Breast Augmentation with Breast Implants

Breast implants are filled with either Silicone or Saline. Silicone implants are safe and have recently been FDA approved for use in breast augmentations. Silicone IMPLANTS are very popular because it feels more natural than saline implants. The new generation silicone implants are safer and last longer. Dr. Wong uses a full range of breast implants catered to the needs and specific requirements of patients including the MOTIVA and MENTOR range of textured, smooth or nanotextured implants.

Breast augmentation can be done with round or tear shaped implants. The round implants are popular with patients who want more fullness in the upper part of the breast (more fullness in the cleavage or the decolletage area). The tear shape implants, so named because it looks like a tear drop from the sides, are popular for patients who are looking for a more natural looking breast. Because of its shape, more of the implant volume is distributed in the lower part of the breast and less in the upper part, giving a more natural and softer look to the breast.

An incision needs to be made to place the implant under the breast. The incision are carefully designed and precisely made so that they are as inconspicuous as possible, hidden in natural creases of the body so that its visibility is minimized. The incision can be placed in the lower fold of the breast (called the inframammary fold incision), around the nipple (called periaereolar incision) or in the armpit. Each of these incisions has their advantages and disadvantages and the selection of the incision placement is made together with the patient.

The Implant can be place either under the breast or under the chest wall muscle (the pectoralis major). The location in which to site the implant is selected based on the patient’s unique tissue characteristics, the degree of droopiness (if present) of the breast and the amount of breast tissue available to cover the implant. This is because the implant needs to be covered with adequate chest wall and breast soft tissues to feel and look natural. In patients with adequate amount of breast tissues, the implant can be placed under the breast. Called the SUBFASCIAL plane, placement here is also more effective in correcting minor drooping of the breast, gives patients a more natural result and allows the implant to move more naturally with different body postures such as when she is lying down. In patients with very little breast tissues in contrast, the implant may be placed under the pectoralis major, to provide more soft tissues to cover the implant so that the breast will look softer and feel more natural. This is called the SUBMISCULAR plane. The decision as to where to site implant will be made together with the patients at the consultation.

During the consultation, a detailed history will be taken. The patient will be examined to determine her tissue characteristics. The decisions as to the type of implants / brand of implants, shape, placement of the implant as well as the location of the incisions are then made jointly with the patient. To select the size of the implant desired, the patient can try on sizer implants available in the clinic and this important decision made. A second consult can be scheduled if the patient wishes to do so.

Surgery is usually done under general anesthesia. The procedure takes about 1 hour. The incisions are then meticulously closed and a firm dressings applied.

The procedure can be performed as a day surgery procedure for most patients. Of course, if patient wishes, she may stay overnight in the hospital. A tight dressing would be applied to the breast for comfort and this can be removed after 1 day. Gentle range of motion and stretching exercises will be started after the surgery and this speeds recovery and minimizes pain from the procedure. Patients need a comfortable soft bra for gentle support after the operation and generally can start light exercises after 2 weeks, and be back to their usual exercises after about 3 – 4 weeks. Regular check ups are important after the procedures and these will accordingly be scheduled.

Please note that Silicone Breast Implants do not increase the risk of Breast Cancer or autoimmune diseases. Mammogram can and should still be done. Please inform the radiologist that breast implants are present so that specialized views maybe taken, specifically for patients with breast implants.

A new development recently is called the COMPOSITE breast augmentation. This technique is ideal for very thin and flat-chested patients who desire a significant breast enlargement. This technique combines the use of both breast implants with structural fat grafting. Before, the use of large implants with these thin patients would inevitably result in suboptimal result because the thin soft tissues of the breast would result in visibility around the implants, particularly in the cleavage area. With the COMPOSITE technique then, fat is injected around the implant, particularly in the upper part around the cleavage, this gives an overall softer look and more natural result.