Since the start of the COVID-19 pandemic, many people are looking towards local plastic surgery clinics since they are unable to travel to Korea for plastic surgery procedures. Eunogo spoke with Dr. Shens of Shens Clinic, a plastic surgery clinic in Singapore, that applies Korean plastic surgery techniques.
Thank you for speaking with us today, Dr. Shens. Can you tell us about your background and training?
Dr. Shens: I'm Dr Shenthilkumar Naidu (also known as Dr Shens), and I'm a Ministry of Health accredited Consultant Plastic Surgeon. I graduated from the National University of Singapore in 1998. Upon completing the basic surgical training, I became a Fellow Member of the Royal College of Surgeons of Edinburgh in 2002.
It was during my basic surgical training, in which I was first exposed to the fascinating specialty of plastic surgery. Hence, I entered the advanced specialty training program in Plastic and Reconstructive Surgery at the National University Hospital. I was also awarded the Health Manpower Development Programme Scholarship to further my training in plastic surgery and the subspecialty of Reconstructive and Aesthetic at the Hanyang University Hospital located in Korea. It is from my experience in Korea, which I have acquired many Korean surgical techniques unique to enhance the beauty of the individual. Furthermore, adapting what I've learnt and modified them to surgical skills for the local requirements in Singapore.
I have been recognized by the Registry of specialists for Plastic Surgery, Singapore and appointed as Consultant Plastic Surgeon in Tan Tock Seng Hospital (TTSH). After several years of service to the government I went on to private practice. With that, I have also maintained my ties with the public healthcare sector as a visiting consultant to TTSH, Gleneagles Hospital and Mount Elizabeth Hospital. To support rising Singapore Plastic Surgeon graduates; I was also appointed as a clinical teacher at the Faculty of Medicine, National University of Singapore, to share my Plastic Surgery knowledge.
What are some of the procedures you are known to do?
Dr. Shens: My main clinical interests are cosmetic surgery of the face and body. Particularly, body contouring and the specialist surgeries for "Mummy Makeover" treatments. I have further attended an International Plastic Surgeons Exchange Programme in Colombia to upgrade and update my skills from Vaser Liposuction to a High Definition 4D Vaser Liposuction for finer and better body contouring.
Furthermore, I also have one of the largest series on double eyelid creation in Singapore, and I was invited to speak on this topic in various regional and international conferences.
Can you please tell us about your experience doing breast augmentations, which is our topic of discussion today?
Dr. Shens: Well, in addition to the combination of my almost 20 years of education and practice, in late 2016, I was handpicked by the distributor of Motiva Breast Implants, and was the first plastic surgeon to use Motiva products in Singapore. Thus, Shens Clinic was also the first Plastic Surgery Clinic to combine Motiva Imagine Centre in our Ministry of Health accredited Day Surgery Centre.
But in short, I've been performing breast augmentations for more than 12 years.
Can you tell us about who is the best candidate for breast augmentation?
Dr. Shens: In general, the best candidate for breast augmentation should be in good physical health with a healthy frame of mind prior to making the decision to proceed with the breast augmentation surgery.
In terms of physical attributes, the individual conceded that they are dissatisfied with the shape, as well as the volume of their breast and wishes to get it fixed (e.g. loss of volume after pregnancy or elongated shape).
Further, in my opinion, the best candidate needs to have the desire to make a change for the matter that has been bothering them. And, taking that step to make the change, is perfectly okay.
It is also important to note for the patients that the breast augmentation needs to be done solely for themselves, as they believe it would help them get their confidence or happiness back on track. Hence, cosmetic surgery or proceedings should never be done due to the demands of someone else.
Please tell us about the different kinds of implants, and especially about Motiva. Is this the brand of implant you prefer/recommend to patients?
Dr. Shens: I've been using breast implants in my private practice for a really long time. I started off using round implants and have since moved on to teardrop implants. Textured MENTOR® brand implants were pretty popular in Singapore at one particular stage. However, as time passed, textured implants got a bad name due to the association of ALCL (Anaplastic Large Cell Lymphoma) so now we use smooth.
Soon after, Motiva implants came along and rose to popularity. Most of my patients request for Motiva implants because it gives a very natural shape (teardrop shape) and delivers a slightly higher profile — fuller-looking breasts (which traditional teardrop implants would not be able to achieve). Thus, giving the patients the best of both worlds.
With that being said, Motiva implants are also softer to touch and don’t cause ALCL as it has been proven in the ten years of study regarding its safety. All of this explains Motiva’s tremendous popularity.
As Motiva implants' popularity continues to rise, our experience with the Motiva implants exponentially grows with more surgeries being carried out. Hence, as I mentioned earlier, because Shens Clinic was the first to receive Motiva implants in Singapore, we hold the record of the most breast augmentation done in Singapore.
From the time we have used the first Motiva implants, we have also held multiple courses alongside the specialized trainers from Motiva, in which overseas doctors came to learn from us.
What is the average size of implants your clinic uses in Singapore?
Dr. Shens: The majority of our patients prefer about 200-300cc implants to achieve a natural look.
Is there more than one type of method for breast augmentation?
Dr. Shens: At Shens Clinic, the breast augmentation procedure can be done by two different methods: breast implants and fat transfer to the breasts (pure graft).
Regarding the method of breast implants, the patient can choose between the silicone and the saline breast implants, which come in various sizes and shapes (mainly round and teardrop shape) to help them achieve their desired shape and look.
The selected implants can then be further inserted over or under the chest muscles through incisions of the armpits (transaxillary), or the areola (areolar), or along the crease of the breasts (inframammary).
Typically, I would recommend my patients to proceed with the preferred method of having the incision along the crease of the breasts. This method confers minimal scarring of no longer than 2.5 cm, without any potential complications of damaging the mammary (milk) glands around the nipple.
Is there a reason you prefer the crease to going through the armpit or the areola?
Dr. Shens: It’s not that I prefer it to the others, but first, I can tell you with a transaxillary (armpit) incision will usually be longer and it is not a direct route to the breast. Second, in the event that a patient either wants to exchange an implant for a different size or correct an issue with their initial procedure or a complication, then we will have to create an inframammary incision anyway. But if the original surgery was already done under the breast crease, we are able to use that same entry point, which creates only one scar at the end of the day. It isn’t the only incision we use, but we do prefer it.
In terms of the areolar (nipple) incision, I have really steered away from it. For one, if the patient is looking to get a bigger implant, it may not fit. Second, it is easier to put in an implant above the muscle through the areola, but not as easy underneath the muscle. It becomes far more difficult. The third, and most common reason, is that the nipple harbors bacteria and we cannot completely seal off the nipple during surgery in order to prevent a bacterial infection. This can cause a capsular contraction of the implant and nobody wants that. The risk does not outweigh the rewards.
How long does the surgery last?
Dr. Shens: On the day of surgery, an anesthesiologist will be present to ensure proper sedation and local anaesthesia are carried out. During the process of the surgery, patients can be rest assured that they will experience no pain as they will be sleeping.
The breast augmentation with the method of using implants would normally take around 45 minutes.
And what about recovery? Does it take long?
Dr. Shens: For postoperative measures, patients would be required to rest up for an hour or two. The medical staff at my clinic will provide specific instructions and guidelines. It is important for the patient to abide by the instructions to prevent postoperative complications and ensure a smooth recovery.
Furthermore, as the anaesthesia starts to wear off, there may be some tightness or feeling of discomfort, but medications will be provided to the patient. The medical staff will explain and guide patients through arm exercises to relax the chest muscles during the recovery period.
In regards to the general downtime, breast augmentation surgery these days has a very short downtime. In fact, this procedure is now a day surgery procedure, which means that the patients can go back within the same day. And, living in the times of a global pandemic, many individuals are still working from home. Thus, after the operation, individuals are able to jump back straight to work after a day of rest.
Can you talk to us about breast augmentation safety risks please?
Dr. Shens: Recently, there has been a lot of discussion about the safety of breast implants and the mentioning of the term, ALCL (Breast Implant-Associated Anaplastic Large Cell Lymphoma). Essentially, in Singapore, there are a couple of brands of breast implants which are available. With that noted, we find that the ones we are using in Shens Clinic do not actually confer such a risk for the patients. For example, we use smooth Motiva implants. These implants are very safe, and they do not have the risks of lymphoma.
One last question, just for fun: Korea is famous not only for plastic surgery, but also for the delicious food! What is your favorite Korean food?
Dr. Shens: Ginseng chicken because it's flavorful and tender!
Get a quote for Breast Augmentation at Shens Clinic here.
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