The Philippines is one of the most visited countries where tourists enjoy travelling to for vacations, especially for those who are fond of visiting beaches and different cuisines derived from different cultures. 

Before the pandemic, the large number of tourists in the Philippines did not only come to the country for leisure. Another reason why they keep on coming is because of the enhancement clinics in the country. Compared to the United States and other Asian countries like South Korea, plastic surgeries- especially breast augmentation- costs a lot cheaper locally. Despite the lower price, these clinics provide satisfying results. Also, clinics are located in areas accessible to hotels and shopping malls, making it a hotspot for a vacation after their recovery. 

Of course, the pandemic gave a halt to the country’s medical tourism. However, not only tourists are customers interested in improving their physical features. Even locals are often customers with these kinds of services.

Despite the “New Normal”, there are still people who seek to undergo beauty enhancements. Most of them take this time to pursue their desire for more beautiful features. With safety protocols and the clinic requirements,  it became possible for these people to continue their journey to having a new look.

One of the clinics that help people on their journey during these times is Zi Institute. 

Dr. Caparas of Zi Institute of Plastic Surgery and Dermaesthetics

Dr. Lutgardo Caparas Jr. has been helping patients achieve their beauty desires for over two decades. Currently, he has been doing his operations at the comfort of his clinic, Zi Institute of Plastic Surgery and Dermaesthetics. 

The clinic is an accredited facility by both the Department of Health and Department of Tourism. It is internationally acclaimed for using quality and innovative techniques in aesthetic and reconstructive surgery, including breast augmentation.

Dr. Caparas got his degree in Medicine and Surgery from the University of Santo Tomas in 1984 and passed the Medical Licensure examination in 1985. His plastic surgery training also came from multiple accredited hospitals in the Philippines, including Veterans Memorial Medical Center, UERM Memorial Medical Center, Makati Medical Center, and Rizal Medical Center. More than that, Dr. Caparas also had additional training overseas at the King’s Daughter Hospital in Virginia, USA, under a physician training program in craniofacial surgery, in 1998.

He is also a member of several local and international medical organizations. He is part of the Board of Directors of the Philippine Association of Plastic, Reconstructive and Aesthetic Surgeons, Inc. (PAPRAS), a fellow at the Philippines College of Surgeons (PCS), and an active member of the International Society of Aesthetic Plastic Surgeons (ISAPS). 

Breast Augmentation with Dr. Lutgardo Caparas Jr. of Zi Institute

While things are opening up, some are still unable to go to clinics to have their personal consultations. So, Breast Surgery  PH and Zi Institute teamed up to create a video about everything you need to know about breast augmentation.

In this video, BSPH talked to Dr. Caparas and SV, one of Zi Institute’s earliest patients, about working together. This way we get to see the journey of undergoing breast augmentation from both the patient and doctor’s perspective.

Here are some of the highlights from that video:

Q: What makes a successful breast augmentation surgery with natural-looking results?

DR. CAPARAS: I think the number one will still be the surgeon itself. The surgeon is fully trained and has a lot of experience. It would probably give the best result for the patient. And the quality of the implant. I go for high-quality implants and should be FDA approved. With that probably- not probably- most often, the patient will have a very satisfying result. 

Again, for you to have a good result, you have to be very in-depth [with] your consultation. Checking all the nuances of the implants, chest, the breast, so you can give a good assessment and good advice to the patient. 

Now, most of the patients that would need breast augmentation would have loss in fullness in the upper pole. Because of that, you have to do a good assessment of this problem and put the right volume of the implant to the patient. 

However, with my experiences with Filipina patients, they want to have more projection and more volume than usual compared to the Chinese, Japanese, and Koreans, who do not want a very big implant. Most Filipina patients would like to have more projection to look good wearing a dress or swimwear. 

Q: How is breast augmentation conducted?

DR. CAPARAS: Breast augmentation is, for me, the number one aesthetic procedure done worldwide. How do I go about this process? Number one, during consultation I explain everything to the patient. 

What do I explain to the patient? I do this under general anesthesia. And how long does it take me to do this procedure? Normally, it would range from one hour to one and a half hours. 

Why one and a half hours? Because sometimes some patients would be on the bleeder side, so it would take me longer to control the bleeders. 

But before we go on to the process of this procedure, I request for laboratory exams. Especially now [due to COVID-19], I also request an RT-PCR test at least two days before the surgery; and have the patient subjected to a cardio-pulmonary clearance by a Cardiologist. Once these are done, and once the patient is cleared to undergo the procedure, then we go to the surgery itself. 

So, what do I do during the actual surgery? Again, I do an initial consultation just like what I do before the patient’s schedule for surgery, reiterating the important points of this procedure. Then, the patient will be brought to the operating room, I do my markings, and the patient is fully prepped before the patient lies down on the operating table. 

Q: What kind of insertion techniques is popular amongst surgeons and patients?

DR. CAPARAS: My preferred incision is the inframammary. Why is this so? Because with the inframammary approach , there is a less chance of going through the breast tissue that can give you a problem. There are three approaches: the inframammary or the fold incision, the periareolar, which is the incision in the areola (It is the junction between the areola and the skin.), and the axillary. 

Why do I prefer the inframammary? Because I can have direct access and see the field I am going to work on, and so I can control the bleeders. And if the patient will have a very good fold, this [the incision scar] would be less visible. 

Q: How big of an incision scar will occur after breast augmentation?

DR. CAPARAS: It will range from 3.5 to 5 centimeters. So, for small implants, I can probably just do the 3.5 centimeter, and for bigger implants, I go for the 5 centimeter incision. And in most patients this will heal perfectly and look like a fine line. 

But then, there would be some patients who are prone to develop keloids. So, these are patients that I need to expound more on the possibility of scarring. Because when you do check on them, you’ll see keloids in the arm, and you can see keloids in the chest where there’s a previous acne. The patient would still go for the procedure because they have the good shape implant that they want in spite of the scar that will develop later. So for me, the inframammary incision is the best.

And I definitely put my implant beneath the muscle. Why is this so? Because I want the added protection from the muscle and the chances of developing a problem is minimal with this kind of approach. Why? One of the possible problems of breast augmentation is the development of a capsule. The capsular contraction is the hardening of the capsule, the firms are on the implants. Putting it beneath the muscle minimizes this. 

So, for me this would give the best looking, natural result. 

Aside from Dr. Caparas, SV, one of Zi Institute’s earliest breast surgery patients, also shared the process of undergoing breast augmentation through a patient’s perspective. SV shared some tips from her own experience of going through the procedure.  

Q: What advice can you give to those who are hesitating to get breast surgery? 

SV: My advice for people who want to have breast augmentation is research. Research, research, research! Research for the best doctor, research for the implant you want, [and] the size.

Q: What are the challenges you face before and after the surgery? 

SV: Some of the challenges I faced before and after the surgery was, first, searching for the right doctor. Because some of my friends, they’re looking for a cheaper option but don’t have good results. It’s a no-no. You really have to go with certified doctors who can provide the right implant for you. It is safer and eventually you’ll have no regrets having the surgery. 

Q: What is your advice during the recovery period of your breast augmentation?

SV: In the second week after the operation, you must massage the implant to make it softer. It might be quite painful. It really needs to have a good massage to make it softer and feel more natural. And also rest, and get rid of stress. Do not overthink. Eventually, you will feel better. 

Q: What is your advice when it comes to emotionally and mentally preparing for breast surgery? 

SV: I think you need to know what you want to happen. Assert yourself if this is what you want. Do you want natural-looking [breasts]? Or bigger than how others usually do it? You need to make sure of what you want to clearly relay that to your doctor and the doctor may also have the chance to explain the in and outs of the procedure. Also, make sure to be emotionally and financially prepared. If you’re planning to have breast augmentation surgery, you should research. If you think that this surgery is for you, just do it. Go for it! 

In Conclusion…

Breast Augmentation surgery is a very crucial procedure. It can be dangerous when it is not done by a professional plastic surgeon. Also, it is important to know what makes a doctor a certified plastic surgeon to operate a breast augmentation surgery, so that will assure the patient quality and safe results. 

Aside from the procedure, a good surgeon recommends good implants that can provide the size that matches the client’s frame, and also does not provide future health complications. Furthermore, note that breast augmentation surgery is a procedure that needs preparation both physically and mentally. That is why those who seek breast augmentation need to do their research regarding the operation before finally deciding on having the surgery. 

Also, consider finding an implant that has fewer complication rates and no record of rupture of the implants after an incision to ensure that the implant you are using will not internally and externally harm you even in the future. 

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