Breast enlargement explained

Are you not satisfied with your breasts? Are they too small, do you not like the shape, or are your breasts different in size?  Breast augmentation, also called breast enlargement or mammoplasty, may be a solution for you. It is the most commonly performed kind of plastic surgery, and over the years the treatment procedures and implants have been improved substantially.

What is breast augmentation or enlargement?

In breast augmentation an implant will be placed in the breast. Nowadays these implants will be either a full silicone implant, or an implant with a silicone shell and saline filling. Sometimes the breast augmentation will be combined with a breast lift (mastopexy) where excess skin is removed and the position of the nipple may be adjusted.

The choice of implants depends on the required result and the preferences of the woman. The implants currently in use are the result of many years of development, and research has not shown any adverse effects on the health to the women.

Saline-filled inplants

Women with thinner skins and little breast tissue usually will choose a saline-filled implant. This kind of implant is less visible or noticeable to the touch. The shell is filled after the implant, so only a small incision is needed.  The saline solution is similar in characteristics to the fluids of the body, and when the shell may leak, the fluid will be absorbed by the body without negative side effects.

Full silicone implant

A full silicone implant is suitable for women with more breast tissue. However, these require a longer incision during the operation.

There is a wide range of implants different in size and other characteristics. Implant shapes may be round or shaped as a drop. The latter often will look more natural.

Procedure

An incision needs to be made to place the implant in the required position. Usually these incisions are made in the fold under the breast (inframammary), in the armpit (transaxillary) or in the navel (transumbilical or T.U.B.A.) where the damage to the breast tissue is minimal. When a substantial change in the shape of the breast is required, it may be decided to have a periareolar incision (around the nipple), in this situation there may be a more effect on the ability for breast feeding and changes in nipple sensation.

Implants will be placed either in front (subglandular) or behind the pectoral muscle. With women with thinner skins it is advised to position the implant behind the muscle to make it less noticeable. However, placement behind the muscle may result in stronger forces on the implant and somewhat more pain after the procedure.

Around the implant a capsule will develop over time, this is a completely natural process and will assist to keep the implant in place.

Aftercare

The operation in itself will take about 1 to 2 hours. Often the woman can return home the same day, however, she needs someone to take her home and assist her at her house for the first days. To prevent pain and nausea, drugs will usually be prescribed. Drains that may have been placed during the surgery need to be taken out by a physician after about two days. Within a few days after the operation it is possible to resume normal activities that put little strain on the operation area. Heavy lifting and exercising usually are to be avoided for about six weeks. Often the woman will be advised to wear a bra or compression bandages to support the breast during the healing process.

Implants will last a long time, in general at least 10 years, and in many cases much longer. However, the implants will wear over time, and most women will need replacement during their lifetime when the implant has lost its shape or the body has changed due to ageing.

Risks of the operation

As with all surgical procedures there are risks involved. These can be the following:

• An adverse reaction to anaesthetics or excessive bleeding (hematoma)
• Changed sensitivity of the nipples and breast
  The sensation in the breast area can be affected by the surgery, the woman can both experience increase sensitivity, or numbness. The change in sensation will usually reverse within a few months.
• Scarring
  Scars will fade over time, usually the visibility will be substantially reduced after about 6 months. In the meantime the scar may be red and tight. The positioning of the incision will be such that the scar is hardly noticeable. Gentle massaging with lotion during the months after the operation may help to reduce the scarring, it is advised to discuss this with your surgeon. In incidental cases the scar will stay large or red, sometimes due to complications in the healing after the operation.
• Breast feeding may be affected
  Breast feeding is usually possible and encouraged for women who had breast augmentation. However, if the implant was placed with an periareolar incision, part of the milk ducts may have been affected.
• Possible deflation of the implant
  Severe pressure or impacts may result in rupture of the implant. The fluid of saline filled implants will start leaking, and the implant loses its shape. The fluid poses no problem as it will be absorbed by the body, but the implant has to be replaced.
• Capsular contraction
  In some instances the capsule around the implant can contract, causing pressure and tension. Sometimes the breast will get hard and it the shape of the breast is very round. The implant will have to be removed. The cause of the contraction is not clear, and it is not possible to predict in advance the risks for a particular woman.
• Rippling and wrinkling
  After a breast implant there is a slight risk of rippling or wrinkling, where a dent or ridge develops in the implant. Rippling can be more or less noticeable, depending on the reaction of the surrounding tissue.
• Infection
  In any surgery there is a risk of infection, the likelihood of this is highest in the first weeks after the procedure. The risk can be reduced substantially by proper wound care and not immersing in water while the skin is healing. Infections will be treated with antibiotics.
• Breast augmentation and mammography
  The detection of abnormalities in the breast may be more difficult after a breast implant. The implant can block the rays and obscure details in the tissue. The mammography may take more time, or additional scans may be required. During the mammography the staff need to take care not to place excessive pressure on the implant to prevent ruptures. When making an appointment for mammography it is advised to discuss the implant and the consequences for the mammography.

Where to go for breast augmentation in Singapore

Singapore has a large number of plastic surgeons that perform breast enlargement. You can find them in our cosmetic surgery directory.

Have you had breast surgery or breast augmentation? We would love to hear your experiences. Share them with us below.

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