Breast Augmentation (Implant)

Breast Augmentation (Implant)

Breast augmentation is a surgical procedure designed to enhance the size and shape of the breasts. It can also improve breast symmetry and correct mild sagging (breast ptosis). Breast augmentation may be performed using breast implants or autologous fat graft (see Breast Augmentation (Fat Graft).  Currently, breast augmentation is most commonly performed using breast implants

Implant Surface Textures

At present, the breast implants most frequently used are available in two main surface types:

1. Smooth surface implants – Smooth surface implants can move naturally within the breast pocket. This allows the breast to look soft and gently teardrop-shaped when you are standing, and to return to a round shape when you lie down. Smooth implants also tend to have a lower chance of visible rippling. Compared with textured implants, they are easier for the surgeon to place and usually need a smaller incision.

2. Nano-textured implants – designed to reduce implant rotation and minimize the risk of capsular contracture (tissue hardening around the implant). They encourage gentle integration with surrounding tissue, improving overall biocompatibility and aesthetic results.

Implant Shapes

Breast implants come in two shapes:

1. Round implants – the most popular choice, as they provide a fuller upper pole and natural shape while simplifying surgery and ensuring predictable, lasting results. The cohesive silicone gel inside moves naturally with gravity—when standing, it gently settles to form a soft, teardrop-like contour, and when lying down, it returns to a round shape, much like a natural breast.

2. Anatomic (tear drop) implants – used less frequently today because they can rotate out of position, require textured surfaces, involve more complex surgery, and cost more—without offering clear aesthetic advantage over modern round implants.

Implant Placements

Implants may be positioned in one of the following locations:

1. Subglandular placement(under the breast tissue) is easier and faster to perform, and produces more pronounced roundness to the breasts and creates better cleavage line. However, subglandular implants may be more visible and palpable especially in skinny patients. Subglandular implants also are associated with slightly higher incidence of capsular contracture.

2. Submuscular placement (under the chest muscle)offers extra tissue coverage for the implant – ideal for slim patients, those with very small breasts, or patients who had undergone prior mastectomy. Extra tissue cover also means less chance for the implants to be visible or palpable. Submuscular implants have lower incidence of capsular contracture and are less likely to interfere with mammography. On the other hand, submuscular placement takes slightly longer operation time and recovery is usually slightly longer. Submuscular implants may interfere with chest muscle movements in athletic patients and cause distortion that may be visible during heavy exercises involving chest muscles.

3. Dual plane placement (partly under the breast and partly under the muscle)is an advanced technique that combines the benefits of both submuscular and subglandular methods. In this approach, the upper part of the implant lies beneath the chest muscle, providing better coverage and creating a soft, natural upper breast slope with reduced risk of visible rippling. The lower part of the implant sits under the breast tissue, giving a fuller, rounder lower contour and natural forward projection. This method also allows surgeons to customise the result by adjusting how much of the muscle is released — known as Dual Plane I, II, or III — to best suit each patient’s anatomy and desired look. Overall, dual plane placement offers excellent implant support, smooth contours, and natural movement of the breasts. Most of the breast augmentations performed by our surgeon use dual plane placement technique.

Preparation

1. Medical Conditions and Allergies
Inform your doctor of any pre-existing medical conditions or drug allergies. All medical conditions must be properly treated and stabilized before surgery.

2. Smoking
Stop smoking at least one week before surgery. Smoking impairs wound healing and significantly increases the risk of post-operative complications.

3. Medications and Supplements
Discontinue the following one week before surgery and continue avoiding them until one week after surgery:

a. Supplements: Avoid all supplements containing vitamin E, ginseng, ginkgo, garlic, fish oil, or any other substances that may increase bleeding. Stop any traditional medicine or herbal remedies with unknown ingredients.

b. Medications: Medications that may increase bleeding—such as aspirin, NSAIDs, and warfarin—should also be stopped. However, please consult your prescribing physician before discontinuing them.

4. On the Day of Surgery

a. Wear simple and comfortable clothing.

b. Do not wear any makeup, jewellery or metal objects on your face or body.

Surgery Overview

Duration: 1-2 hours

Anaesthesia: General Anaesthesia

Hospitalization: Half a day (daycare)

Breast implant – incision placements

Surgery Technique: There are 3 approaches to insert breast implants:

2. Periareolar approach (around the areola): In this method, the incision is placed along the lower half of the areolar border. The scar is usually well-camouflaged by the natural colour and texture of the areola. However, this approach may carry a slightly higher risk of changes in nipple sensation, difficulty with future breastfeeding, and possibility of infection. It may also be unsuitable for patients with small areolae, as the incision may be too short for safe implant insertion.

3. Transaxillary approach (armpit incision):The incision is made within the armpit crease, and a tunnel is created towards the breast to insert the implant. Endoscopic assistance is often used to enhance visibility and accuracy. The main advantage of this approach is the absence of any scar on the breast itself—the scar remains hidden in the armpit. However, because the surgical access is more distant, the technique requires higher technical precision and offers less direct visual control compared to incisions made directly under the breast.

Recovery and Post-operative Care**

Most patients can return to work within 3–7 days, resume light exercise after about 1 week, and return to regular workouts after 4 weeks. Recovery times may vary depending on individual healing and activity levels.

What to Expect After Surgery

1. Swelling is normal and typically peaks around the second to third day post-surgery, gradually improving thereafter.

2. After the procedure, your breasts will be supported with a surgical bra to provide support during healing.

3. Showering is usually permitted 2–3 days after surgery, but you should take care to keep the dressings dry and avoid soaking the surgical area.

4. There may be tight sensation in the chest for one to 2 weeks, especially if large implants are used in patients with tight chest skin.

5. During the early recovery period, the breasts may appear slightly higher and appear fuller in the upper part. This is normal and temporary. Over the next one to two months, they will gradually soften and settle into a more natural, balanced contour.

General care instructions:

1. Wear a supportive bra — Continue wearing the special supportive bra provided by the clinic day and night for at least one month. This helps reduce swelling, supports healing, and maintains the new breast shape.

2. Avoid smoking — Do not smoke for at least one month after surgery. Smoking reduces blood flow and greatly increases the risk of delayed wound healing and other complications.

3. Sleep on your back — Sleep on your back with your upper body slightly elevated, and avoid lying on your sides or stomach to prevent unnecessary pressure on the breasts.

4. Get adequate rest — Allow your body enough time to recover by getting plenty of rest and good-quality sleep. Avoid strenuous activities or heavy lifting until your surgeon advises otherwise.

5. Stay calm and relaxed — A positive and relaxed mindset helps your body heal more effectively. If you have any questions, discomfort, or concerns during your recovery, please contact our clinic — we’re here to support you.

Medicine instructions:

1. Complete the antibiotics — Take the full course of oral antibiotics exactly as prescribed, even if you feel well before finishing them.

2. Pain management — Take the prescribed painkillers when necessary.

Wound Care Instructions:

1. Keep the dressing on — Leave the wound dressing in place until your scheduled review at the clinic.

2. Change if necessary — If the dressing becomes wet, dirty, or loose, replace it with a clean, dry one, or contact the clinic for assistance.

3. After dressing removal — Once the dressing is removed (as advised by your doctor) -Gently clean the wound using a clean cotton tip soaked in sterile water or saline. Apply ointment — After cleaning, apply antibiotic ointment as directed.

Physical Activity Instructions:

1. Limit activity — Avoid lifting heavy objects, stretching your arms excessively, or performing strenuous exercise for at least one month to ensure proper healing.

2. Rest and recovery — Gentle movements are fine, but listen to your body and stop any activity that causes discomfort.

Follow-Up Instructions:

Post-op review —Return for your follow-up appointment one week after surgery for wound inspection and recovery assessment.

Emergency Instructions:

Seek immediate help — If you experience heavy bleeding, a rapid increase in swelling, severe pain, high fever, or notice redness, warmth, or discharge from the wound, please contact the clinic immediately for advice.

Please Note:
These instructions are intended as general guidance. Every patient’s recovery may vary. If you have any doubts, discomfort, or specific concerns, please contact the clinic directly for personalised advice.