Breast Augmentation Surgery

Breasts have long been the subject of fascination for both women and men alike. It has captivated the imagination of many. Who wouldn’t want to be born with a pair of beautiful breasts? After all they are more than just mammary glands for newborn to suckle on. Breasts can make a woman look good and feel sexy, and to many, size DOES matter. For many decades, the desire for more beautiful and fuller breasts has been fulfilled with breast augmentation surgery.

For many women around the world, breast augmentation has not only improved their looks but has enhanced their self confidence and esteem.

Dr Norazlin Moktar of Sun Sea Surgery took a closer look into this intriguing subject with Malaysia’s very own Consultant Plastic and Reconstructive Surgeon, Dato’ Dr. A. Jalil Jidon.

Breast augmentation is usually done to correct un-even breasts size, improve body contour, or as a reconstructive technique following surgery.

“Also known as augmentation mammoplasty, it is a surgical procedure to enhance the size and shape of the breasts, and most importantly to improve body image”, Dr. Jalil reckons. “Breast augmentation is a very safe procedure,” he continues. Most of the patients who seek his expertise are those with small breasts or breasts that require a lift. “Basically it is a personal choice.”

This brings to mind a very interesting question, “How do you choose the size of implants to be used?”.

The choice of sizes (commonly used are 250 ml to 500ml) depends on remaining breast tissue, that is, the size of breasts, the surrounding skin, level of ptosis (droopiness) and patient’s physical appearance which will give you the appropriate size of the new breasts. For example the size should be in proportion to the patient’s height or body frame, among others.

According to Dr. Jalil, there are two types of implants used; silicon gel and saline filled implants. He personally prefers silicon gel because it gives a more natural feeling to the breasts. I had a feel of the silicon gel and it DOES feel like natural breast tissue - really soft, like the real thing. Besides that, its considered to be very safe since rupture rate is only 1%.

Saline implant is less favored now because it doesn’t feel as natural and hardens easily. As it is water-based, it can also reduce in size over time and many patients experience the feeling of water “sloshing” around in their breasts. However, the rates of contractures of both implants are the same.

The breast implant may be inserted directly under the breast tissue or beneath the chest wall muscle.

There are two approaches normally used in breast implants, the i) below and ii) above the muscle (pectoralis major) approach. For small breast without the complications of droopiness the below muscle approach is used and for higher grade of ptosis (droopiness),the above muscle approach is used.
The grade of ptosis depends on individual shape and size of breasts as well as laxity of skin and remaining breast tissue. Breasts with an uneven shape due to grade two ptosis can also be corrected with breast augmentation.

Dr Jalil uses an inframammary crease approach to create a good pocket and subsequently, the scar will heal nicely. “Another approach is the auxiliary approach but it will have the hanging effect which is quite undesirable. Transcircumareola incision is not favourable either because it will go into the breast tissue and increase the risk of bleeding and infection”, he adds.

The procedure usually takes one to one and a half hours and can be done under both general and local anaesthesia. Recovery period is very fast where patient can be discharged the very next day and they can go straight under the shower. Any pain or discomforts which could be felt for a few days can be alleviated with painkillers. Dr Jalil’s patients won’t require removal of stitches removal, however post-op check-ups are required at one, three and six months or more.

Patients are taught breast massages to be applied after one week which will help to reduce contracture. There shouldn’t be any reduction in size with silicon gel implants but 30% reduction in size is expected in saline implants after a few years.

Incisions are made to keep scars as
inconspicuous as possible, in the breast
crease, around the nipple, or in the
armpit. Breast tissue and skin is
lifted to create a pocket for each implant.

After surgery, breasts appear fuller and
more natural in tone and contour. Scars
will fade with time.



Possible complications of breast augmentation include haematoma, infection which is minimised with intravenous antibiotics and contracture in 5% of cases which can be minimised with clean pockets and breast massages. On the subject of oversensitive nipples post-surgery, Dr. A. Jalil says that it is not as common as numbness, which could occur as a result of sensory nerve being resected during surgery. However, these will usually disappear over time.
Cautions are practiced with those having a history of breast lumps where a biopsy will be carried out. Should a lump biopsy reveal a fibroadenoma (a benign tumor), it will be resected during the operation. Patients with a family history of breast cancer will be required to undergo a mammography. Dr. Jalil stresses that there is no evidence that breast augmentation will increase the incidence of breast cancer.

To my question whether an augmented breast can withstand normal mammography, the answer is a resounding yes. More importantly, patients must be realistic in their expectations in a sense that they have to abide by certain guidelines to avoid going into revision.
When asked if he thinks breast augmentation surgery is suitable as a Health Tourism product, Dr. Jalil is absolutely certain that it is. This is not only because the procedure and recovery period is relatively short, but also because of the high level of expertise that we offer and at much lower cost than what most visitors would have to pay in other countries. The surgical fees here are generally 50% or more, cheaper than it is compared to their home countries.
Most of Dr Jalil’s foreign patients are from Australia, New Zealand and the United Kingdom as well as from Hong Kong, Germany, the U.S and Singapore.
Dr. Jalil noted that “every breast is different” and agrees if a woman feels that a breast augmentation would improve her body image-she should go ahead with it because it’s a natural thing to do. Besides, it is a safe procedure.

Dato’ Dr A. Jalil Jidon is a member of the Malaysian Association of Plastic,
Aesthetic and Craniomaxillofacial Surgeons (MAPACS).

Cost of procedure:
Breast lift USD3,400/-
Breast enlargement USD4,800 (with implants)
For info: www.makeovervacations.com