Breast Augmentation (Implant)
Breast augmentation using silicone implants is a surgery performed to enhance the volume and projection of the breast, while creating a natural looking but well defined cleavage. The type of implants available include Motiva and Mentor.
What is it?
Breast augmentation is also commonly known as a “boob job”. It is one of the most popular cosmetic surgery procedures done to increase the volume of the breast. This can be done either with breast implants or with fat grafting or a combination of both the techniques called hybrid breast augmentation. These options have long-lasting results and high success rates.
What happens during the consultation and planning stages?
An in-depth discussion will be done at the initial consultation, to understand your general health, desired breast goals and sizes, together with a thorough examination and evaluation. During this visit, a 3D simulation of the appearance of your desired implant size will also be created using Quantificare 3D imaging. With this 3D image, you can better visualize the possible final appearance. This will aid with your final decision on the implant type, size, and placement.
It would be helpful to bring along any previous mammogram or ultrasound reports.
How is the breast augmentation surgery done?
This is done under general anaesthesia in a day surgery setting. The procedure will take less than 2 hours. There will be a short incision placed in the lower fold (infra-mammary fold) of the breast, which will ultimately leave you with a well-hidden scar once it has healed. The implants can be placed in 2 different planes of your breasts, either subglandular (under the breast tissue) or subpectoral (under the pectoral muscles). Often, they are also placed in a dual-plane method to achieve the benefits of each of the 2 different locations. This will be further discussed during the consultation based on your clinical examination.
What type of implants are available?
In our clinic, we have a range of implants for you to select from, both Mentor as well as Motiva implants are available. Implants come in various fill, sizes, shape and outer covering. Breast implant can be filled with cohesive silicone gel or saline. Cohesive silicone gel implants are also called gummy bear implants because they keep their shape, even when the implant shell breaks.
Breast implant shapes can either be anatomical or round. Anatomical or teardrop shaped implants have texturing on the surface. The textured surface allows increased friction between the implant and the surrounding breast tissue, ensuring that the anatomical implants are less likely to move around inside your breast and better stay in place. Anatomical implants are shaped to appear more naturally like a breast. It has a slope in the upper part which increases to a fuller rounder base.
Round shaped implants have a smooth outer texture. Round implants will make your breast look fuller over the top and cleavage area. They do slide more easily when compared to textured implants. These also feel softer.
Motiva implants are “next generation” ergonomix implant which are round in shape, while their texture is made of nanosurface texture, this marries the benefit of textured implant with round shaped implants. They have a round shape when you are lying down but form a natural slope when standing up as the silicone settles down at the base. This design allows the Motiva implants to follow the movements of your body.
The type of implants and the nature will be discussed with you during the consultation to aid with your decision.
Any there any other methods?
Breast augmentation can also be done using fat grafts. Fats are commonly harvested from the abdomen and thighs via liposuction. Thus, there is the additional benefit of reducing the volume of fats over those areas of concern at the same setting. Find out more about Breast Fat Grafting here.
What are the benefits of breast augmentation
with breast implants?
Breast implants will provide you with an immediate and significant degree of volume enhancement when compared to fat grafting. Depending on your desired volume of improvement, appropriate breast implant can be chosen to achieve your goals. It can range from a more naturally appearing ‘mini boob job’ with smaller implants to an obviously voluptuous augmentation with larger implants. The augmented breast will appear well defined, particularly over the cleavage. Depending on the volume of the breast implant, it may also help to lift slightly droopy breasts up.
Are there any limitations?
Breast augmentation will not be able to correct severely droopy breast (breast ptosis). For some of these cases, a combination of breast lift (mastopexy) may be required to reposition the nipples and the areola to a more ideal position. This can be done at the same time as the breast augmentation. An assessment will be made during the consultation and management options provided.
What is the recovery like after breast augmentation?
This is done as a day surgery procedure and you are able to go home on the same day. You will be placed in a supportive bra following the surgery. Ideally the supportive bra should be worn for 4-6 weeks to help with reduction in swelling and optimize the position of the implants.
Everyone heals differently, but generally there is minimal downtime. You should be able to return to work after at least 3 days. Swelling and bruising is expected after surgery, this will mostly settle down over the next two weeks and continue to improve with time. On average, full recovery takes about six weeks.
You should avoid doing sporting activities or lifting of heavy objects for at least six weeks following surgery, this is to ensure that the implants are given time to settle into place.
What should I prepare for the surgery?
As breast augmentation is done under sedation or general anaesthesia, you will need to be fasted for 8 hours prior to surgery.
It would also be ideal for someone to take you home after the surgery and have someone stay with you at least for the first night. We will provide you with the necessary medications to return home with to manage the discomfort and to aid with recovery. Do prepare plenty of comfortable front button shirts or dresses to wear after the surgery.
Frequently Asked Questions about Breast Augmentation
Breasts that have been augmented with implants generally feel slightly firmer than your natural breasts. Particularly for women with smaller natural breasts and thinner skin, you may be able to feel the outline of the implant through your skin and breast tissue. Otherwise, once the implants are placed beneath your pectoral (chest wall) muscles, there are sufficient tissue covering the implant to reduce its palpability.
The type of implant chosen will also affect how the breast feels like after augmentation. Generally, Mentor round implants and Motiva ergonomix implants are much softer in feel than anatomical (teardrop) shaped textured implants.
This is a breakdown about the differences between each type of implant.
| Benefits |
- No association with BIA-ALCL - Feels softer and more natural - Greater upper pole fullness - Smaller incision in the inframammary fold |
- Less risk of malposition - More natural slope of the upper pole - Lower risk of capsular contracture - Less risk of gel leak due to the cohesive nature of the silicone gel |
- Radiofrequency identification device that stores the implant information - Implant adjusts to your body movement, more natural slope when standing and fuller upper pole when lying down - Feels softer and more natural |
| Limitations |
- Higher risk of capsular contracture - Implants can rotate or flip - Increase risk of malposition / lower pole stretching out ‘bottoming out’ especially with larger implants |
- Very low risk of association with BIA-ALCL - May require a slightly longer inframammary incision - May feel slightly firmer due to more highly cohesive gel fill |
- Shorter period in the market with - Approved for use in Singapore (HSA) & other countries since 2016 - It is not FDA approved and not used in USA. - Slightly more costly than the other available implants |
| Selection Considerations |
- If you desire greater upper pole volume - If you are worried about BIA-ALCL |
- If you desire a more natural breast shape - If you have had recurrent capsular contracture - If you desire more stable outcome |
- If you desire a more natural breast shape and softer feel |
The scar will be placed in the inframammary fold region and is generally between 3-5cm long depending on the size of the implant chosen. Once the wound has healed, scar management will be instituted to allow the quality of the scar to improve to a fine, flat and pale scar.
Breast implants are largely safe, they have been used for over 50 years. However, breast implants are not lifetime devices, the life expectancy of the breast implant cannot be estimated, some woman can have their implant intact for over 10 years.
Here are some of the potential risks that can occur with implants:
- Changes to the sensation of the breast or nipple
- Palpability / rippling
- Capsular contracture is caused by hardening of the capsule around the breast implant. This hardening and shrinkage of the scar tissue causes the shape of the implant to distort
- Implant silicone gel leak
- Rupture
- Implant malposition
- Breast tissue thinning and stretching out with time
- Infection
- Seroma
- Breast implant associated anaplastic large-cell lymphoma (BIA-ALCL)
It generally takes about 3-4 months for the swelling to completely settle down. This is when you will be able to appreciate the final appearance of your breasts.
Any woman below the age of 21 will need to have parental consent for breast augmentation.
Breast implants are medical devices that does not last for a lifetime. The average lifespan of a breast implant can range between 10 to 20 years. The older the implants are, the risk of complications sequentially increases. However, breast implants only need to be replaced if any complications arises or if you are dissatisfied with them.
Sometimes after breast augmentation, the sensation of the nipples/areola may increase or become temporarily dulled. However, most of the time, the sensation gradually returns to normal after about 3 months.
Sometimes the direction of the nipples can alter after surgery, the final appearance will generally stabilize after about 3 months.
Some woman with mildly inverted nipples may find that following breast augmentation, their nipples may pop out with the stretching of the skin and pushing effect of the implant. Alternatively, you can also consider correcting the inverted nipples at the same time as your breast augmentation. Surgery is only recommended if you have completed your family and are no longer planning to breastfeed your child.
Breast implants are placed under the glandular tissue or under your pectoral muscles. This avoids interfering with the breast ducts and glands from which milk are produced and excreted. There are also other factors that can contribute to low milk supply.
If breastfeeding is important to you, it would be advisable not to have the breast augmentation done via the peri-areolar approach as there is some interference with the glandular tissue during the surgery. Instead, an inframammary approach should be performed.
During mammogram, additional views are required to allow better imaging of the breasts if there are implants in place. It is very rare for the mammogram process to rupture your implants.
Sometimes additional imaging may be necessary and includes ultrasound as well as MRI.
Mammograms should be done yearly starting from the age of 40.