Are there different types of breast surgery? How are they different?
When most people think of breast surgery, their mind typically relates it to breast enlargement, or simply boob job. However, a breast surgery or breast augmentation (also called mammoplasty) is actually a group of surgical procedures to modify the appearance of the breast. It can be performed to increase or reduce the size of the breast, alter the shape of the breast, or even reposition the nipple.

Types of breast surgery:

Breast Enlargement Using Implants: Come in different shapes, sizes, and materials. Depending on your body condition and surgeon’s recommendation, the breast implants may be inserted under the breast tissue or behind the chest muscles.

  • Round shaped breast implants are the most used shape for breast enlargement. Commonly filled with either saline or silicone.
  • Teardrop shaped breast implants have a thinner upper and a full, round base to mimic the appearance of a natural breast, commonly constructed from semi solid silicone. Many thinks that teardrop shaped breast implants will look more natural. It is a matter of personal preferences. When you are lying down, round shaped breast implants actually look more natural as their filler becomes evenly distributed, whereas teardrop shaped breast implants will remain confined to their original shape.
  • Saline breast implants: Filled with sterile saline solution.
  • Silicone breast implants: Filled with silicone gel and encased in silicone outer shell.

Breast Enlargement Using Fat Transfer: Uses liposuction to extract fat from other parts of your body such as tummy or thighs, then inject it to the breasts. Using your own fat for breast enlargement can be advantageous because there is no chance of an allergic reaction. However, the result might not be as obvious as using breast implants, since you can only increase 1 cup size at a time. Breast Reduction: Removes excess fat, glandular tissue and skin from your breast to ease discomfort on symptoms associated with large breasts. Breast Lift: Removing excess skin and tightening the surrounding tissue to achieve ideal breast shape and firmness. Gynaecomastia: For men with overly large breasts. Our surgeon can create a firmer and flatter chest by removing excess fat, breast tissue and skin. Nipple Reduction: To reduce the size of excessive long or wide nipples. Nipple Lift: To correct hidden and inverted nipples. Why do people seek breast surgery?There are a number of reasons why women and even sometimes men would like to have breast augmentation. For some who think their breasts are too small, breast enlargement is done to boost self-esteem. For others, a breast augmentation is crucial to rebuild their body confidence due to various conditions, such as asymmetrical breasts, mastectomy due to cancer, change in breast size and shape after childbirth, breastfeeding, extreme weight loss and aging. Whatever your reasons are, breast augmentation is a deeply personal procedure, and it’s important that you’re doing it for yourself, not to fulfill someone else’s expectation, as the result is something you live with for years, if not your entire life. ConsiderationsBefore you decide to have a breast surgery, here are some things that you should know:

  • Breast implants won’t save your breast from sagging: In addition to breast enlargement, you will need a breast lift to correct sagging breasts. That aside, your breast will continue to age and factors such as gravity, weight loss or weight gain will affect the way your breasts look in future. This may lead to more surgeries.
  • Breast implants might hamper breast-feeding: Many women considering breast augmentation are still quite young, and the ability to breastfeed is one of the issues to consider. While medical professionals share the common opinion that breast enlargement using implants should not interfere with your ability to breastfeed in any way, all women are different. As such, some might be successful at breast feeding, whilst others struggle after the surgery. Nowadays, the implants are placed away from the breast tissue so it doesn’t affect the lactation.
  • Mammograms might be complicated: Mammograms are meant to be routinely done as check-up, however if you have breast implants, you may require specialized settings.
  • Most breast augmentation procedures are not covered by insurance: Unless its medically necessary like a mastectomy – procedures such as breast enlargement and breast lift aren’t covered. If you are planning to get breast augmentation for aesthetic purposes, be prepared to handle the expenses and future follow-up examinations.
  • You may need additional surgery after removal of breast implants: If you decide to remove your breast implants, you may require a breast lift surgery or other corrective surgery to help restore the appearance of your breast.
  • You may need an MRI scan: As a precaution, after breast enlargement using implants, it is recommended by the FDA to get monitored routinely with MRI check every 3 years.
  • Breast enlargement using fat transfer may not be able to produce significant result: Your body will reabsorb some of the injected fat. This can mean the initial size you get right after the procedure is not the same as the final result. On a plus side, the results are extremely natural, and you’ll have fat removed from other body parts, giving you a contoured bodyline.

Before Breast Surgery
It is important to have a consultation with the surgeon to discuss your expectations. Once the date is set, there is a few things you must adhere to as a patient, it’s vital to follow the guidelines provided otherwise your breast surgery may be postponed. For example, certain medications like
aspirin need to be stopped as they can increase bleeding. If you are a smoker, you will need to stop for a period of time before the surgery.

During Breast Surgery
On the day of the surgery, the patient will be checked-in and examined by the nurses. Then the surgeon will do initially marking at the point of incision, areas to be lifted, the depth of incision etc. Once the marking is complete, the anaesthetist will put the patient under local or general anaesthesia.

For breast enlargement using implants, the surgeon will make an incision in one of these three places:

  • The crease under your breast (inframammary incision): The incision is made in the crease where the breast meets the chest to better conceal the surgical scar.
  • Under your arm (axillary incision): This incision is made in the armpit, where the surgeon creates a tunnel through the subcutaneous fat to create the pocket behind the breast,
    helped endoscopically. It is primarily used for saline breast implants. Some considers this the best incision as it does not leave scar in the breast itself.
  • Around your nipple (periareolar incision): This incision is made in the inferior-half border limit of the nipple areola, in a half circle shape. This results in a smaller, lighter and therefore, usually less visible scar.

After the incision is made, the surgeon will separate the breast tissues from the muscles and connective tissues of your chest. This creates a pocket either behind or in front of the outermost muscle of the chest wall (pectoral muscle). The surgeon will insert the implant into this space and centre it behind your nipples. Once the implant is in place, the surgeon will close the incision with sutures and bandages.

For breast enlargement using fat transfer, there are two phases: liposuction and fat injection. First, the surgeon will extract fat from other parts of your body using liposuction technique. The removed fat cells will be isolated, cleansed, and prepared for injection. Then, the surgeon injects the fat into your breasts.

After Surgery & Recovery
You will need to be warded for at least one night, during this period you will be under observation. Soreness and swelling will last around two weeks.

For breast enlargement using implants, there will be scarring that will fade over time but will not disappear completely. If this is something that bothers you, talk to our surgeon about it, we have lasers that can flatten the scar to make it less obvious. You may start the laser treatment one month after the surgery.

For breast enlargement using fat transfer, only minimal incisions are made to suck out the fat cells, hence the scars are small and barely noticeable.
For the first 48 hours after breast augmentation, you may have a slight fever and the skin of your breasts may become pink or red. However, if the fever and redness doesn’t get better 48 hours after the surgery, there is a chance that you have an infection. Do not hesitate to call the nurse.

Our surgical team will guide you for the following:

  • Care for your wounds after breast surgery: The surgeon will most likely suggest that you wear a compression or sports bra after the surgery to support and position the breast implants. It is important to follow the surgeon’s instructions to speed the recovery process. The patient should not engage in strenuous activities for at least 6 weeks.
  • How to use the prescribed medications
  • When to attend a follow-up visit: You will need to come back for follow-up appointments to remove sutures and thereafter for check-up on a monthly basis.

Possible Side Effects/Risks
As with all surgeries, there is a chance of complication arising from breast surgery, such as:

  • Infection: This can be treated with antibiotics and is fairly uncommon as surgical wards are clean (sterile).
  • Pain: All patients will receive pain relief medications right after breast augmentation.
  • Changes in nipple and breast sensation: Changes in nipple sensation are common after breast augmentation. Most people will return to normal nipple sensation within a few months after surgery.
  • Scar tissue forming around the breast implants (capsular contracture): The scar can become thick and hard and changes the breast shape. We might need to remove it through surgery or other methods.
  • Breast implants might rupture: Back in 70’s to 90’s, the rupture rate is 30% (Note: The numbers information is for reference only, the contents are not authoritative and is not an indication of future performance). In those days, breast implants need to be changed every 10 years. Nowadays, the rupture rate for new implants is 1% which is very low and don’t have to be changed. Rest assured that we use only FDA approved breast implants. The silicone is made of cohesive gel, a soft consistent type of silicone that avoids leakage in the improbable moment where the implant capsule is breached. So, look for a board-certified cosmetic surgeon, discuss your concerns during the consultation and you’re on your way to your desired breast augmentation results. With more than 25 years of experience in plastic surgery, Dr. Abdul Jalil Jidon is the one of the best people to talk to for a safe and comfortable breast augmentation experience.
  • KENANGA TOWER (Cosmetic Surgery, Aesthetic Medicine, Healthy Aging, Hair Restoration, Fat Reduction) • 3 DAMANSARA (Aesthetic Medicine, Fat Reduction) • JALAN MAAROF (Aesthetic Medicine, Fat Reduction) • MENARA LANDMARK (Cosmetic Surgery, Aesthetic Medicine, Healthy Aging, Hair Restoration, Fat Reduction)