Breast Surgery

Combination Breast Augmentation

Combination Breast Augmentation korea
Breast implants + fat grafting for soft & full breasts with a beautiful cleavage

What is Combination Breast Augmentation?

Combination breast augmentation enhances the breast fullness with a natural look

Many women undergo breast augmentation wanting beautiful and natural-looking breasts. However, if the original breasts are very small, or the subcutaneous fat layer is thin, a general breast augmentation using only implants can result in the implant edges or the wrinkled surface becoming noticeable.

Using the combination breast augmentation techniques the surgeon can make the soft tissues thicker by grafting autologous fat and increase the breast size by inserting breast implants.

  • Surgery Duration1.5 - 2 hours
  • HospitalizationNot required
  • # of Postoperative visits3 times
  • AnesthesiaGeneral anesthesia
  • Removal of Stitches5 - 7 days after the operation
  • Recovery PeriodAble to return to daily activity within 2 - 3 days after operation

Combination Breast Augmentation

Implants are inserted using HD endoscopy technology.

Fat Graft Breast Augmentation

We recommend combination breast augmentation to the following people:
  • Those who have extremely small breasts or thin subcutaneous fat. There is a high probability that the inserted breast implants may be visible if the patient has extremely small breasts or thin subcutaneous fat. The grafted fat layer complements the implants and creates natural-looking breasts.
  • Those who have pectus carinatum (pigeon chest) or wide breastbones (sternum).In the case of pectus carinatum (pigeon chest), an implant alone cannot create a beautiful cleavage. Cleavage is considered a desired feminine trait; many women who undergo breast augmentation wish to have a well-defined cleavage after the surgery. However, if the patient has a wide sternum or pigeon chest creating a natural-looking cleavage with implants alone will be difficult. In such cases, you can beautifully shape the breasts, and create the desired line, by grafting fat tissue and reinforcing the volume in between the breasts.
  • Those who have too much space between their nipples. In the case of wide-set nipples, simply placing implants towards the center will not make the breasts seem closer together. In fact, it can make the nipples look even farther apart. In such cases, the center of the nipple should be aligned with the center of the implants and breast asymmetry corrected with fat grafts. Using the combination breast augmentation method, the surgeon can make the nipples appear to be in the center of each breast and the wide-set appearance will be corrected.

The Features of Combination Breast Augmentation

Soft Texture

If the subcutaneous fat is thin, the implant can be felt through the skin after the operation. In this case, autologous fat grafting covers the implant and creates a more natural feeling.

Enhance Breast Fullness

Combination breast augmentation makes your breasts feel fuller and creates more volume than only performing either breast implants or fat grafting. If you are choosing large breast implants that do not fit your body measures, without fat grafting the breasts can look and feel unnatural under the skin.

Natural Movement

Whenever you stand up, lie down, or other positions, the breast movement will look natural and elastic.

Teardrop Shaped Implants

Even though the same teardrop implants are inserted, the breast shape may appear differently from patient to patient. Fat grafting can be used to refine the shape of the breast and create a beautiful and voluptuous teardrop shape.

Breast Symmetry

Asymmetrical breasts can be corrected by inserting different sized breast implants. In addition, the combination breast augmentation allows the surgeon to be more precise about size through fine fat grafting.

Beautiful Cleavage

In the case of wide-set breasts or pigeon chested patients, the gap between both breasts is more noticeable with only implants. In this case, filling the inner part of the breasts with fat transfer can create a beautiful cleavage.


For fat grafting, the fat is harvested from the patient themself, so the procedure also reduces cellulite and unnecessary fat in the abdomen or thighs.

JW’s Natural Breast Augmentation Know-How

#1 | Breast Augmentation With HD Endoscopy Equipment

#2 | Prescription Of Medications After The Operation

  • We prescribe special medications based on the patient’s specific needs and situation to help the healing and create natural-looking breasts.
  • By prescribing select medicines, we minimize the chances of capsular contracture.

#3 | Minimized Scarring

The area of incisions has to be minimized; longer incision can make surgery easier but create more visible scars. For sutures, we use a type of thread that absorbs into the body for the hypoderm and special tape on the surface of the skin to bring the edges of the incision together. There will be no need to remove the stitches and the visible scarring is minimized. You can start to take showers 2 to 3 days after the operation.

Step 1

To minimize the scar on the armpit, we’ll look for the deepest set wrinkle in the armpit.

Step 2

The incision made is about 3.5 cm long on the deepest wrinkle to hide the scar after the operation.

Step 3

Local anesthesia is applied to the armpit and breast.

Step 4

After the incision is made the HD endoscopy is used to create the space needed for the implant and insert it.

Step 5

Using the suture techniques for facial plastic surgery, the incision will be closed in a way that leaves minimum scarring.

Step 6

12 months after the breast augmentation the site of the incision will be almost invisible.
b. Periareola Incision

The common periareolar incision method uses a circular incision shape which could leave a visible scar. 

In JW Plastic Surgery Korea we use the more complex “zigzag periareolar incision method” which minimizes visible scarring.

c. Inframammary Fold Incision Method

The picture on the left shows JW’s site of incision after breast augmentation surgery with the IMF incision method (inframammary fold incision method).

The picture on the right shows another clinic’s work which has left a scar after the breast augmentation using the IMF incision method (inframammary fold incision method).

#4 | Special Shaping Bra

Although breast symmetry is considered during breast augmentation, the breast shapes may become asymmetric as time passes depending on the lifestyles or breast tissue type. For example, a right-handed person uses their right arm much more frequently putting more strain on that side. In addition, the heart is tilted towards the left side of the chest and the general usage of the muscles of each side varies.

A shaping bra helps maintain the balance of the breasts. In addition, some patients may find the bottom line of the breasts change or become unnatural after breast augmentation. To prevent this, a shaping bra is recommended to the patients who want beautiful and natural-looking breasts.

JW Plastic Surgery provides a free special shaping bra after the operation. We’ll adjust the shape of the bra whenever you visit the hospital.

#5 | Pain Management System

Many patients worry about the pain during and after breast augmentation surgery. Pain is usually generated by bleeding and tissue damage. Using HD endoscopy, JW Plastic Surgery minimizes bleeding and tissue damage during the operation to reduce pain.

During the operation, intercostal anesthesia is applied to prevent pain. Analgesics will be prescribed after the operation. The patients hardly feel any pain and don’t need any epidural injections for pain management. Patients can leave the hospital on the day of the surgery without hospitalization.

#6 | Breast Surgery That Doesn’t Require Massage Therapy

Smooth Breast Implants Textured Breast Implants (JW)
Massage required (O) Massage NOT required (X)
  • When using smooth breast implants, the implant space should be maintained actively. The implant space can narrow which blocks let the breast implant from moving freely.

  • For this purpose, the patient has to receive massage therapy starting one week after the operation.

  • The rough surface of textured breast implants prevents capsular contracture and induces the assimilation of the breast implants with the neighboring tissues by weakening the tightening force of the capsule.

  • Textured breast implants reduce the risk of side effects such as capsular contracture and location transformation, compared to smooth breast implants.

  • In addition, breast augmentation using textured breast implants does not require any massage therapy. In the past, textured breast implants were not widely used because their texture was deemed unnatural compared to smooth implants. Now, textured breast implants have become more widely used since their texture has been greatly improved.

Note:What is capsular contracture?

When breast implants are inserted, a thin layer of scar tissues will form around them. This film is called a capsule and is your body’s natural reaction. Capsular contracture refers to a phenomenon where this capsule layer becomes abnormally thick and puts pressure on the implant. If the patient experiences severe capsular contracture, it may make the breasts seem unnatural.
Capsular contracture may occur when the surgical site is infected or filled with blood. The patient may experience capsular contracture due to severe rejection reactions as well. To prevent this, the surgical sites should be carefully stanched and disinfected. Also, the space for breast implants should be secured accurately.
In addition, the patient should take preventive measures after the operation. The patient should receive massage therapies after for smooth breast implants. However, textured breast implants do not require massage therapy because their surface is already treated with capsular contracture preventives.

JW’s Know-How For Natural-Looking Breast Augmentation

#1 | Pioneer In Endoscopic Breast Augmentation

M.D. Seul Chul-hwan, director of JW Plastic Surgery, has been performing endoscopic breast augmentation since the method was first introduced in Korea.

Through numerous academic presentations and academic activities, he played a pioneering role in disseminating the endoscopic breast augmentation technique in Korea. He operates using an HD breast endoscope from the beginning to the end of the procedure to complete the operation more safely.

#2 | Asymmetry Correction

If the patient’s breast size, shape, nipple position, sagging degree, inframammary fold position, and chest wall are asymmetric, different sizes and shapes of implants will be used on each side to create harmony.

In addition, other breast asymmetry correction methods such as different degrees of muscle detachment, levels of inframammary fold correction, degrees of breast lifting, and simultaneous fat grafting (combination breast augmentation) can be combined to achieve better results.

#3 | 20 Years Of Experiences And Expertise In Fat Grafting

Smooth Liposuction

After harvesting fat, skin irregularities may occur on the harvestation site. JW Plastic Surgery performs liposuction evenly in various directions to create smooth body surfaces.

High Cell Survival Rates Through Micro Fat Grafting

In traditional fat grafting procedures, a lump of fat is taken and used for grafting. However, JW Plastic Surgery Clinic uses the micro fat grafting technique. After the fat separation process, the fat is grafted under the skin using a microsyringe, which minimizes pain but maximizes the survival rate of grafted fat cells.

#4 | Customized Breast Augmentation Using A Sizer

Before inserting breast implants, we check the optimal breast size, breast symmetry, and detachment using a tool called ‘sizer’.

Since this step extends the surgery duration and increases the costs, many hospitals often skip it. However, JW Plastic Surgery considers this step to be very important in finding the most suitable sized breast implants and obtaining optimal results.

Step 1

Secure space for breast implants using HD endoscopy equipment for breast surgery.

Step 2

Insert a sizer to find the appropriate size of breast implants.

Step 3

Based on the analysis results, the appropriate-sized breast implants are inserted.

Step 4

Using a sizer to find the appropriate size is important when creating beautiful and natural-looking breasts and essential in correcting asymmetrical breasts.

#5 | Minimized Incisions, Scars, & Pain

JW Plastic Surgery minimizes the size of incisions to reduce scarring, patient satisfaction, and rapid recovery.

#5 | Various Breast Implants

JW Plastic Surgery uses various types and sizes of breast implants to match the best breast implant option to each patient.

In order to design beautiful breasts, we are using the highest quality Motiva breast implants.

JW’s Combined Breast Augmentation

Combination breast augmentation for a beautiful cleavage shape

If you have a wide sternum, pigeon chest, or wide-set breasts, it may be difficult to create natural-looking cleavage. In combined breast augmentation, autologous fat is grafted to the empty part between the breasts to create a beautiful cleavage.

Combination Breast Augmentation Procedures

Step 1

We’ll find the suitable breast shape and size using a sizer.

Step 2

We harvest fat from unwanted areas and graft it to the breast to reinforce the soft tissues.

Step 3

The breast implants are inserted in the designed area.

Step 4

We’ll graft more fat, if necessary.


The postoperative complications, such as infection and bleeding, can vary depending on the patient’s conditions. The patients need to pay extra attention to postoperative management.

With more than 21 years of experience, a surgeon specialized in Breast Surgery.

JW surgeon for the Breast has been performing surgery with know-how from various clinical experiences, as well as dedication to achieving the best result by medical research.