A well-formed and good size breast is recognized as a feminine asset. It is aesthetically pleasing and provides for easy fitting of clothes. There are commonly 2 groups of patients who will benefit from breast enhancement or augmentation. The first group of patients are usually young girls who have smaller breast as a result of breast hypoplasia. The second group of patients are adults who develop breast flattening or droop after pregnancy and breast feeding due to breast tissue atrophy. The enlargement or enhancement of breast can be achieved reliably and safely using breast implants. Currently silicone breast implants are the most popular and commonly used implant for augmentation. It gives a more natural shape and texture as compared to saline implants which tend to be rounded and firmer. The newer breast implants have been made safer with the use of cohesive gel, commonly known as “gummy bear” type of gel. The gel is more cohesive or “viscous” and thus less likely to leak out into the surrounding tissues.
The implants may be inserted through 3 different approaches namely the axilla, periareolar and inframammary approach. The implant may be placed under the breast tissue (sub-glandular) or below the chest muscle (sub-muscular) or dual plane, where part of the implant is under the muscle and part under the breast and subcutaneous tissue. The choice of approach is dependent on the patient’s physical attributes, the size of breast and thickness of soft tissue. One of the most preferred surgical approach for Asians is through the peri-areolar incision because the scar heals well and is least visible. It is also a more direct approach, thus less dissection and less painful.
The procedure takes about 2 hours under general anesthesia. Hospitalization for 1 day is recommended for more comfortable recovery. One of the possible complication for this surgery is bleeding or haematoma and infection (<5%). In the long term, there is a 3%-10% risk of capsular contracture, rippling or palpability of implant.
For secondary breast augmentation or correction of capsular contractures, generally the inframammary approach is advised. This approach gives better exposure for capsulectomy (removal of capsule) and to control bleeding. Sometimes the peri-areolar approach is possible.
The enhanced breast will improve the body proportion and facilitate the wearing of clothes. It will increase your attractiveness and give you added self- confidence. You can enjoy more sports like swimming and outdoor activities without feeling inhibited because of the sports wear. There is no increased risk of cancer and you can continue to breast feed baby naturally.