there any risks of placing the implant under the muscle?
Yes. After several years, especially in cases of weight changes or after pregnancy, breast deformation may occur. In some cases, a so-called “double-bubble effect” or “waterfall effect” develops, when the breast tissue descends in front of the implant. This happens rarely, but the result looks unnatural.
- Where is the incision made during implant placement?
First, the incision can be made around the areola. However, there is an important risk here: most breast implant patients are young women who may still plan pregnancy and breastfeeding in the future. If the incision is made through the areola area, there is a risk of damaging the milk ducts, which can interfere with breastfeeding later.
Secondly, breast tissue itself is considered to naturally contain bacteria. This is not dangerous for health, but when an incision is made through the breast tissue, there is a risk of micro-contamination around the implant, which may lead to capsular contracture.
To reduce these risks, I place the implant through a small 3–4 cm incision in the inframammary fold. It heals on its own and becomes almost invisible after about a year.
- What recommendations do you give patients after surgery?
The most important thing is to monitor the condition of the breasts, as there is a risk of capsular contracture after implant placement.
This risk depends mainly on the patient’s individual body response rather than the implant type or the surgeon’s experience. Patients are advised to regularly check their breasts by touch several times a week — they should remain soft and symmetrical. If one breast becomes firmer, gentle massage should be started immediately to prevent progression. Otherwise, revision surgery may be required. This is the most common complication, but it is rare and always treatable.
- How long should compression garments be worn?
After surgery, a special supportive bra must be worn. It is essentially similar to a sports bra.
It should not cause friction under the breast and must provide proper support. It is usually worn for about two months. After that, patients can return to normal clothing or stop wearing a bra if they wish.
- Does compression underwear cause discomfort?
No, it is simply a comfortable supportive bra. The only exception is when the implant is placed under the muscle, in which case a model with an additional strap is used to stabilize the implant. It may be slightly less comfortable, but it is worn for only about one month.
- When can surgery be performed after breastfeeding?
After breastfeeding, it is recommended to wait at least 9 months. During this period, residual milk may still be present, which increases the risk of infection during surgery. After this period, surgery can be performed safely.
- When can pregnancy be planned after surgery?
Approximately 3 months after the operation.
- Does breast sensitivity decrease after surgery?
This happens very rarely — in less than 1% of cases. In my practice, I have seen only one such case, and even then the loss of sensitivity was partial. Most often it is temporary, and sensitivity returns within a few months.
- Does sensitivity differ depending on implant placement (under muscle or under tissue)?
If the patient has sufficient natural breast tissue, the implant is not felt on touch — you only feel the breast itself. If there is less tissue, the implant is partially placed under the muscle, but the lower part is still covered by breast tissue.
Modern implants feel very close to natural tissue, so the difference is almost unnoticeable on palpation. There is no reason for concern.
- Do breast implants have a lifespan?
Modern implants come with a warranty of about 10 years. After this period, patients are advised to undergo an examination — ultrasound or MRI — to ensure the implant is in good condition. If there are no issues, it can remain in place. If damage is suspected, replacement is recommended.
- Are benign breast lesions a contraindication for surgery?
No, this is not a contraindication. Whether the implant is placed under or over the muscle, breast tissue is not removed. Therefore, the procedure remains safe. Moreover, 60–70% of women have small cysts, which is considered normal.
- How many breast augmentation surgeries do you perform per year?
Approximately 20–25 operations per month, which is around 300–400 implant surgeries per year.
- Thank you very much.
You are welcome, it was a pleasure talking to you.
How to travel to Turkey for breast augmentation with Dr. Ergin Er?
Breast augmentation with Dr. Ergin Er is performed with a focus on natural results, safety, and individualized implant selection based on the patient’s anatomy and preferences. The doctor pays special attention to body proportions and the long-term stability of the outcome.
Beauty by Experts Medical works only with certified clinics and leading surgeons in Turkey, ensuring a high standard of medical care for patients. Each clinic is carefully evaluated, and the choice of surgeon is made individually according to the patient’s specific needs.
To organize a trip for breast augmentation in Turkey with Dr. Ergin Er, it is enough to contact Beauty by Experts Medical. Coordinators will assist at every stage — from consultation and implant selection to travel arrangements, accommodation, and postoperative care.
