Breast augmentation is a surgical procedure that takes about 90 minutes to perform. It is generally performed under general anaesthesia and as a day surgical case. The down time ranges from 5 to 10 days depending on whether the implants are placed on top or below the chest muscle. Patients will be able to resume normal aerobic and gymnasium exercise after 4 weeks.

Whilst it is a comparatively simple procedure, to obtain a consistent, predictable and great augmentation results require:
Artistry, Aesthetic sense, Symmetry and Balance

Normal saline Vs Silicone
This is an issue that is still troubling some women who are contemplating breast enlargement surgery. This arose following the media coverage on silicone related illness that was first reported in America in the early nineties. This led to the withdrawal of silicone implants worldwide. Since 1999 the use of Silicone implants for cosmetic uses has been approved in Australia by TGA (Governing body on the safety of surgical products in Australia)

This approval came about following a number of well published scientific studies on close to 100,000 women worldwide, looking into the safety issues of silicone implants. The results confirmed that the silicone implant is a safe product and its use does not increase the risk of any auto immune related illnesses, and is not linked to breast cancer.

The latest cohesive gel silicone implant reduces the risk of gel leaks and rupturing even further. Making it an even safer implant to use.

Whilst both types of implant are safe, Dr Liew prefers silicone than saline implant for it produces an aesthetically more natural and pleasing looking breast. It also produces a more natural feel compared to the normal saline implant.

The Teardrop vs Round implant
The increase in the choice of implants available in the market whilst allowing surgeons more flexibility, can however, at times create confusions for women who have to make decisions on the type of implant to have.

The new anatomical/teardrop shape implant has been widely publicised and marketed by some in providing a more natural breast shape. Whilst this is true in general, it is certainly by no means necessary in all cases.

Our philosophy on the type of implant to use is quite simple. If the patient’s existing breast shape and form is good, a round gel filled implant will be able to enhance the existing breast with equally good result, thus saving the patient in the cost of the implant. Dr Liew will use a tear drop/anatomical implant if there is a need to improve the overall shape of the breast in addition to increasing the volume.

What size implant ?
This is probably the hardest piece of information for most patients and their treating plastic surgeon to agree upon. Some patients will come in with an implant size in mind based on their friends recommendation who has had breast augmentation surgery. Others come in requesting a specific bra cup size and in some with photos of women in bra or lingerie, not realising that a bra can distort the overall shape and apparent size of the breasts.

In reality, choosing the right size implant is more complex then just the grams or the cc’s of implant. The final size of your breasts depends on your existing breast volume, the thickness of the soft tissue covering of the breast, the bulk of the muscle and the tightness of the skin envelope. In essence, a 300gm implant on one patient will look different in a different individual of the same build and similar breast shape and size.

The implant size should take into account of all the above varying factors of an individual as well as the overall shape and size of the patients chest and body. Dr Liew believes that this important decision should be a combined effort between you and the surgeon based on all the criteria above as well as individual requests.

Type of incision
Whilst this is the most commonly asked question, Dr Liew feels that this is probably of secondary importance. His philosophy is to use the incision that will gives the patients the most aesthetically pleasant looking breasts. The incision chosen must allow the surgeon to adequately visualise each step of the surgical procedures and hence reducing any potential risks of complications.

Being a plastic surgeon, meticulous incision as well as paying attention to closure of the wound in ensuring perfect skin closure, is what Dr Liew does on a daily basis. This attention to detail as well as our vigorous post op care on the wound will ensure the incision heals up nicely and least noticeably in most cases. (NB: Some bad scars are genetically determined and cannot be controlled by the surgeon)

On top or behind the muscle
The implants can be positioned either on

1. On top of the muscle 2. Behind the muscle. 3. Dual plane: where the top half is under the muscle and the bottom half is in direct contact with the breast tissue.

The whole issue of where to place the implant is to ensure that the implant is not visible and cannot be felt when touched.

In general, if the amount of soft tissue padding is adequate, than, Dr Liew would insert the implant in the subfascial plane which is on top of the muscle but behind the a layer of thin tissue superficial to the muscle. However, if the patient does not have adequate padding, then he will place it behind the muscle, in order to cover the implant and ensure the implant is not visible or palpable.

In some patients who present with some droopiness and inadequate tissue on upper chest then a dual plane technique will be utilised, where the lower half of the implant is in direct contact with the breast tissue, to create a lifting effect and also ensure the implant is well padded on top by placing it behind the muscle.