9 Key Breast Augmentation Q&As Answered by Dr Colin Tham

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Due to the nature of the Asian genes, many Asians find their breasts less voluminous as compared to their Caucasian counterparts.

As such, Breast Augmentation procedure is one of the most common procedures performed in Asia today.

For those of us who are keen on a Breast Augmentation procedure but have some pressing questions such as the suitability of the different methods, expectations and pre-breast augmentation surgery preparations, here are some answers and tips from one of Singapore’s most renowned plastic surgeon, Dr Colin Tham in this Doctor Opinion segment.


Breast Augmentation

1) Qn: Who are the suitable candidates for a Breast Augmentation procedure?

Ans: Any lady who is bothered by the size, shape or position of her breasts, nipples or areola.

2) Qn:What determines a good breast surgery?

Ans: A good breast surgery is a surgery, which delivers durable aesthetically-pleasing results, while preserving the function and sensation of the breast and nipple-areolar unit.

3) Qn: What can a breast augmentation do for the breast?

Ans: A breast augmentation improves the volume, shape and position of breasts.  The procedure can be used to lift sagging breasts, or improve symmetry with unequal breasts.  Nipples can be reduced if large, or pulled out if inverted.  Areola can be reduced.

4) Qn: Implants vs fat grafting vs fillers, what is the difference amongst the three and which is the best for whom?


There used to be 3 brands of fillers available in Singapore.  Aqualift had problems with infections, Hyacorp had problems with lumps and migration.  Macrolane was quite safe but was costly and only lasts 1-2 years.  I stopped using Macrolane as the manufacturer issued an advisory that it could interfere with the screening for Breast Cancer; we shouldn’t be performing procedures, which can interfere with the detection of something as serious as cancer.

Fat Grafting

Fat grafting is a good option for those patients who have enough fat to achieve the breast enhancement they desire.  It is a natural result with minimal scarring, and there is the advantage of excess fat from another area (usually tummy or thighs) being removed.  The advantage over implants is that there is no foreign material used.  The main drawback is that many patients who want breast enhancement have insufficient fat to achieve their desired size.


Implants are my personal preference, as the result looks the best of the 3 options while being predictable and durable.  Of the 3 options, implants are the most effective at reshaping breasts, not just increasing the volume.  If performed well, they do not sag much with age.  In contrast to fat transfer, implants are possible for most candidates.  Contrary to a lot of info online, implants do not need to be changed unless problems arise.  Some patients have had their original implants for 30+ years.  The main psychological barrier for some patients is the presence of foreign material.

5) Qn: Silicone implant vs saline implant, which is better?

Ans: Silicone, hands down.  Better look and feel.

6) Qn: What is done during the surgery for each method?

Fillers:  Just the simple injection of fillers under local anaesthetic.

Fat Transfer:  Usually performed under local anaesthesia and sedation or general anaesthesia.  The fat is harvested from the donor areas (usually thighs or tummy), then prepared / filtered.  The pure fat is then injected through a long cannula (blunt needle) into the breast tissue.

Implants:  I only perform this under general anaesthesia.  A deep pocket is created to exactly fit the implant underneath the breast tissue (and muscle).  The implant is inserted and the small incision (3+cm) is closed.

7) Qn: Any lifestyle habits to change or eliminate before the surgery?

Ans :Smoking would be the main habit to eliminate.  It decreases fat transfer survival and increases the risk of infection for all methods.

8) Qn: What are some of the things one has to do in preparation for the surgery?

Ans: There is a list of medications and supplements to avoid from 1-2 weeks before surgery.  If the surgery is performed under sedation or general anaesthesia, patients are required to fast 6 hours beforehand.

9) Qn: What to expect right after the surgery?

Ans: There is some swelling which will make the breasts appear larger than they will be.  There is some discomfort as well, more with implants than the other methods.

Read more for Part 2 of Dr Colin Tham’s expert opinion on post breast augmentation care and expectations.

Colin Tham Hsien Jen

Plastic Surgeon

304 Orchard Road
Lucky Plaza #05-06
Singapore 238863

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