There are many reasons why you might want a Breast Augmentation in Singapore. Perhaps you want to correct a physical asymmetry, or perhaps you had an accident that reduced your breast volume. You can choose to go for Breast Augmentation if you are physically and mentally suitable. But how does augmentation, particularly fat grafting, work?
In this article, I answer questions about fat grafting, the steps involved in transferring fat from other parts of the body to your breasts, its costs, and whether you can claim Medisave for treatment.
What does Breast Augmentation mean?
Breast Augmentation is defined as a procedure where some form of liquid is placed within the breasts to enlarge and enhance them.
This liquid can be fat from your own body or breast implants that are filled with saltwater or silicone. These results can last for 5-15 years for breast implants and can be permanent for fat grafting.
In this article, I focus on fat grafting, with references to breast implants when a comparison is helpful.
How does Breast Augmentation work in Singapore?
There are two procedures for augmenting breasts:
- Breast implants
- Silicone
- Water
- Fat grafting
With breast implants, a shell filled with either silicone or water is placed inside your breast, either under or over your pectoral (chest) muscle. These implants then stay there for the next decade or so, lasting over 10 years.
You will have to go for regular Magnetic Resonance Imaging (MRI) scans every 2 years to ensure the implants are functioning properly and are not leaking.
Fat grafting uses your own fat as the medium to be placed inside your breast. This fat normally comes from areas full of fat, such as your thighs, belly, and buttocks [1].
- Fat is extracted from these areas through liposuction.
- Fat is then processed into a liquid so that it can be used for your breasts.
- Lastly, fat is injected into your breasts. Only small cuts are required for this step.
Also Read:
Breast Augmentation In Singapore Versus Korea Or Thailand: Which To Choose?
Fat Transfer Versus Breast Implants: A Singaporean Plastic Surgeon Discusses
Although this procedure is still quite new, there are some procedural variations for every patient. However, the procedure as a whole has been deemed safe [2].
How old must I be to perform Breast Augmentation?
For breast implants, you need to be at least 18 years old to receive saline breast implants. If you are above 22 years old, you can receive silicone based breast implants.
About 50% of patients using fat grafting are between ages 18 to 34. This is to ensure that the breasts are fully developed so that it does not change in size.
However, more important than your physical suitability is your mental suitability. If you have any serious underlying mental issues like psychosis, or if you are suffering from mania from Bipolar Disorder, then you should not go through breast augmentation.
If you have no mental issues but are adamant that breast augmentation is the only way to regain your confidence, then you may need to go for psychological counselling before treatment.
This will ensure that you are truly ready for the benefits and consequences of undergoing this expensive procedure.
What kind of Breast Implants can I use?
Besides the type of implants, water and silicone, you need to consider the shape of the implants. Currently, there are three types of implant shapes, round, teardrop, and Motiva Ergonomics.
Round implants
Round implants were the first generation of breast implants and, for a long time, were the only choice available. These types of implants give a round shape to your breasts when you lie down and only give a teardrop shape when you stand up. They provide more lift and cleavage.
Teardrop implants
Teardrop implants are ‘form-stable’, meaning they keep their shape whether you lie down or stand up. These implants came in a later generation and are a good choice if you want your breasts to keep a natural shape.
Motiva Ergonomix implants
The latest in breast implant technology, they are part of the sixth-generational implants. These implants are extremely safe and designed to be very smooth, to avert the risks that come with textured implants.
The results show that it works with less than 1% complication rates [3] and it provides high rates of satisfaction to patients [4].
This innovation is significant because it is one of the few technologies that have come out since the last major innovation in the 1980s. The last wave of breast implants come with unwanted complications, such as a higher risk of a certain type of immune system cancer [5].
However, Motiva Ergonomix implants have been designed so that they minimise any complications and do not give any increased risks in cancer! I recommend these implants whenever possible.
Read my response to: What are the advantages and disadvantages of the 6th generation Motiva breast implants?
How much fat do I need for Fat Grafting?
Fat and breast implant volumes both use a system of measurement called ‘cc’, meaning ‘cubic centimetre’. For reference, the smallest breast implant is at 100cc, with 10cc increments up to 800cc.
Different women require different breast implant sizes to enlarge their breasts by one cup size. Similarly, the amount of fat you require to enlarge your breast by one cup size will differ from another woman.
You can require anything between 100cc to 390cc of fat to increase by one cup size.
However, even if you are too skinny for breast enlargement, you can use the fat you do have to perform minor breast augmentation.
This Small Volume Fat Grafting uses small amounts of fat, less than 100cc, to fix minor deformities. Such deformities include irregular contours, or lines, across your breasts [6].
Also read this: What is the difference between a breast lift vs breast augmentation to increase breast size?
Breast implants generally allow you to go larger than fat grafting can, so if you want to increase your breast size by two cup sizes, I recommend you use breast implants instead.
However, fat grafting can last longer than breast implants as there is no object that will break or require monitoring.
Will my breasts look natural after Fat Grafting?
Your breasts may be stretched and tight during the first few weeks after treatment, but after approximately 6 months your breasts will return back to feeling soft and natural again.
If your breasts still feel tight after 6 months, you might have had too much fat injected.
Also read: A Plastic Surgeon’s Complete Guide To Breast Reconstruction In Singapore (2020)
Will I be able to Breastfeed?
There is no evidence that fat grafting affects breastfeeding negatively or positively. I recommend that you return to your surgeon often for checkups to ensure that there are no complications.
What is the Treatment like for Fat Grafting?
Fat grafting is split into several steps, called ‘Harvesting’, ‘Processing’, and ‘Injection’. These refer to harvesting fat before processing it and injecting it into your breasts [7].
Before the procedure, you may be asked to wear a tissue expansion system to stretch and grow skin around your breasts [8].
1. Harvesting
First, the area where fat will be harvested is marked. Then, using either a surgical vacuum, syringes, or direct fat extraction, the fat is collected. The most common areas where fat is excised are the abdomen, buttocks, and the inside of the thighs.
2. Fat Processing
The collected fat needs to be processed because it is full of elements like fibre, blood, and other bodily debris. These elements are unwanted because they can cause inflammation at the breasts.
Blood can also degrade the fat faster [9], while the debris will be absorbed back into the body after a few hours, resulting in a smaller breast size than aimed for.
We do not have to go into detail about how the fat is processed, but it is done through one of centrifugation, filtration, or sedimentation methods.
3. Injection
Your surgeon would have decided where in the breasts to inject. After putting you on general anaesthetic and ensuring you are asleep, they will make a small cut and use an object called a cannula to help inject the fat in small doses.
Small amounts of fat give better results than simply using one long injection and reduces the risk of negative effects like fat necrosis [10].
What is recovery like from Breast Augmentation in Singapore?
You may feel soreness in or around your breast area. There may also be some discomfort, but the incision made during fat grafting is very small and there is an easier recovery period.
You may experience swelling and bruising that will subside in a couple of weeks. You may also experience bruising near or around the area where you received liposuction. This bruising will fade away within a few days.
To aid in your recovery, you may be prescribed painkillers. You should not carry out any intense physical activity, including exercising or performing heavy lifting.
You should limit sexual activity and avoid touching your breasts to let them recover. You should be able to return to work after a week or two of rest.
How long do Breast Augmentation results last for?
This depends on how many fat cells survive the transfer. If enough of the fat cells survive, the results can be permanent or even result in more growth as the fat cells grow.
A 2015 meta-analysis found a wide range of survival rates, from 34% to 82% [11]. Research is being done to improve this rate and make survival rates more consistent.
Are there any side effects from Breast Augmentation?
There are some possible side effects, even if the treatment is done properly and safely. For example, there is a chance that the injected fat cells will necrose, meaning die and rot.
The necrosed fat can form cysts and lumps, which will have to be removed. This chance is increased if a large amount of fat is injected into your breasts in one go, which is why multiple small injections are recommended.
Related: This Singapore Plastic Surgeon Discusses The Link Of Textured Breast Implants To Lymphoma (BIA-ALCL)
How much does Breast Augmentation surgery cost in Singapore? Is it Medisave-claimable?
Prices vary for private clinics. In private practice, most fat grafting breast augmentation costs between $10,000-$14,000. Others may have a cheaper cost which you ‘add on’ extras too, ranging from $3500-$6000 onwards.
If you are going for breast augmentation for aesthetic reasons, meaning you do not have any birth defects, then you cannot claim any Medisave money.
However, if you have any conditions from birth, called congenital conditions, then you can claim between $600-$1550 depending on how much fat you need to transfer over [12].
Conclusion
Fat grafting is a new procedure that has promise in giving you permanent results. While research is still being done to find the optimal and safest way of transferring fat over, certain best practices have spread among plastic surgeons.
Also Read: What are the risks of undergoing breast augmentation overseas?
Feel free to ask your surgeon questions about how many of the same procedure they have done, or how long they have been certified, to relieve any fears or issues you may have!
Dr Andrew Tay provides cosmetic surgery (both face and body) and craniomaxillofacial surgery, which is facial skeleton reconstructive surgery. He has a special interest in managing facial trauma, having served with the AO Centre Executive Committee (Craniomaxillofacial Surgery).
Dr Tay also was actively engaged as a member of the AO international teaching faculty for craniomaxillofacial courses. Other memberships include The Singapore Society of Cosmetic (Aesthetic) Surgeons, The Singapore Association of Plastic Surgeons, as well as The International Society of Aesthetic Plastic Surgery.
