Breast Augmentation in Kuching

Overview

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Two different operations

Breast augmentation increases breast volume, and sometimes improves symmetry or restores fullness lost after pregnancy, breastfeeding or weight loss. There are two fundamentally different ways to do it, with different trade-offs.

Implants

A silicone or saline implant is placed through an incision in the breast fold, around the lower edge of the areola, or in the armpit. It may sit in front of the chest muscle or partly behind it. Implants give a predictable, controllable increase in size and can achieve larger changes in a single operation.

Implants are medical devices, not permanent fixtures. They do not last a lifetime, and most patients should expect further surgery at some point — whether for capsular contracture, rupture, a change in position, or simply because the implant needs replacing.

Fat transfer

Fat is taken from another area by liposuction, processed, and injected into the breast. There is no foreign material, the result feels natural, and you get a contour improvement at the donor site as well.

The limitations are real: the increase in size is modest — typically less than one cup size per session — a proportion of the grafted fat is reabsorbed, and more than one session is often needed. You also need enough donor fat to begin with.

When a lift is needed instead

If the main concern is that the breasts sit lower than you would like, augmentation alone will not lift them. A breast lift (mastopexy), with or without an implant, is the operation that addresses position. Dr Kueh will tell you plainly which of these your anatomy calls for.

Who it may suit

• Adults whose breast development is complete
• Women seeking greater volume, or correction of noticeable asymmetry
• Women restoring volume lost after pregnancy, breastfeeding or weight loss
• Non-smokers in good general health, at a stable weight

Who it may not suit

• Anyone pregnant or breastfeeding, or planning pregnancy in the near future
• Anyone with an untreated breast lump or abnormal screening result — this must be investigated first
• Smokers who will not stop, given the effect on wound healing
• Anyone with significant sagging who is unwilling to consider a lift

What recovery involves

The first few days involve tightness and soreness across the chest, more so when the implant is placed behind the muscle. A support bra is worn for four to six weeks, and you are asked to avoid lifting your arms above shoulder height, heavy lifting, and strenuous activity in the early weeks.

Most people return to desk work within one to two weeks. Implants often sit high at first and drop into a more natural position over the following weeks to months. The settled result is usually apparent at three to six months. With fat transfer, final volume is judged at around three to six months, once the reabsorption has finished.

Risks and limitations

General risks include bleeding, infection, haematoma, poor scarring, and changes in nipple or breast sensation, which may be permanent.

Specific to implants: capsular contracture, where scar tissue tightens around the implant and makes it firm, distorted or painful; rupture or leakage; rippling or visible implant edges, particularly in women with thin tissue cover; malposition; and the need for further surgery over a lifetime. Implants can also make mammogram interpretation more complex, so tell your radiographer you have them.

Breast implant-associated anaplastic large cell lymphoma (BIA-ALCL) is a rare cancer of the immune system linked to certain textured implants, and breast implant illness is a term used for a cluster of systemic symptoms some patients report. Both will be discussed with you as part of consent, so that your decision is properly informed.

Specific to fat transfer: unpredictable fat survival, fat necrosis, oil cysts, and calcifications that may appear on future mammograms and require assessment.