Breast Implants: Choosing Size, Shape, Profile and Placement
A Thai Board-certified surgeon explains how implant size, profile, surface and placement are really chosen — and what the price gap between brands buys.
By Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689
Last reviewed: 26 AUG 2026
You have probably already picked a number. Somewhere between the forums, the Instagram saves and a friend's result you admired, a figure like 350cc has lodged in your head, and you are now looking for a surgeon who will agree to it. I want to talk you out of that way of thinking before you get on a plane — not because your number is necessarily wrong, but because it is the wrong place to start.
I have been placing breast implants for over two decades at Intrarat Hospital in Bangkok, a large proportion of them in Australian and New Zealand patients. The consultations that go well begin with a tape measure and a pinch test, not a volume. The ones that go badly begin with a number the patient will not let go of. This article is the conversation I would have with you across the desk, including the parts that do not help me sell surgery.
Why your chest decides the base width before you do
Every implant has two defining dimensions: its base width — the diameter of its footprint on your chest — and its projection — how far it stands forward off the chest wall. Volume in cubic centimetres is simply what you get when you combine the two.
Here is the concept that clarifies almost every sizing decision: your base width is essentially fixed, and projection is the free variable. Your breast has a natural footprint, measured from its inner border to the anterior axillary line. An implant meaningfully wider than that footprint has nowhere legitimate to sit. Push past it and the implant drifts into the armpit, blunts your cleavage line, or produces the shelf-like upper pole that reads as "operated" from across a room. An implant much narrower than your footprint leaves the outer breast empty and the implant visible as a mound within a breast rather than a breast.
So when I measure a base width of, say, 12 centimetres, I am not restricting your choices — I am telling you which family of implants fits your skeleton. Within that family, projection is where your preference genuinely operates: a low-profile implant of that width might be 260cc and look like a subtle fullness; a high-profile implant of the same width might be 400cc and look emphatically augmented. Same footprint, very different result. That is the honest sense in which you choose your size.
What "profile" actually changes
Profile is simply the ratio of projection to base width. Manufacturers name the steps differently — moderate, moderate-plus, high, extra-high; Motiva uses "mini" through "corse" — but the principle is constant: as profile rises, the implant projects further forward from the same footprint.
Higher profile is not "better" and is not simply "bigger". On a broad chest, a high-profile implant can look narrow and bolted-on. On a petite frame with a narrow base width, high profile is often the only way to achieve meaningful volume without violating the footprint. The right profile is the one that delivers the look you have described within the width your chest dictates — which is why I ask patients to bring photographs of results they like on bodies shaped like theirs, not on bodies they wish they had.
Tissue-based planning versus "my friend got 350cc"
Your friend's 350cc sits on your friend's base width, under your friend's skin thickness, over your friend's chest wall shape. On you, the same implant can look smaller, larger, wider or frankly wrong. Chest wall curvature alone changes apparent projection: an implant on a convex chest throws forward; the same implant in a slightly sunken chest partially disappears.
Tissue-based planning works the other way around. I measure:
Base width of the existing breast, which sets the implant width range
Soft-tissue pinch thickness at the upper pole and lower pole, which tells me how much cover your tissue can provide
Skin stretch and nipple-to-fold distance, which tell me how much the envelope can accept and whether you need a lift rather than, or as well as, an implant
Existing asymmetry — almost every patient has some, and an implant magnifies whatever it sits behind
From those numbers comes a narrow range of implants that will fit you, and within that range we discuss taste. Patients sometimes hear this as the surgeon overriding their wishes. It is the opposite: it is the method most likely to produce the result you actually pictured, and it is the method most likely to still look right in ten years, because implants chosen beyond the tissue's capacity are the ones that thin the skin, drop, and ripple.
Smooth or textured — and what BIA-ALCL changed
Texturing was developed to help implants adhere to tissue and to reduce rotation of teardrop-shaped implants. Then came breast implant-associated anaplastic large cell lymphoma (BIA-ALCL), an uncommon cancer of the immune system that develops in the fluid and capsule around an implant, typically years after surgery, most often announcing itself as a sudden swelling of one breast.
The evidence is now consistent on the central point: BIA-ALCL is overwhelmingly a disease of textured implants, particularly the high-surface-area macrotextured types, and to date no confirmed case has involved a woman exposed only to smooth implants. Risk estimates from confirmed cases and sales data give a lifetime risk between roughly 1 in 2,200 and 1 in 86,000 for textured implants, and Australian and New Zealand data — which are among the best in the world on this disease — put the risk for the highest-surface-area textured implants at approximately 1 in 2,800 to 1 in 7,000, versus about 1 in 35,000 for lower-surface-area textured surfaces. In 2019 Australia's TGA removed a number of macrotextured and polyurethane implant models from the market. Importantly, regulators and surgical societies on both sides of the ditch agree that women with textured implants and no symptoms do not need them removed; the absolute risk remains low and surgery has risks of its own.
In my practice the practical consequence is simple: for routine cosmetic augmentation I now use smooth or nanotextured-surface round implants. The Mentor and Motiva devices I offer both sit at the smooth end of the surface classifications regulators use. When a patient asks me for a macrotextured anatomical implant because a website from 2015 recommended one, I explain why I will not.
Over the muscle, under it, or dual plane?
Placement is decided mainly by two findings: your upper-pole pinch thickness and your degree of ptosis (droop).
If I can pinch more than about two centimetres of soft tissue at your upper pole, you have enough natural cover for the implant to sit in front of the muscle (subglandular) without visible edges or rippling. If you are lean — and many of the Australian patients I see are — that cover does not exist, and the implant belongs at least partly under the pectoralis major muscle, which adds a layer of padding exactly where the implant would otherwise show.
Dual plane splits the difference: the upper implant sits under muscle for cover, while the lower pole is released so the implant can expand the lower breast directly. It is my usual choice for lean patients and for those with mild ptosis or a slightly deflated lower pole after breastfeeding, because it lets the implant fill the loose lower envelope while keeping the upper edge concealed. Full submuscular placement gives maximal cover but can produce animation deformity — visible distortion when the pectoral muscle fires — which matters to women who lift weights seriously.
Which incision, and what each trades away
IncisionWhere the scar sitsAdvantagesTrade-offsInframammary (under the fold)In the crease under the breastBest visibility and control; lowest reported contracture and reoperation rates; my defaultScar on the breast itself, though hidden in the foldPeriareolar (around the nipple)Lower border of the areolaScar at a colour transition; useful when a small lift is combinedPasses through duct tissue — higher bacterial exposure, linked to higher capsular contracture rates; possible nipple sensation changeTransaxillary (armpit)In the axillary creaseNo scar on the breastLongest instrument path; less precise pocket control; harder revision
I use the inframammary incision for the large majority of augmentations because the evidence and my own revision workload both point the same way: the shortest, cleanest path to the pocket produces the fewest problems later.
What the Mentor–Motiva price gap actually buys
Patients see the price list and reasonably ask what an extra two thousand dollars purchases. Indicative prices in my practice, confirmed at booking:
ImplantIndicative price (AUD / THB)Round Gel (Mentor)A$5,500 / ฿125,000Silk Surface Plus (Motiva)A$6,400 / ฿145,000Round Ergonomix (Motiva)A$7,300 / ฿166,000Ergonomix V.2 (Motiva)A$10,900 / ฿250,000
Mentor's round gel is a thoroughly proven device from one of the two longest-studied manufacturers, with decades of core-study data behind it. It holds its round shape in all positions. Motiva's Ergonomix range uses a softer, more mobile gel designed to behave differently with gravity — rounder lying down, more teardrop standing — with a nanotextured surface and, in the V.2, further refinements to the gel and shell.
Here is the honest version: the price gap buys you a more naturally mobile gel and a more recently engineered surface. It does not buy you immunity from capsular contracture, rupture, malposition or reoperation, and it does not buy a visibly different result in every patient. In a woman with generous natural tissue cover choosing modest volumes, the Mentor implant is often the better clinical choice — her own tissue will dominate how the breast moves and feels, and the extra spend changes little. The Ergonomix earns its price mainly in lean patients with thin cover, where the implant itself contributes most of the breast's movement and feel, and in patients who strongly prioritise a soft, gravity-responsive look. I tell patients which category they fall into; I do not upsell the dearer device to someone whose tissues will hide the difference.
Implants are not lifetime devices
The US FDA's wording is the one I quote because it is blunt and correct: breast implants are not lifetime devices, and the longer you have them, the more likely you are to develop complications, some of which will need further surgery. Rupture, capsular contracture, malposition and simple changes in your own body — pregnancy, weight change, ageing — mean that a proportion of augmented women will face revision surgery at some point. There is no fixed replacement schedule; an intact, comfortable implant does not need swapping at year ten. But if you are twenty-eight and considering augmentation, you should budget — financially and emotionally — for at least one further operation in your lifetime. Any clinic that leaves this out of the consultation is not consulting; it is selling. The risks I go through with every augmentation patient include haematoma, seroma, infection, wound-healing problems, altered nipple sensation, asymmetry, rippling, capsular contracture, rupture, BIA-ALCL, anaesthetic risks, venous thromboembolism — and the result that is technically satisfactory but emotionally disappointing, which is real and deserves naming.
When to seek care
In Bangkok, in the first two weeks: a breast that becomes rapidly swollen, tight and much more painful than the other — especially within the first 48 hours — may be a haematoma and needs review the same day; contact me, do not wait for your scheduled appointment. Fever above 38°C, spreading redness, or discharge from the incision needs same-day review. Calf pain or swelling in one leg, breathlessness, or chest pain are emergencies — in any country, go directly to an emergency department, and on a plane, tell the crew.
Back home in Australia or New Zealand: sudden swelling of one breast months or years after surgery is not an emergency, but it is never something to ignore — it needs an ultrasound and, if fluid is found, aspiration with the fluid tested for BIA-ALCL. See your GP promptly and tell them you have implants, which brand, and which surface. New hardness, distortion or pain in a previously soft breast warrants specialist review within weeks. Remember that Medicare does not cover treatment overseas and your private insurer is unlikely to cover complications from surgery performed abroad — factor that into your planning, not into your delay in seeking care.
Questions worth asking any surgeon, including me
Ask what your base width is and how it constrained the recommendation. Ask why this profile and not one step lower. Ask which surface the implant has and how the surgeon responded to the BIA-ALCL evidence. Ask what the revision rate is for the operation proposed, and what a revision would cost you, in which country. A surgeon who answers those four questions specifically, with numbers where numbers exist and honesty where they do not, is telling you something more important than any before-and-after gallery ever could.
Dr. Rushapol Sdawat (known to international patients as Dr. Dominic) is a Thai Board-certified plastic and reconstructive surgeon practising at Intrarat Hospital, Bangkok, Medical Licence No. 17689. He holds Thai Board certification in General Surgery (Phramongkutklao Hospital) and in Plastic and Reconstructive Surgery (Ramathibodi Hospital, Mahidol University), has been a member of ISAPS since 2008 and is an international member of the American Society of Plastic Surgeons. Dr. Rushapol holds Thai specialist certification; he is not registered with Ahpra and does not hold Australian or New Zealand specialist registration. His registration can be verified on the Medical Council of Thailand register at checkmd.tmc.or.th.
This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.
Breast Augmentation and Lift Cost in Thailand: An AUD Price Guide
Real AUD and THB prices by implant brand and generation from a Bangkok plastic surgeon, with Australian comparisons and the reoperation cost nobody quotes.
By the MedSanctuary Team
Medically reviewed by Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689 · Last reviewed: 28 / AUG / 2026
You have worked out by now that "breast augmentation" is not one price, because you have seen four quotes with four different numbers and none of them told you which implant they included. You have probably also worked out that the implant names — Mentor, Motiva, SilkSurface, Ergonomix — are being used as tiers on a price list without anyone explaining what moves between them.
I want to fix that. Below are our real prices in baht and Australian dollars, what actually differs between the implant tiers, and — the part that matters more — when the cheapest implant on our list is the better clinical choice for a particular patient. It often is.
I also want to put something at the front rather than bury it. The United States Food and Drug Administration's position is unambiguous: "Breast implants are not lifetime devices. The longer a woman has implants, the more likely it is that she will need to have surgery to remove or replace them." Whatever you pay today, you are very likely buying at least one more operation over the following decades. Budget for the device, and budget for the fact that it is not permanent.
What we charge, by implant tier
Procedure and implantTHBAUD (indicative)Breast augmentation, round gel implants (Mentor)฿125,000A$5,500Breast augmentation, Silk Surface Plus (Motiva)฿145,000A$6,400Breast augmentation, Round Ergonomix (Motiva)฿166,000A$7,300Breast augmentation, Ergonomix V.2฿250,000A$10,900Breast lift with implants (3rd degree ptosis)฿240,000A$10,500Breast reduction฿220,000–310,000A$9,600–13,500
AUD figures are indicative, converted from Thai baht at approximately 23 THB/AUD, and confirmed at booking. The baht figure is the contracted one, and the implied rate is not identical across every line, so please do not apply a single conversion formula yourself.
Each price includes airport transfer, a pre-operative health check, anaesthesia, surgery at Intrarat Hospital (ISO 9001:2015 certified — it is not JCI-accredited and we do not say it is), monitoring in ICU on the first night, a serviced apartment, take-home medications, IV therapy, red light therapy, lymphatic massage and coordinator support. It excludes airfares, a support person, food, insurance, lost income and any follow-up in Australia. A revision case originating from another hospital is priced at base plus 30%.
What actually differs between the tiers
Here is what the manufacturers claim, stated as claims rather than as findings.
Motiva describes its SilkSurface / SmoothSilk shell as "a controlled uniform surface" designed to "mitigate the inflammatory and fibrotic response of your body," "limit bacterial load, reducing the risk of biofilm formation," and "reduce the prevalence of chronic inflammatory complications." Ergonomix uses a more viscoelastic gel which Motiva says allows the implant to "hold a round shape when the patient is lying down and form a natural looking teardrop shape when she is standing." Ergonomix2 is described as softer again, with greater elongation and higher compressibility, "facilitating the insertion of the device through smaller incisions."
Mentor's round gel implants are a long-established device from a major manufacturer with a substantial published clinical record accumulated over decades.
Now the honest part. Newer generations of implant are newer. That is the whole of their disadvantage and it is not a small one: the comparative long-term data — capsular contracture rates at fifteen years, rupture rates at twenty — necessarily favours the devices that have been in patients longest, because those are the only ones with fifteen and twenty year data. A softer gel and a refined shell are plausible improvements. They are not yet improvements demonstrated over the timeframe you will be living with the device.
So the tiers are not a quality ladder from bad to good. They are a set of trade-offs.
When the cheapest implant on our list is the right choice
I put a Mentor round gel implant in patients where it is the better answer, and it is the better answer more often than the pricing implies. Specifically:
Where you have generous native breast tissue. A well-covered implant is not palpable and its gel cohesivity contributes little to the visible result. You are paying for a property you will not be able to detect.
Where you are having a submuscular placement with good soft tissue cover and the muscle, not the gel, determines the upper pole shape.
Where budget matters and the difference would come out of your contingency fund. An extra A$1,800 spent on a shell technology, taken from the money that would have paid for an extra week in Bangkok if your wound is slow to seal, is a bad trade. I will say so.
Where you want the device with the longest track record and are willing to forgo newer features to get it. That is a defensible, informed preference and I have never argued a patient out of it.
Where I do lean towards the Motiva devices: thin soft tissue cover, a subglandular or dual-plane placement where the implant edge risks being visible or palpable, a patient with a strong preference for a more mobile, tissue-like feel, and revision cases where the capsule and soft tissue are already compromised.
None of that is a guarantee about your result. Implant choice influences feel and edge visibility. Your existing tissue, your chest wall shape, your skin quality and how you heal will do more to determine what you see in the mirror than the brand will.
Lift, lift with implants, and reduction are different operations
A great many people searching for "augmentation" actually need a mastopexy — a lift. If the nipple sits at or below the inframammary fold, an implant alone will not raise it; it will produce a larger breast with the same descent, and often a worse shape. The lift is a skin and parenchymal rearrangement with a permanent scar around the areola, usually vertically down to the fold, and often horizontally along it. Our breast lift with implants for third-degree ptosis is ฿240,000 / A$10,500.
Breast reduction (฿220,000–310,000 / A$9,600–13,500) is a functional operation dressed as a cosmetic one, and it is the operation in this article most likely to be better done at home. More on that below.
What Australian specialist plastic surgeons publish
ProcedureDr Scott J Turner, Sydney (all-inclusive)Plastic Surgery Hub (national)Dr Ellis Choy, SydneyBreast augmentationfrom A$11,000A$6,000–12,000A$9,000–15,000Breast lift (mastopexy)from A$13,950A$11,990–15,700—Breast lift with implantsA$24,900–25,750A$12,000–18,000—Breast reductionA$18,600–23,250A$10,000–30,000—Hybrid (implant plus fat)A$15,600–16,450—A$14,000–25,000
Dr Turner charges A$450 per consultation and requires two; Dr Choy lists A$350. Plastic Surgery Hub breaks its augmentation range into surgeon's fees of A$3,500–6,000, anaesthetist's fees of A$1,000–2,000 and hospital fees of A$1,500–4,000 — useful, because it shows you how much of an Australian quote is not the surgeon.
The candour passage: breast reduction, and why you may want it done in Australia
Breast reduction in Australia may attract MBS item 45523 — "reduction mammaplasty (bilateral) with surgical repositioning of the nipple" — where you have macromastia and documented neck or shoulder pain with evidence of attempted conservative management. Implants cannot be inserted in the same operation and still qualify. [CONFIRM: current MBS 45523 schedule fee and 75% benefit amount]; Dr Turner's practice describes the rebate as "just over $1,000" and, more importantly, states that item eligibility combined with private health cover can "reduce total out-of-pocket cost by $5,000 or more" by bringing hospital and anaesthetic fees under your fund.
If that describes you — and if you have private cover with the relevant hospital tier and have served your waiting period — you should be assessed in Australia before you consider coming here. Medicare does not cover overseas treatment, Australia has no reciprocal health agreement with Thailand, and your fund is generally unlikely to cover a procedure performed overseas. Travelling forfeits an entitlement you have already paid for, and you would be swapping a surgeon in your own city for one nine hours away.
I am aware of what that paragraph costs me. I would rather write it than have you find out afterwards.
Implants are not lifetime devices, and that is a future cost
The FDA lists capsular contracture, reoperation, and implant removal with or without replacement as the most frequent complications of breast implants. Reoperation is on that list not as a rare disaster but as an expected event over a long enough horizon.
Practically: assume that at some point you will need imaging surveillance, and that at some point — years or decades out — you may need an exchange or an explantation. Price that into the decision now. If a second operation in fifteen years would be financially impossible for you, that is a genuine reason to think harder about having the first one.
BIA-ALCL, texture, and what is actually known
Breast implant-associated anaplastic large cell lymphoma is a rare lymphoma of the capsule around an implant, not a breast cancer. Australian public health information states that people with highly textured implants "seem to be at the greatest risk (between 1 in 2,500 and 1 in 25,000)" and that "this risk significantly decreases with a decrease in texturing of the implant." Nearly all diagnoses are made between three and fourteen years after surgery, with an average of around eight years.
What that means for you: the surface of the device you receive is a legitimate question to ask your surgeon, and you should ask it and get a specific answer, not a reassurance. It also means late-onset swelling of one breast years after your surgery is never something to ignore.
The complications I discuss with every augmentation patient
Bleeding and haematoma requiring a return to theatre. Infection, which in an implant patient can mean removal of the device. Capsular contracture — the scar shell tightening around the implant, causing firmness, distortion and pain — which can occur at any time and can recur after correction. Rupture, silent in silicone implants and typically found on imaging. Rippling and palpable edges, particularly with thin tissue cover. Loss or alteration of nipple sensation, sometimes permanent. Asymmetry, which is universal to some degree because you were asymmetric before surgery. Malposition, bottoming out, and implant descent over years. Scarring that is hypertrophic or keloid. Interference with breastfeeding, and altered mammographic imaging requiring additional views. Venous thromboembolism.
And the one that is rarely listed: a result that is technically correct and emotionally disappointing. It happens, it is not a failure of character, and it is worth raising before surgery rather than after.
When to seek care
Emergency — nearest emergency department immediately, in Bangkok or Australia, without waiting for a reply from anyone. Sudden breathlessness, chest pain, coughing blood, or a hot, swollen, painful calf — signs of venous thromboembolism, which can occur days to weeks after surgery, including in flight and after you land. Tell the cabin crew if you are airborne. Also: one breast rapidly enlarging, becoming tense, hard and painful within hours, which suggests haematoma; fever above 38.5°C with rigors; or skin over the breast turning dusky, grey or black.
Same-day review. Escalating pain after day three; spreading redness over the breast; a wound edge separating or discharging pus; the nipple turning white, blue or black; fever; or a sudden change in the shape or position of one implant.
Next available appointment, wherever you are. Firmness developing over weeks to months, which may be capsular contracture; rippling or a palpable edge; asymmetry that is not settling; persistent altered sensation; a lump in a scar.
Years later, and this one matters. New swelling of one breast, a lump, or a fluid collection appearing months or years after your surgery should be assessed promptly by a doctor who knows you have implants. Tell them the brand, the surface and the date. Keep your implant card.
How to read an implant quote
Ask which device, in writing: manufacturer, product line, surface, volume and projection. Ask for the implant card and the lot numbers at discharge, and keep them somewhere you will still have them in fifteen years. Ask what the price includes and what it excludes. Ask who administers your anaesthetic, and ask what happens if you need a reoperation after you have flown home, including who pays.
And ask the surgeon to tell you what they think you actually need, before you tell them what you want. If the answer is a lift rather than an implant, or a smaller implant than you had in mind, or nothing at all this year, that answer is worth more than the price difference between any two devices on the list above.
Dr. Rushapol Sdawat (known to international patients as Dr. Dominic) is a Thai Board-certified plastic and reconstructive surgeon practising at Intrarat Hospital, Bangkok, Medical Licence No. 17689. He holds Thai Board certification in General Surgery (Phramongkutklao Hospital) and in Plastic and Reconstructive Surgery (Ramathibodi Hospital, Mahidol University), has been a member of ISAPS since 2008 and is an international member of the American Society of Plastic Surgeons. Dr. Rushapol holds Thai specialist certification; he is not registered with Ahpra and does not hold Australian or New Zealand specialist registration. His registration can be verified on the Medical Council of Thailand register at checkmd.tmc.or.th.
This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.
Breast Augmentation and Lift Cost in Thailand: An AUD Price Guide
Real AUD and THB prices by implant brand and generation from a Bangkok plastic surgeon, with Australian comparisons and the reoperation cost nobody quotes.
By the MedSanctuary Team
Medically reviewed by Dr. Rushapol Sdawat, MD — Thai Board-certified Plastic and Reconstructive Surgeon, Medical Licence No. 17689 · Last reviewed: [SET DATE ON PUBLISH]
You have worked out by now that "breast augmentation" is not one price, because you have seen four quotes with four different numbers and none of them told you which implant they included. You have probably also worked out that the implant names — Mentor, Motiva, SilkSurface, Ergonomix — are being used as tiers on a price list without anyone explaining what moves between them.
I want to fix that. Below are our real prices in baht and Australian dollars, what actually differs between the implant tiers, and — the part that matters more — when the cheapest implant on our list is the better clinical choice for a particular patient. It often is.
I also want to put something at the front rather than bury it. The United States Food and Drug Administration's position is unambiguous: "Breast implants are not lifetime devices. The longer a woman has implants, the more likely it is that she will need to have surgery to remove or replace them." Whatever you pay today, you are very likely buying at least one more operation over the following decades. Budget for the device, and budget for the fact that it is not permanent.
What we charge, by implant tier
| Procedure and implant | THB | AUD (indicative) |
|---|---|---|
| Breast augmentation, round gel implants (Mentor) | ฿125,000 | A$5,500 |
| Breast augmentation, Silk Surface Plus (Motiva) | ฿145,000 | A$6,400 |
| Breast augmentation, Round Ergonomix (Motiva) | ฿166,000 | A$7,300 |
| Breast augmentation, Ergonomix V.2 | ฿250,000 | A$10,900 |
| Breast lift with implants (3rd degree ptosis) | ฿240,000 | A$10,500 |
| Breast reduction | ฿220,000–310,000 | A$9,600–13,500 |
AUD figures are indicative, converted from Thai baht at approximately 23 THB/AUD, and confirmed at booking. The baht figure is the contracted one, and the implied rate is not identical across every line, so please do not apply a single conversion formula yourself.
Each price includes airport transfer, a pre-operative health check, anaesthesia, surgery at Intrarat Hospital (ISO 9001:2015 certified — it is not JCI-accredited and we do not say it is), monitoring in ICU on the first night, a serviced apartment, take-home medications, IV therapy, red light therapy, lymphatic massage and coordinator support. It excludes airfares, a support person, food, insurance, lost income and any follow-up in Australia. A revision case originating from another hospital is priced at base plus 30%.
What actually differs between the tiers
Here is what the manufacturers claim, stated as claims rather than as findings.
Motiva describes its SilkSurface / SmoothSilk shell as "a controlled uniform surface" designed to "mitigate the inflammatory and fibrotic response of your body," "limit bacterial load, reducing the risk of biofilm formation," and "reduce the prevalence of chronic inflammatory complications." Ergonomix uses a more viscoelastic gel which Motiva says allows the implant to "hold a round shape when the patient is lying down and form a natural looking teardrop shape when she is standing." Ergonomix2 is described as softer again, with greater elongation and higher compressibility, "facilitating the insertion of the device through smaller incisions."
Mentor's round gel implants are a long-established device from a major manufacturer with a substantial published clinical record accumulated over decades.
Now the honest part. Newer generations of implant are newer. That is the whole of their disadvantage and it is not a small one: the comparative long-term data — capsular contracture rates at fifteen years, rupture rates at twenty — necessarily favours the devices that have been in patients longest, because those are the only ones with fifteen and twenty year data. A softer gel and a refined shell are plausible improvements. They are not yet improvements demonstrated over the timeframe you will be living with the device.
So the tiers are not a quality ladder from bad to good. They are a set of trade-offs.
When the cheapest implant on our list is the right choice
I put a Mentor round gel implant in patients where it is the better answer, and it is the better answer more often than the pricing implies. Specifically:
- Where you have generous native breast tissue. A well-covered implant is not palpable and its gel cohesivity contributes little to the visible result. You are paying for a property you will not be able to detect.
- Where you are having a submuscular placement with good soft tissue cover and the muscle, not the gel, determines the upper pole shape.
- Where budget matters and the difference would come out of your contingency fund. An extra A$1,800 spent on a shell technology, taken from the money that would have paid for an extra week in Bangkok if your wound is slow to seal, is a bad trade. I will say so.
- Where you want the device with the longest track record and are willing to forgo newer features to get it. That is a defensible, informed preference and I have never argued a patient out of it.
Where I do lean towards the Motiva devices: thin soft tissue cover, a subglandular or dual-plane placement where the implant edge risks being visible or palpable, a patient with a strong preference for a more mobile, tissue-like feel, and revision cases where the capsule and soft tissue are already compromised.
None of that is a guarantee about your result. Implant choice influences feel and edge visibility. Your existing tissue, your chest wall shape, your skin quality and how you heal will do more to determine what you see in the mirror than the brand will.
Lift, lift with implants, and reduction are different operations
A great many people searching for "augmentation" actually need a mastopexy — a lift. If the nipple sits at or below the inframammary fold, an implant alone will not raise it; it will produce a larger breast with the same descent, and often a worse shape. The lift is a skin and parenchymal rearrangement with a permanent scar around the areola, usually vertically down to the fold, and often horizontally along it. Our breast lift with implants for third-degree ptosis is ฿240,000 / A$10,500.
Breast reduction (฿220,000–310,000 / A$9,600–13,500) is a functional operation dressed as a cosmetic one, and it is the operation in this article most likely to be better done at home. More on that below.
What Australian specialist plastic surgeons publish
| Procedure | Dr Scott J Turner, Sydney (all-inclusive) | Plastic Surgery Hub (national) | Dr Ellis Choy, Sydney |
|---|---|---|---|
| Breast augmentation | from A$11,000 | A$6,000–12,000 | A$9,000–15,000 |
| Breast lift (mastopexy) | from A$13,950 | A$11,990–15,700 | — |
| Breast lift with implants | A$24,900–25,750 | A$12,000–18,000 | — |
| Breast reduction | A$18,600–23,250 | A$10,000–30,000 | — |
| Hybrid (implant plus fat) | A$15,600–16,450 | — | A$14,000–25,000 |
Dr Turner charges A$450 per consultation and requires two; Dr Choy lists A$350. Plastic Surgery Hub breaks its augmentation range into surgeon's fees of A$3,500–6,000, anaesthetist's fees of A$1,000–2,000 and hospital fees of A$1,500–4,000 — useful, because it shows you how much of an Australian quote is not the surgeon.
The candour passage: breast reduction, and why you may want it done in Australia
Breast reduction in Australia may attract MBS item 45523 — "reduction mammaplasty (bilateral) with surgical repositioning of the nipple" — where you have macromastia and documented neck or shoulder pain with evidence of attempted conservative management. Implants cannot be inserted in the same operation and still qualify. [CONFIRM: current MBS 45523 schedule fee and 75% benefit amount]; Dr Turner's practice describes the rebate as "just over $1,000" and, more importantly, states that item eligibility combined with private health cover can "reduce total out-of-pocket cost by $5,000 or more" by bringing hospital and anaesthetic fees under your fund.
If that describes you — and if you have private cover with the relevant hospital tier and have served your waiting period — you should be assessed in Australia before you consider coming here. Medicare does not cover overseas treatment, Australia has no reciprocal health agreement with Thailand, and your fund is generally unlikely to cover a procedure performed overseas. Travelling forfeits an entitlement you have already paid for, and you would be swapping a surgeon in your own city for one nine hours away.
I am aware of what that paragraph costs me. I would rather write it than have you find out afterwards.
Implants are not lifetime devices, and that is a future cost
The FDA lists capsular contracture, reoperation, and implant removal with or without replacement as the most frequent complications of breast implants. Reoperation is on that list not as a rare disaster but as an expected event over a long enough horizon.
Practically: assume that at some point you will need imaging surveillance, and that at some point — years or decades out — you may need an exchange or an explantation. Price that into the decision now. If a second operation in fifteen years would be financially impossible for you, that is a genuine reason to think harder about having the first one.
BIA-ALCL, texture, and what is actually known
Breast implant-associated anaplastic large cell lymphoma is a rare lymphoma of the capsule around an implant, not a breast cancer. Australian public health information states that people with highly textured implants "seem to be at the greatest risk (between 1 in 2,500 and 1 in 25,000)" and that "this risk significantly decreases with a decrease in texturing of the implant." Nearly all diagnoses are made between three and fourteen years after surgery, with an average of around eight years.
What that means for you: the surface of the device you receive is a legitimate question to ask your surgeon, and you should ask it and get a specific answer, not a reassurance. It also means late-onset swelling of one breast years after your surgery is never something to ignore.
The complications I discuss with every augmentation patient
Bleeding and haematoma requiring a return to theatre. Infection, which in an implant patient can mean removal of the device. Capsular contracture — the scar shell tightening around the implant, causing firmness, distortion and pain — which can occur at any time and can recur after correction. Rupture, silent in silicone implants and typically found on imaging. Rippling and palpable edges, particularly with thin tissue cover. Loss or alteration of nipple sensation, sometimes permanent. Asymmetry, which is universal to some degree because you were asymmetric before surgery. Malposition, bottoming out, and implant descent over years. Scarring that is hypertrophic or keloid. Interference with breastfeeding, and altered mammographic imaging requiring additional views. Venous thromboembolism.
And the one that is rarely listed: a result that is technically correct and emotionally disappointing. It happens, it is not a failure of character, and it is worth raising before surgery rather than after.
When to seek care
Emergency — nearest emergency department immediately, in Bangkok or Australia, without waiting for a reply from anyone. Sudden breathlessness, chest pain, coughing blood, or a hot, swollen, painful calf — signs of venous thromboembolism, which can occur days to weeks after surgery, including in flight and after you land. Tell the cabin crew if you are airborne. Also: one breast rapidly enlarging, becoming tense, hard and painful within hours, which suggests haematoma; fever above 38.5°C with rigors; or skin over the breast turning dusky, grey or black.
Same-day review. Escalating pain after day three; spreading redness over the breast; a wound edge separating or discharging pus; the nipple turning white, blue or black; fever; or a sudden change in the shape or position of one implant.
Next available appointment, wherever you are. Firmness developing over weeks to months, which may be capsular contracture; rippling or a palpable edge; asymmetry that is not settling; persistent altered sensation; a lump in a scar.
Years later, and this one matters. New swelling of one breast, a lump, or a fluid collection appearing months or years after your surgery should be assessed promptly by a doctor who knows you have implants. Tell them the brand, the surface and the date. Keep your implant card.
How to read an implant quote
Ask which device, in writing: manufacturer, product line, surface, volume and projection. Ask for the implant card and the lot numbers at discharge, and keep them somewhere you will still have them in fifteen years. Ask what the price includes and what it excludes. Ask who administers your anaesthetic, and ask what happens if you need a reoperation after you have flown home, including who pays.
And ask the surgeon to tell you what they think you actually need, before you tell them what you want. If the answer is a lift rather than an implant, or a smaller implant than you had in mind, or nothing at all this year, that answer is worth more than the price difference between any two devices on the list above.
Dr. Rushapol Sdawat (known to international patients as Dr. Dominic) is a Thai Board-certified plastic and reconstructive surgeon practising at Intrarat Hospital, Bangkok, Medical Licence No. 17689. He holds Thai Board certification in General Surgery (Phramongkutklao Hospital) and in Plastic and Reconstructive Surgery (Ramathibodi Hospital, Mahidol University), has been a member of ISAPS since 2008 and is an international member of the American Society of Plastic Surgeons. Dr. Rushapol holds Thai specialist certification; he is not registered with Ahpra and does not hold Australian or New Zealand specialist registration. His registration can be verified on the Medical Council of Thailand register at checkmd.tmc.or.th.
This article is provided for general information and education. It is not medical advice and cannot substitute for individual assessment by a qualified practitioner who knows your history. Surgery carries risk, including risk of serious complications and of outcomes that do not meet expectations. Results vary between patients.
