Augmentation mammaplasty in asian women.

With the rapid economic development of Southeast Asia, the demand for cosmetic surgery has increased rapidly. Breast augmentation is among the most frequently performed cosmetic procedures. However, breast augmentation still has "bad press" in Southeast Asia because of not so distant catastrophes caused by direct liquid silicone injection and "Amazing Gel" augmentations. Asian patients have special characteristics that need to be taken into consideration when performing breast augmentation. The patients are usually thin and small with proportionally smaller breasts. The areola is often small with a large nipple. Because of poor scar healing, incisions need to be hidden. The transaxillary approach is therefore favored. A frequently performed adjunctive procedure is nipple reduction. In this article, the authors present their preferred technique for augmentation mammaplasty: endoscopically assisted subpectoral placement of smooth saline-filled implants via a transaxillary approach. Simultaneously, nipple reduction with the "modified top-hat flap" procedure is presented. Complications and their management are also discussed.