If you landed on DoctorXDentist searching for "breast augmentation Singapore" - you're not alone! Breast enhancement is by far the most common procedure that I've performed over the last 10 years as a plastic surgeon in Singapore.
I've found that Singaporeans tend to be amongst the most well-read when it comes to finding out more information about the entire breast augmentation procedure.
The bad news? You may already have realised that there's a whole lot of misinformation about breast enlargement going round on the internet. This is often propagated by fake sponsored reviews and suspect forum posts (it's easy to spot these - they tend to be a newly created account that raves about a particular breast clinic/breast surgeon/breast augmentation procedure).
In this 4000 word article, I'll cover all the essentials you need to know before seeing your plastic surgeon for the first time. This includes:
- A breakdown of the costs you can expect to pay in Singapore for breast augmentation
- How to choose the best breast augmentation surgeon and clinic in Singapore (Hint: you can send a free enquiry to a few expert surgeons at the same time here)
- Whether others will be able to tell if your breasts are "fake"
- How painful the actual breast augmentation surgery is
- How to get the best results after your breast augmentation surgery
First up, are you suitable for breast augmentation surgery?
This depends on which type of breast augmentation surgery you are looking at. There are 2 main types of breast augmentation surgeries:
- Fat grafting with your own fat (also known as fat transfer), or
- Inserting silicone breast implants
For fat grafting, you must have enough good quality fat for transfer. This is usually from your tummy and inner thigh.
Fat from areas like your arms and back area aren’t as suitable. Each cup size increase requires around 200cc of fat.
Silicone breast implants are far more popular in Singapore as they provide a more definite shape and size increase.
You are also able to jump more cup sizes in 1 sitting as compared to fat grafting, eg. from A to C or D.
Will you have difficulties breastfeeding or getting pregnant if you have silicone breast implants?
This is probably the most common concern highlighted to me by patients in my clinic.
Rest assured that there are NO issues with getting pregnant if you have a breast implant. Nor are there any problems with breastfeeding - silicone does NOT leak into breast milk.
In fact, studies have found higher levels of silicone in cow’s milk than in mothers with silicone breast implants!
However, you may experience more engorgement, or reduced breast milk production if you choose breast implants that are too big (usually those who choose to go 3 or 4 cup sizes up).
Therefore, I tend to dissuade my patients from going too large if they are planning for kids in the future.
How much bigger can your breasts get after breast augmentation surgery?
This depends on 2 things:
- Your personal wishes
- Your breast characteristics, such as your skin laxity and the measurements of your natural breast
In general, when I measure your breasts, there are 2 - 3 breast implants that are considered close to ideal for your breast.
You shouldn't go more than 2 sizes up from the recommended size due to a longer recovery time, and a slightly higher risk of complications in the future.
Based on these recommendations, you can then choose to:
- Go a size up or down
- Have a narrower cleavage, or
- More side-boob
All these factors will change the dimensions and the volume of the breast implants.
“I’m worried that my breasts won’t look and feel natural after breast augmentation surgery”
Breast augmentation surgery that's performed by an experienced surgeon will look and feel natural. However, it takes time to get there.
It usually requires between 1 - 3 months for the breast implants to settle into the most natural position. This is because your breasts will feel very firm, and appear high as the skin is stretched tight during the initial recovery period.
By the 5th or 6th month, your breast implants should feel completely soft and natural.
If your breasts still feel unnatural after 6 months, it's almost always because of:
- A poor/wrong choice of breast implant, or
- An improper breast pocket dissection during surgery
So yes, your breast augmentation surgeon plays a hugely important role in recommending the best breast implant for you (and of course, carrying out the actual procedure)!
“But my friend got a boob job, and everyone can tell it’s so obviously fake”
Fake is a very subjective term – whether it's due to feel/texture, shape or size.
1. Breast implant feel
It takes 3 - 6 months for the feel of your breast implants to become soft and natural.
2. Breast implant shape - tear-drop versus round breast implants
Choosing tear-drop shaped breast implants gives your breasts a more natural appearance, as opposed to round breast implants.
Round breast implants produce a very high cleavage that adds to the “fake” appearance, simply because normal breasts are not round!
3. Breast implant size - don't go more than 2 cup sizes!
There are a variety of breast sizes that can be chosen. To prevent a “fake boobs” appearance, you should choose a size increase within 2 cup sizes (eg. A to C, or B to D).
Just how painful is breast augmentation surgery?
This is the number 1 question I get from patients.
Short answer: there's no pain during the surgery. It's General Anaesthesia, so you'll be fast asleep with no recollection of the surgery or any pain.
I wouldn’t say it’s painless after the surgery; that'd be a blatant lie. What you'll feel is a stretch discomfort and mild pain over the cut. It's very tolerable - all my patients are able to walk out of the day surgery on their own.
You'll be able to shower by the very next day. After 2 - 3 days, you'll be able to drive and return to office-based work.
There may be occasional aches and pain during the recovery period of 1 to 2 weeks, but it does NOT stop you from performing daily activities.
How much does breast augmentation surgery cost in Singapore?
The total cost of breast augmentation surgery in Singapore should not exceed SGD$15,000.
Anything beyond this figure is usually down to a high surgeon fee or operating room charges.
Do note: you should NOT be made to pay for a high operating room charge in a private hospital. Breast augmentation is a day surgery procedure that can be performed in any MOH-accredited day surgery centres.
What factors affect the price of breast augmentation surgery in Singapore?
The cost of breast augmentation can be broken down to the following factors:
- The surgeon’s fee
- The anaesthetist’s fee
- The breast implant cost
- The operating room charge
- The surgical equipment and consumables charge
- The medications
- The breast band
- The Government charge aka GST
Here's an example of the costs breakdown of an actual breast augmentation surgery in my clinic:
Breast surgery: $8044
Breast implant cost: $1960
6 sessions of review after surgery: $600
Consultation fees: $160
2 hours of anesthesia charge: $1800
2 hours of Day Surgery charge: $1000
Breast band: $150
Total cost: $13,838 excluding GST
“I've heard breast fillers are cheaper, and no need surgery!”
Breast fillers are illegal in Singapore. They are outlawed by MOH and cannot be performed in Singapore because they've been found to cause serious problems 5 - 7 years after the original filler procedure.
These problems include:
- Cyst formation
- Filler migration causing breast distortion and chronic pain
The breast cancer risk also remains unknown.
"Crap, I had breast fillers done in the past. What should I do next?"
If you are experiencing pain or breast distortion after the breast filler injection, do consult an experienced plastic surgeon!
Removal of the breast filler via surgery is often required. I've had to remove a number of these breast fillers injected many years ago.
During the consultation, an MRI scan needs to be performed to evaluate the condition of the breast filler, as well as your breast/muscle tissue.
The subsequent breast augmentation should always be staged 3 - 6 months later. If you have no symptoms, then you can choose to electively remove the breast filler at any stage to avoid future problems.
Are there any other options to get bigger breasts without surgery?
Bigger breasts without any surgery is NOT possible.
It's common to see beauty spas in Singapore offering miracle breast enlargement treatments such as:
- Suction cups
- Laser bust enhancement
- Herbal breast massages
However, none of these produce a permanent increase in size, beyond the initial swelling and skin tightness. Oh, and, you'll end up with a lighter wallet as well..
What about MINIMALLY INVASIVE procedures to get bigger breasts?
This breast enhancement method kills 2 birds with 1 stone:
- It reduces unwanted fat in areas such as your tummy and love-handles
- The fat is moved to enlarge your breasts
Some patients also like that it's a "natural procedure" with no synthetic material placed within their body.
How is fat transfer for breast enhancement performed?
Fat harvest is done via a few small 5 mm ports in your groin crease area. The fat is then processed and injected via a needle hole in your lower breast fold area.
Typical areas that would yield a good amount of useable fat for breast enhancement are:
- Your abdomen
- Your flanks
- Your thighs
Do note that slim ladies with a low fat % may not be suitable.
This procedure is virtually scarless, and there's a very short recovery period.
You'll be able to return to work in 1 - 2 days, with the only discomfort being an aching sensation in the tummy area (like you just did a couple of 100 crunches!).
How much bigger can your breasts get after fat transfer?
The maximum cup size after fat transfer is dependent on 2 main factors:
- The amount of fat that you have
- The laxity/stetchiness of your native breast pocket
My patients typically go up 1 cup size after a single procedure, and the overall shape of their breasts also improves.
Repeat procedures can be performed to achieve the desired cup volume, but this has to be spaced 2 - 3 months apart.
Do you need a breast lift or breast augmentation?
The 2 key factors in determining if you need a breast lift or breast augmentation are:
- The amount of skin laxity you have
- The position of your nipple, and the direction it's pointing
Breast lifts are typically required if you have a lot of skin laxity, or when your nipple is pointing down.
I like to break it down as follows for my patients:
1. If your skin quality and nipple location is good, but the breast volume is small, then a breast augmentation would be great.
2. If your skin quality is lax, the nipple location is low, and the breast volume is small, then a breast lift would be required. This can be combined with breast augmentation at the same time.
3. If your skin quality is either lax/good, the nipple location is low, and the breast volume is big, then you need a breast reduction + breast lift.
All 3 scenarios require different surgeries. The best-suited surgery depends on my assessment of your breasts in clinic.
What’s the most common breast implant brand used in Singapore?
The 3 most widely-used breast implant brands in Singapore are:
- Mentor breast implants
- Motiva breast implants
- Natrelle breast implants
Each breast implant brand has different properties in terms of:
- How they’re filled
- The consistency of the gel
- The dimensions of the implant
Amongst all the breast implant brands available in Singapore, only Mentor and Natrelle breast implants are FDA-approved for their long track record of safety.
What's the most popular breast implant shape and size chosen in Singapore?
The most commonly requested breast implant shape in my clinic is tear drop - my patients tend to prefer a natural look (breasts aren't round!).
295cc and 330cc breast implants are the most popular sizes. These 2 sizes fit 50 - 60% of patients that come to my clinic.
Your actual breast implant volume will be 100% customized to measurements I take of:
- Your breasts
- Your height
- Your torso shape and length
- Whether you are post-breastfeeding, and so on.
The first consultation with my patients often takes up to an hour - there are just so many variables to consider!
What are the most important factors to discuss with your surgeon before breast surgery?
These are the 4 most important things to always ask your Surgeon:
1. Is he or she a Plastic Surgeon?
No, this isn't a joke as we do have non-Plastic Surgeons performing breast augmentation surgery in Singapore.
2. What type of breast implant is your surgeon using, and is it US FDA-approved?
This is for your own safety! The only 2 FDA-approved breast implants available in Singapore are Mentor and Natrelle breast implants.
You really don’t want some strange breast implant that has a poor safety record inside your body.
3. Where will your surgeon make the cut, and how long will the cut be?
Your surgeon should only make a cut in your breast fold to produce the best cosmetic results.
You should also ask how long the scar will be, as I'm sure you don’t want to end up with a long scar!
The average length of your scar after breast augmentation should be between 3.5 - 4 cm for breast implants of less than 400cc in size.
Beyond that, it’s about 0.5 cm more for every additional 100cc.
4. Where is your surgeon placing the breast implant?
Breast implants should almost always be placed under the muscle, and not only under the breast.
This is technically more difficult for your surgeon, but gives you the best possible long term results (proven by many large scale studies!).
Not many people and even surgeons know this, but there are also a few methods of placing breast implants under the muscle. One example is the dual plane placement, where the breast implant is placed only partially under the muscle to provide better support, as we well as to slow the rate of sagging.
If your surgeon is unsure of this or when to use it, he's obviously not very experienced in breast augmentation!
How is breast augmentation surgery performed?
This entire breast augmentation process takes between 60 to 80 minutes.
1. You are put to sleep with General Anaesthesia
First, you are put to sleep by the anaesthetist. Then, a nerve block is administered to minimized any pain after the surgery.
I use a special form of General Anaesthesia known as TIVA (total intravenous anaesthesia) combined with a brain wave monitor, so there's no need for anaesthetic tubes in your mouth, gases or ventilators.
This minimizes any sorethroat, coughing or nausea/vomiting after the surgery, which helps to reduce chest pain.
2. A cut is made to create space for your breast implant
A small cut (3.5cm to 4cm) is made in the skin. Electrocautery is then used to create a space under the chest muscle that is sized exactly for the breast implant that you'll be getting.
I typically perform a Dual Plane IIa pocket, which allows for the best possible shape in the majority of the patients. There's minimal bleeding as I carry out the whole procedure under direct vision with an endoscopic light.
3. Your breast implant is inserted, and the cut is closed
The implant is inserted with a special sleeve, and the cut is closed with absorbable sutures.
A special waterproof dressing is then placed over which allows you to shower.
What can you expect after breast augmentation surgery?
You can expect a few things during the recovery period after breast augmentation:
1. The breast implant will "sit high" initially
This takes a while to settle down, and is usually due to some amount of muscle swelling as well. It typically affects the upper part of your breast.
The swelling takes a couple of months to completely settle, but it does not interfere with daily activities in any way.
Give it 2 - 3 months, and it will settle into a nice shape.
2. Bruising typically occurs in the middle of the chest and sometimes at the side, near where the cut was made
This resolves in a week to 2, and will not affect your daily activities.
3. Pain is the biggest complaint, but will be closely managed by oral medication
You will feel tight and achy around the chest area for the first 1 week.
Off and on sharp pain lasting for a few seconds may also occur in the first week or 2 due to muscle spasms.
Some patients also feel a little bit breathless when they lie flat for the first few days; this is normal due to the weight of the breast implant. You will soon get used to it.
How can you get the best results after breast augmentation surgery?
Here are the 3 most important pointers to follow in order to get the best breast augmentation results:
1. Be conscientious with the stretching exercises taught to you after the surgery
You have to start on the night of surgery, and continue for the first week. This helps the muscle stretch out and relax over the breast implant.
2. Don’t wear a bra for the first few weeks – just nipple stickers and a camisole if necessary
Doing so will allow your breast implants to settle as quickly as possible.
3. Use the scar gel religiously over the scars
This will help the scar fade as soon as possible.
Will others be able to tell if you had breast enhancement surgery?
For starters, there will be an obvious increase in size, so that part is obvious. Certainly, friends and family who have known you for a long time will notice the change in size.
However, strangers whom you've only just met while wearing a bikini at the beach - they'll never be able to tell that you’ve had breast augmentation surgery.
It's also quite unlikely that future boyfriends/husband will find out, as the scar becomes imperceptible after 9 to 12 months. The shape and feel of the breast implants also reaches normalcy by then.
Will there be any loss of sensation after breast augmentation surgery?
Permanent loss of sensation is extremely rare unless your surgeon chooses to put the cut at the nipple/areolar area.
Otherwise, 3 things typically happen to the nipple/areolar after breast augmentation surgery:
- The majority of people will have normal sensation.
- About 10-20% will have numbness for a week or 2, which will then return to normal.
- Another 10-20% might have increased sensitivity, which will also return to normal after a couple of weeks.
Do breast implants last forever?
The new 5th generation breast implants are meant to last a lifetime, as opposed to 4th generation breast implants with weaker shells, which only lasted somewhere between 10 and 20 years.
The American College of Radiologists recommend a 2-yearly MRI scan after insertion of breast implants.
Of note, both Mentor and Allergan provide lifetime warranties against breast implant rupture.
How can you prevent capsular contracture of your breast implants?
Best advice? Choose your Plastic Surgeon very carefully, as avoidance of capsular contracture is largely down to how well the surgery is performed!
This involves precautions such as:
- Placement of breast implants below the muscle
- Use of a triple antibiotic wash prior to breast implant insertion
- Use of a special insertion sleeve for your breast implant and most importantly,
- A bloodless breast augmentation surgery with no use of drains to remove excess blood and fluids after the surgery
There are some "old-school" Plastic Surgeons in Singapore who still rely on drains (most likely because his/her surgery is bloody). Others don’t use an insertion sleeve, or neglect to use a triple antibiotic wash.
All of these will place you at a higher risk of capsular contracture!
What happens if you are not satisfied with the outcome of your implanted breasts?
If you aren't satisfied with the final outcome of your breasts at the 3 to 6 months mark, do consider what exactly it is that you are not happy about:
- Is it the size of your breasts?
- The shape?
- The position?
- The scar?
- The symmetry?
Some aspects can be rectified easily. Others may require more major interventions.
Having said that, there has to be some moderation of expectations. As I was once told, breasts are not twins, they are sisters.
No one is born with carbon copy breasts. Hence, you should expect minor differences between your 2 breasts, even after breast augmentation surgery.
How can you choose the best plastic surgeon in Singapore for breast augmentation?
1. Pick a plastic surgeon in Singapore who is trained in cosmetic breast augmentation surgery
There are different sub-specialities within Plastic Surgery in Singapore.
You certainly won’t want a Plastic Surgeon who's fellowship-trained in:
- burns surgery
- congenital cleft lip/palate surgery or
- reconstructive surgery
to be performing breast augmentation for you!
2. Find out how many breast augmentation surgeries the plastic surgeon has perform
Second, choose a plastic surgeon that does a substantial volume of breast augmentation surgery.
During this research phase, you can save time by sending a free enquiry to a few plastic surgeons with expertise in breast augmentation.
If he/she does 1 or 2 breast augmentation surgeries a month, then you'd be wise to seek a 2nd opinion.
One good tip is to see if the clinic has a big consignment of breast implants in their clinic – I’d be very worried if the clinic had hardly any breast augmentation-related items.
3. Ask to look at before/after pictures of the surgeon's breast augmentation work
Third, look through their work. Most of us who do a substantial amount of breast augmentation surgery will have a large portfolio of Before and Afters.
Of course, we have many patients who request that their pictures not be shown. Even then, there should still be a lot of other photos available.
If the Plastic Surgeon is very hesitant to show you pictures, then please be wary.
4. Make sure you are able to build a rapport with your surgeon!
Lastly, go with your gut feeling. Rapport is very important.
You should go with the surgeon who makes you feel the most comfortable, and whom you believe will take good care of you! Never feel shy about asking “silly” questions, or having a 2nd or 3rd consultation. All these will prevent a poor outcome.
Please don’t proceed if you still have doubts after your discussion, or if the surgeon rushes you through the consultation and into making a decision.
I've even heard of patients telling me that their surgeons pushed them towards a same day operation! This should NEVER be the case for an elective procedure such as breast augmentation.
I always believe in giving my patients all the time they need to come to a decision.
Dr Samuel Ho is a plastic surgeon at Allure Plastic Sugery. He has worked alongside top plastic surgeons at plastic surgery centres in Korea, such as the Hanyang University Hospital, 101 Plastic Surgery Clinic and BIO Plastic Surgery Clinic. Aside from regular work, Dr Samuel is a supporter of a not-for-profit medical volunteer organization that provides reconstructive facial surgery to young children in Indonesia.