Breast enhancement -- does size really matter?

Wed, 07/02/2008 10:53 AM  |  Health

The obsession with bigger breasts is not a new phenomenon but we have definitely come a long way from the time when small-breasted women used toilet paper to pad out their bust.

In Asia, the demand for bigger-cup bras has been growing steadily during past years to cater to the increasing numbers of well-endowed women. Hence, the popular notion that most Asian women are small breasted is no longer valid. But what has contributed to this shift?

While some of us fault men for being genetically programmed to zero in on "Pamela Anderson-like breasts" (technically, this is only a half-truth), women themselves are becoming much more willing to spend a fortune on improving their cleavage.

That explains why getting breast enlargement surgery is fast becoming the modern day equivalent of buying a Louis Vuitton handbag.

However, unlike handbags, there are many things a woman should consider before jumping onto the bandwagon. It is not a one-size-fits-all kind of matter.

Dr. Marco Faria-Correa, a renowned Brazilian cosmetic surgeon who practices at the Gleneagles Hospital, Camden Medical Centre and East Shore Hospital in Singapore, points out there are a few important factors patients have to consider before making their decision -- and choosing the right doctor is the most crucial one.

"Patients must spend some time 'investigating' the doctor's credentials and reputation in the industry. Visiting the doctor's clinic a few times and talking to other patients in the waiting area is a good way to validate the doctor's experience," Faria-Correa advises.

As most patients are ignorant about the type of breast enlargement that will best complement their figure, they need to rely on the doctor's judgment to guide them in making their decision.

A highly professional and experienced doctor is someone who is able to advise patients on the correct implant size according to their body balance, the degree of the upper pole fullness and cleavage, the right implant shape (whether it is round or anatomical), the nipple position and the placement of the implant (whether it should be under the muscle or on top of the muscle).

The doctor should also highlight the amount of breast tissue in the patient's breasts. This is important in determining the cosmetic results.

For example, skinny women with little or no breast tissue are more prone to wrinkling and implant palpability, so they need to go through a different procedure than that for women with flabbiness in the area.

Careful surgical planning and technique will minimize the chances of disasters such as scarring, loss of sensation (usually if it cuts through the periareolar or transareolar nipple) and seroma formation (a collection of the watery part of blood).

Opting for breast implants is undoubtedly a personal decision but patients should be made to fully understand and accept the potential risks of the operation.

While some women see an enormous benefit to getting implants (claiming it can significantly improve their quality of life), they should have realistic expectations and not push the boundaries based on aesthetics alone. They should also recognize the importance of follow-up evaluations with their doctor, as proper counseling is crucial in preventing unnecessary complications.

"As a doctor, it is very important you never damage a person and it is our moral duty to guide them to making the right decisions," he says.

"Breast implants that are too heavy look very artificial and can also be bad for the woman's back, and the body's support for the breasts will not last very long. Furthermore, the support bras they wear will be very tight, which could result in shoulder pain."

Lifestyle-wise, large breasts can be a burden for women. Simple activities such as jogging and dancing can become cumbersome and obstructive. Breasts that are too large can literally be a pain in the neck.

Whatever your reasons may be, the cosmetic surgery procedure is just a tool to help promote a more positive self-image. For some patients, even the slightest change on the outside can create an extraordinary positive psychological change.

Patients who are considering cosmetic surgery have to be honest with themselves about their own goals. Because the changes resulting from plastic surgery are permanent and often dramatic, it is crucial you have a clear understanding of how the surgery might make you feel.

"Surgeons need to explain, show examples and manage the expectations of their patients. We must discuss not only the benefits but also the risks. You must say, yes, the risk of complications such as capsular contracture is minimal but there is still around a 6 percent chance. Scars may also be a consideration, especially if the patient has a high tendency for keloids."

Highlighting the negative aspects of large breasts often does the trick in dissuading a woman from choosing implants that are too big for her frame but sometimes, when that does not work, a more "direct" approach is needed. The most effective tactic for Faria-Correa is simply by saying the magic word: "fat".

"Simply tell a woman that very large breast implants will make her look fat and she will usually change her mind," he laughs.

However, in cases where patients refuse to budge, the surgeon has to use his or her better judgment and decide whether or not to proceed with the surgery. Ultimately, regardless of the motivation, the surgeon has to be answerable for the results of the surgery.

"In some extreme cases, when I feel there may be some sort of competition issues (just like men with their penises) and when the request is out of the ordinary, I will deny them the surgery," he said.

Fortunately, breast augmentation for most women today is no longer about trying to look like Pamela Anderson or Dolly Parton. Rather, the trend now is to achieve a look that is as natural and in proportion as possible, which in Faria-Correa's opinion is a very promising trend.

These days, with the wide variety of implants available, patients are able to choose not only the size but also the shape, projection and the prominence of their breasts.

"When considering cosmetic surgery, it is not the time for you to think about saving money. You shouldn't even think about looking for the cheapest surgeon. Top premium implants cost almost S$3,000, so technically if you can find a surgeon who is packaging the entire surgery for less than the price of the implants themselves, then you have to really worry and question the quality and safety of the surgery," he emphasizes.

"An experienced surgeon is someone with an eye for detail. They are able to listen to your request and tailor your breast implants according to your body shape. They take the time to explain at length about breast and chest shapes, which is beyond compare.

"Despite some of the risks mentioned, breast augmentation surgery is a safe way for a woman to improve the way she feels about her physique -- provided, of course, she entrusts her body to an experienced surgeon. The surgery is safe because the doctors know how to handle the situation."

Articles in this column, which appears every two weeks, are provided by a panel of health professionals from www.flyfreeforhealth.com. Our health service providers include Dr. Marco Faria-Correa, a worldwide pioneer in using endoscopic methods in plastic surgery; Dr. Beh Suan Tiong, a pioneer in gynecological "Key Hole" surgery and President of the Obstetrics & Gynecologic Society of Singapore and Singapore National Eye Centre. Email us at info@flyfreeforhealth.com.

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