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Breast Augmentation
What is the ideal breast?
The idea of an ideal breast may differ between
But generally it should have the following features:
- a gentle (slightly concave) slope from the shoulder to the peak of the breast at the nipple
- a good cleavage
- the nipple is located on the centre of the breast mound and tilted slightly outwards and upwards
- a gentle arc from the nipple to the inframammary crease (breast fold)
- a silhouette line so that when viewed standing front-on, a gentle bulge is apparent on the side of the chest wall
- an areola diameter of 35 – 45 mm
What is so special about the breast?
The breast is a dynamic structure that changes due to the effects of
- gravity
- pregnancy
- weight changes
- aging
Why do women go for breast augmentation?
The female breast is a primary symbol of feminity. There are several reasons why women choose breast augmentation:
- obtain fuller breasts
- restore breast volume and shape lost after pregnancy
- balance breasts that differ in size or shape
What influences a woman’s decision to go for breast augmentation?
- dissatisfaction with one’s appearance
- self esteem
- for clothing to be better fitting
- sexuality
- opinion of others
- media influence on the ideal figure
What factors need to be considered before planning the procedure?
- symmetry of the breasts/nipples
- width of the breasts
- breast tissue characteristics
- skin characteristics
- patient's desire
In other words, the procedure needs to be individualized
What are the different types of breast implants available?
Breast implants can be classified according to their contents or shape
Silicone vs saline
* images courtesy of Allergan Inc
Most surgeons would recommend silicone implants as they feel more natural and has less problem of rippling. Silicone breast implants have been extensively studied and regarded as safe. All silicone implants available here are cohesive gel (aka "gummy bear") implants, and do not leak like traditional liquid gel implants in the event of rupture:
Round vs anatomical (teardrop shape)
Anatomical implants give the breast a more natural shape. They are more effective in correcting breast imperfections & balancing breasts that differ in size and shape. this is because the matrix system allows the surgeon to select implants of a particular height and projection according to patient's desired breast size/shape as well as existing breast and chest dimensions/shape:
The Natrelle™ Style 410 Matrix of Implants
Natrelle™ Style 410 Form Stable Highly Cohesive Anatomical Implants
What are the choices when it comes to incisions (to insert the implant)?
Inframammary (within the breast fold)
- preferred by most surgeons since it gives the surgeon most control and hence most predictable results
- more concealed compared to axillary, but less concealed than periareolar
Periareolar (along the margin of the areola)
- most concealed among the three
- associated with higher risk of difficulty to breastfeed and altered sensation to the nipple
Axillary (armpit)
- furthest from the breast, hence no scars on the breast
- gives the surgeon the least control
- least concealed among the three
- scars in the axilla may look obvious in Asians at least during the first few months after surgery
Where will the implant be placed?
This depends on the amount of breast tissue present and its ability to adequately cover the implant. If there is sufficient breast tissue, the implant can be placed under the breast. Otherwise the implant should be placed under the muscle to be better concealed.
What happens during the recovery period?
In general, patients will feel a bit sore and tight over the chest for several days after the procedure. There may also be some limitation of upper limb movements for the same duration of time. The breasts may also be swollen for a month or so. However, most patients are able to return to work a few days after the procedure. One can resume light gym activities after one month and full gym activities after 3 months. Patients are advised not to wear a bra for at least a month after procedure, and definitely no push-up bra for at least 3 months.
What are the complications involved in this procedure?
As with all surgical procedures, breast augmentation has risk, which is why at The Sloane Clinic; our utmost priority is patients' safety. Apart from bleeding, infection and scarring which are not common, other complications include capsular contracture, which is the development of scar tissue around the implant, implant leakage or rupture, as well as alteration of sensation of the breast or nipple. Over the years, surgeons have modified their operating styles to minimize the occurrence of these complications. Implants on the market now are more safer and more durable than what they used to be.
What is the relationship between breast implants and breast cancer?
Researchers from The National Cancer Institute (NCI) of the United States conducted one of the largest studies on the long-term health effects of silicone breast implants, and found no association between breast implants and the subsequent risk of breast cancer.
Many other studies have also found that should women who have breast implants develop breast cancer, there is no delay in breast cancer detection. They are also not found to be diagnosed with later-stage breast malignancies, are not at increased risk for breast cancer recurrence, and do not have a decreased length of survival.
When do the implants need to be changed?
It is a myth that implants need to be changed every 10 years. In general, if there are no problems with the implants, they do not have to be changed. If one suspects that there is something wrong, one should go for a workup to evaluate the implants. At The Sloane Clinic, we encourage our patients to come in at least once a year for consultation as a preventative measure.
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Take note:
Before and after photos of patients have been removed from The Sloane Clinic Singapore as MOH Singapore does not allow such photos to be displayed for local clinics. For patients visiting The Sloane Clinic Malaysia or The Sloane Clinic Vietnam, please refer to their respective websites for their clinics' photos.
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