DxD Session held on July 7, 2018.
Dr Samuel Ho received the Gold Medal from the College of Surgeons in 2014 and was awarded the MOH Health and Manpower Development Program award for Aesthetic Surgery and Craniofacial Surgery Fellowship in Seoul, South Korea.
Dr Samuel Ho answered questions from readers on:
- The effectiveness of laser bust enhancement
- The cost of breast augmentation in Singapore
- Breast enhancement using fat transfer
Sensory loss in the breast or more specifically, the nipple-areolar, complex is an uncommon complication of breast augmentation, occurring in less than 1% of simple breast augmentation. This is more associated with excessively large implants, poor breast pocket dissection and excessive retraction, and the use of surgical incisions around the areolar to place the implant in.
I typically place my implants through a tiny incision in the fold on the underside of the breast. Excessively large implants result in the nerves to the nipple/areolar being stretched, thus proper implant selection is very important.
Any nipple numbness that occurs after breast augmentation is temporary and will resolved in a few weeks to a few months. Very rarely is the loss of sensation permanent.
Breast augmentation is a relatively simple procedure but it is vital that you go to a certified plastic surgeon that will best advise you on the implant and technique of breast augmentation.
Breast lift, or mastopexy, is a procedure performed for droopy breasts that usually occur after breastfeeding or with age. It seeks to remove excess skin laxity and reposition the breast tissue and nipple/areolar to a higher, more aesthetic-looking location.
However, it does not add volume to the breast, although the breast may appear to be “fuller” or perkier after the mastopexy procedure. An implant may still be required to add volume to the deflated breast in addition to the mastopexy; this is more accurately termed augmentation mastopexy.
In selected cases, a breast implant alone may be all that is required to create the lift need for a droopy breast.
To determine whether you require a breast lift/mastopexy, an augmentation mastopexy or a breast augmentation alone, it is best that you are examined by a fully-qualified plastic surgeon, who would then be best placed to advise you.
Breast augmentation is a straightforward procedure which can be performed as a day surgery in any Ambulatory Day Surgery Centre under general anaesthesia. The procedure is completed between 1 to 1.5hrs. There is no inpatient stay involved and typically patients are able to go home 2-3 hrs after the surgery.
Breast augmentation at my clinic, all-inclusive of implants, anaesthetist fees, facility charges and standard medications, starts from $14,000.
Breast implant surgery is a simple day surgical procedure that should not require a long leave of absence.
Downtime can refer to return to work, return to light exercise and return to normal activities, such as going to the gym, yoga or simply carrying a young child.
On average, my breast implant patients return to office-based work in 2 to 3 days, and go back to light exercise in a week and normal activities in 2-3 weeks. They are able to shower on the night of the surgery itself.
The main factor that affects downtime would be the amount of post-surgical pain; everything else such as swelling, bruising and the breast band can be concealed under regular clothing.
The key to controlling post-surgical pain is gentle surgical technique, minimal bleeding and a good anaesthetic nerve block.
Certainly implant size and placement also affects but that is already pre-determined, i.e. no one chooses smaller implants so as to have less pain, rather one chooses the best implant to achieve the best possible result.
A surgeon that takes a long time to perform the surgery, causes a lot of intra-operative trauma or bleeding is likely to result in significant pain after surgery.
Thank you for your questions! In my experience, Asian women tend to prefer a more natural breast shape with a full but not excessive cleavage. Hence, I prefer tear-drop 5th generation cohesive gel textured implants for my patients to achieve this.
To further attain a natural appearance and feel, I place most of my implants under the pectoralis muscle using a Dual Plane technique. For someone who is petite like yourself with a narrow ribcage, I would use a moderate-plus profile implant to get a full look without going over the top.
Cost of a breast augmentation, all-inclusive of standard medications, anaesthetist and facility fees, starts from S$14,000.
Laser Bust enhancement is a relatively new procedure that has recently gained some attention due to its promise of non-surgical breast enlargement.
It is a 3 step procedure that involves the use of a laser to produce skin tightening and “stimulate glandular enlargement”, followed by lymphatic massage of the breasts, then application of suction therapy to the breasts.
Although pictures provided by the manufacturer look very promising, do note that the pictures are almost all taken very recently after the procedure. The laser probably does induce mild skin tightening and firming, but its penetration is too shallow to induce any glandular enlargement at all. Most of enlargement is probably a result of tissue swelling after the application of the suction cups, which will disappear after a few days to a week at most. The shape of the enlarged breasts also follow the suction cups, which means it is very unnatural.
This procedure has been met with skepticism from many plastic surgeons on the long term maintenance of the breast enlargement or even its efficacy, if any at all. You are probably paying for some mild skin tightening and a very temporary and unnatural breast engorgement.
Fat transfer is a popular method of increasing bust size, with the other being the use of implants. The attraction of fat transfer is the ability to use only "self" tissue, thus negating the risk of foreign material in the body, as well as that of removing fat from unwanted locations in the body and placing them in desirable locations, in this case the breast, thus achieving 2 aims with a single procedure.
The maximum cup size is dependent on 2 main factors -
- The laxity/stetchiness of your native breast pocket
- The amount of donor fat that you have
Typical areas that would yield a good amount of useable fat are the abdomen, flanks and thighs. In this regard, certain slim ladies with a low fat % are not suitable.
The laxity of the breast pocket is important as high pressure fat injection usually results in high percentages of fat loss.
My patients typically go up 1 cup size after 1 procedure, depending on the factors I mentioned above. The overall shape of the breast also improves.
Repeat procedures can be performed to achieve the desired cup volume but this has to be spaced 2-3 months apart.
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