Taking care after the breast augmentation surgery 

There are many patients who ask me what to do after the breast augmentation surgery and so I would like to answer this question today with this post.

A surgery must be done perfect so that the patient does not have to do much after-surgery management.

But the body is complex and different from one person to another and also some implants might have problems even before using. There are many variables so it would be good to know that you need to carefully take care of your body after the surgery.

1. Breast augmentation after care massage

Before, we used to think that massaging was a “must”.
Massaging was only for those body parts that used implants, especially the breasts. The main objective of massaging was to make the breast more soft.



Massaging in other words could be described as enlarging the non-surgical epithelium.
This would be to push the implant from the outside so that the epithelium opens up in order to make the implant move more easily.

But, epithelium is not something that is bad, and it is necessary for the implant to be secure at its original position and also it is something unavoidable.
Also, enlarging non-surgical epithelium is disregarded today.
If you look at the textbook of breast surgery, you would not find any details on massaging. This is not necessary any more.
I, too, do not provide massaging to my patients unless there is some special case.

2. Removing stiches, dressing 

Where ever the incision was, there is an entrance of the implant and this entrance needs to be closed properly and dressed properly as well.

It is good to close the incision from the outside, but the trend today, is to use the thread that dissolves inside the derma and use adhesive gel on the outside.
We cannot say which is the better method of the two because each has its own advantages.

I usually put sutures because I think that this is the most comfortable method for the patient.

Do not forget that there are no differences in the wound or scar with the two different methods. Scar is not an important factor in deciding which method to apply.
Putting sutures is to make the patient more comfortable. It would save the patient coming to the hospital and allow her to shower freely.
Sometime we apply taping so that the implant places itself properly and securely. This taping loses stickiness after 3 to 4 days so we remove the taping after so many days.

3. Compression garments breast augmentation

Corrector bras are used commonly in order to secure the position / location of the implant during the earlier stages after the breast surgery.
The important thing is that the implant does not move about to different location but maintains the appropriate position. You do not need to use the corrector bra.

But some special cases require you to use the corrector bra. If you have bird chest or have problem with the thorax, you might be required to use the corrector bra.

4. Managing scars 

The epithelium is formed 48 hours after the stitching leading to water tight closing. The recovery from the scar takes about 3 to 6 months.
If you look at the scar for a month, some might see red swelling.
If this is you, it would be better to leave it as it is.
This red look might change its color to brown after 3~6 months.




The tissue around the scar generates leading to scar remodeling. This takes about 2 to 3 years. There are many procedures that we can take during this period for better recovery.
I will add more details regarding this in the future posting.

5. Ultrasound 

There are many things that we check for when doing the ultrasound test on the breasts.
If there is blood between the implant and the skin?
If there is any other seroma?
How thick is the epithelium? Is it very thick and white? (Capsular contracture)
Is there any problem with the implant? (leak, damage)
Is the implant properly positioned? (Rotation, change of position)
The good thing about the ultrasound is that the patient feels no pain and she can do this test any time she wants.



Ultrasound test is subjective and it cannot accurately make out if there is a damage on the implant.
You need to do MRI to see if there is a damage on the implant but this is too expensive therefore, many patients take ultrasound tests.

 6. High frequency 

High frequency is used to send heat to the deeper layers below the epidermis. It is used to control the pain.
This is used in orthopedics for physical treatment. High frequency sends heat making the blood circulation better and makes the breast with implant feel better as well. If a patient feels pain after the surgery, we apply the high frequency as well.




There is no preparation necessary for high frequency therefore it is comfortable and frequently requested by the patients. If there is no problem with the recovery then you would not need this.

We have looked into few measures that you can take after the breast surgery. A patient might require some treatment but the doctor needs to check on the status of the patient and decide what to do.
Thank you for reading.

Textured silicone breast implant use in primary augmentation 

Academical findings do not stay fixed but the details are changed as new findings and results come out. So the doctors pay careful attention to the new findings.
The doctors who do not study would not provide outmost result to the patients.
Also, science is something that “you might think correct, but can be mistaken”.
Medicine is a part of science.

Below is an article, released on January 2015, on “Textured silicone breast implant use in primary augmentation core data update and review"





It is stated that in 2013, there were about 290,000 breast augmentations done in US. This figure comes from American Society of Plastic Surgeons, so maybe the actual number may be greater. One of the most popular plastic surgeries around the world is breast augmentation.

The most common side-effects of breast augmentation are
Contracture, moving location, refilling, seroma, etc

Why is a contracture?

There are various reasons but the most commonly stated one is that the strain around the skin and the breast tissue comes in contact with the implant and this contaminated implant causes infection within the pocket.

How does textured implant minimize the contracture?

In theory, the texture physically breaks down the epithelium tissue, leading to the breakdown of the collagen fibers and reducing the epithelium. This is what we currently understand. 
(But using textured does not mean that you are completely free from the contracture)

What can you do if there is a contracture? 

The most effective method would be to cut off the epithelium. The epithelium incision would reduce the muscle tension so the cell that makes the epithelium would not grow and therefore not survive. 

Does the appearance of the textured implants differ according to different products?

Yes, they are different. The most widely used on is Allergan’s textured salt loss technique which leads to deeper and more textured surface.
Mentor’s textured uses imprinting technique which makes the surface little thinner and smooth. 

Does the anatomical type lead to less contracture?

Yes. The 5th generation tear-drop type implants have strong exterior with strong agglutinability on the inside therefore, it causes tension with the breast tissue and sticks together more firmly leading to lower possibility of contracture.

There are many who thinks that the tear-drop implant feels better.

Tear-drop type implant feels better because the implant / breast / epithelium all move together naturally. 

But the smooth type implant is relatively more separated from the epithelium therefore when you touch it the implant seems to be separated from the skin. 

(This comment does not apply to all patients. This applies more to those patients who gave birth) 




Some say the refilling is more common with textured type

There is still not much reference for this. We are short of data on this. 
The type of the implant do not matter, but thinner patients have higher possibility of refilling than those who are not.
Also there are some who say that more texture implants lead to more refilling than the smoother ones.


Then which type shall I use? Textured or smooth?

It is said that textured minimizes contracture and also limits rotation and movement of the implant. However, there is a higher possibility of seroma and more texture it is, there is higher chance of refilling as well.

I tend to use the textured implant more.

As a surgeon, it is more relaxing for me to use an implant that does not move or rotate easily.

Today, we share a little about the textured implants.

Thank you for reading.

Breast Augmentation For Older Women [KIES-U Korea]

Q. I am kind of old, but can I get a breast augmentation?

A. Age is not important. The health status is.

This is a commonly asked question.
There are many who are about 50 years or older, and think that they have problems with the breasts. These women think “Am I too old to have a breast augmentation?”

In our country, there are many women who want their breast size to be larger in order to show their body appeal through swimwear. So there are many in 20’s ~ 30’s who are relatively interested in the breast correction.




But in the western countries, where there is more number of those having breast augmentation, the main patients are those aged 35 ~ 50 years old.

Most of them want the breasts to look prettier after pregnancy or diets. Also, there are some who think of the breast augmentation as antiaging surgery.




There are very few of those in our country who think that the breast augmentation is an antiaging one. The most important objective of the breast augmentation is that the implant goes into the breast in order to improve the shape of the breasts to make them more elastic and look younger.

It is not only to make the breasts look larger.

The oldest patient that I had was 65 years old.
She needed a revision surgery because the saline bag implant that she had from her previous surgery needed replacement.

She asked me whether it was better to remove the implant or replace it. My answer to her was that the old implant was fine before, there would not be much problem replacing the old ones.

So this patient replaced the old ones with the cohesive gel implants with the concern of the breasts collapsing without the implants.

Is age important? If a patient who is older than 65 years old wants breast augmentation, we must first check if she has any problems with her body.
She might have diabetes, heart problems, cancer, lung disease, etc. In such case, it would be difficult to have the breast augmentation

But, if the woman does not have any illness and wants the breast correction, she will not be able to give it up.

Health status is more important than age

If a woman in her 30’s has a severe illness, then I would recommend her to rethink about the breast augmentation. If she is in her 60’s but is healthy, then I would recommend the breast augmentation.

Most of the aged patients who come to our clinic have problems with the previous surgery (most come due to the implant rupture).

If there are not problems with the tests prior to the correction and the general anesthesia, then we go ahead with the replacement surgery. Also, the result of this is similarly good to that of those patients who are younger.

Is there any pain or inconvenience for the aged patients?

No, in fact, they recover with better conditions.

The younger you are, the tighter the skin and the tissue are therefore the implant is compressed and there is much friction. However, those who are older have loose skin and tissue.

KIES-U Korea Real-Time Operation Monitoring system

So, there is not compression on the implant.
The patients recover comfortably.

There are many aged patients who do revision surgeries, and there are many who have the first surgeries as well. Also most of the surgeries are inferior breast crease.

Thank you for reading this post.

How to reduce pain after breast augmentation surgery

There are many who are concerned about the pain after the breast augmentation surgery and therefore do not want to get it.

There are many around who suffer from the pain so the patients get scared about the breast augmentation surgery.

There are many internet advertisements that read “no pain breast augmentation surgery” or “no pain surgery” but this will not help you relax and stop thinking about such concerns.




First, let’s find out why the pain is caused.

Pain can be felt if you irritate the pain receptor.
If there is much pain after the surgery, then this means that much of the pain receptors have been irritated during the procedure, and vice versa.

The parts of the body with much pain receptors are skin tissue, fascia, and periosteum.
You cannot feel pain in the subcutaneous fat. Also in the muscle itself and the bones. If you break and bone and it hurts a lot, the pain does not come from the bone but the skin that surrounds the bone.




When you have breast surgery, the pain is caused when the implant and the periosteum interact with one another.

So the best method of avoiding this pain is to avoid going into the periosteum area.

We need to make the pocket at the position higher than the pectoral muscle.
If we do the surgery above a certain muscle, the pain is minimized. You can move about freely as you want without any pain. Normally, if you have a surgery on the belly button, there is no pain. This is because one uses the upper layer of the muscle for the procedure.



But, why is this method, putting the implant from the upper muscle area, not used widely?

This is due to the fact that a lot of patients who want breast correction are thin.
The patients do not have much fat and the original breasts are small therefore, if you put the implant from the top, you can feel that the implant is too close to the skin.
If you touch the breast, it will feel artificial. You might be able to see the re-filling or that the implant is there.

If your original breasts are comparatively big then you would not have any problems with this method. The breasts will look more natural and larger without any pain.

But there are many problems of those in 20’s and 30’s in Korea because many of the patients are thin.



Most of the breast surgeries are done under the muscle when the implant covers the pectoral muscle.

So in such case where you cannot avoid the pain, the homework would be on how to minimize the pain.

- If the implant is relatively big compared to the body, then there is much pain. The larger the implant is, there would be more pressure on the skin.

- There will be more pain if your skin is less elastic but tight. As the implant goes in, the skin needs to stretch but those with tight skin, especially those women before pregnancy, would have skin that press against the implant causing pain.

So in order to minimize the pain, it is important that you select an appropriate size of the implant. Mid aged women after pregnancy have relatively elastic skin therefore they feel less pain.

- There is less pain with less inflammation and less bleeding. Although the surgery is same, there are some patients with more bleeding than others. Also, there is much bleeding the inflammation if the surgeon destructs more skin and fat.
There are patients with much bleeding more so than others without any reason or cause. If there is an inflammation, the breasts swell and the swelling leads to continuous pain.

- If the surgeon is more careful during the surgery, there would be less pain. If the surgeon is aggressive, there would be much pain. The aggressiveness leads to much movement therefore, the pain will be caused from the surgery tools used. So there are some patients who say that they do not feel pain because of a certain surgeon and those who fell pain because of a certain surgeon as well.

- Pain comes from sensitivity.
There are some people with developed pain receptors, and those with less developed ones. If we eat same type of food, some might find it hot or spicy, and some who do not. This is all personal sensitivity issue.


Below is the summary on how to minimize the pain with doing the surgery underneath the muscle.
1. Choose an implant with an appropriate size
2. If your skin is tight, use a smaller sized implant
3. A surgeon must be careful and minimize the bleeding

Above are important as well as,

If the surgeon is much experienced and the surgery planning is perfect, then the pain that the patient feels can be decrease by 90%.


Thank you. Have a great day.

Passion to protect the patient’s rights

KIES-U Realtime Surgery Monitoring System

Q. Today we will be interviewing with Kies-U’s Doctor Lee about a unique real-time monitoring system in the surgery room. Hello Doctor Lee.

A. Hello.

Q. There is an issue about people playing with implants, cutting cakes, and having a party inside a surgery room in one of the plastic surgery clinics in Kangnam. Does this happen quite a lot in the surgery room?

A. I have read that news as well. I think something this ridiculous happens for a reason. A surgery room is a much closed environment, therefore, people inside the room think that they think it is ok to be by themselves in the room and do anything. A surgery room needs to be closed for the safety and hygienic issues of the patients, but to think that anyone could do anything that they want inside this room is a very serious issue.

Q. You can do anything in a surgery room that is a closed environment… this is rather scary. What do you think about a “shadow surgeon” issue?

A. Shadow surgeon, by the words themselves, means that the doctor is just a shadow without a face. There is a doctor who does an interview with the patient and there is another doctor who does the surgery. However, the patient does not about this so it is unethical to have a shadow surgeon and another one who interviews the patients.

KIES-U Realtime surgery monitoring system

Q. After listening to you, it seems that there is a relation between the shadow surgeon and people have parties in the surgery room that these activities are happening in a closed environment. Is it alright for me to understand that you have made ‘real-time monitoring system for the surgery room’ in order to prevent such activities?

A. A surgery room needs to be a closed environment in respect to safety and hygienic status for the patients, not anything more. The trust between the patients and the surgeons, the hospital and the family members of the patients is at the bottom. I think that the related members of the patients need to know what is happening insider the surgery room in order to recover the trust between the doctor and the patient. The best method to do this, is making it possible for the relative members to see real-time activities in the surgery room through wifi connection. As a result, the relatives will feel secure. They will be able to see from the anesthetic stage until the patient comes out from the room. They will be able to check if the patient is being treated properly or not, and if the surgeon and the nurses are not doing anything inappropriate. Therefore, I think that the real-time monitoring system in necessary.

Q. Do you feel uncomfortable if you think that someone is watching what you are doing behind your back?

A. I have done many surgeries with other doctors on site who ask various questions and I provide answers and description of the surgery to them. The relatives of the patient have the right to check and see if the patient is being treated properly therefore, this is not something that is uncomfortable to me. 

Q. Thank you very much for the interview Doctor Lee.

A. Thanks a lot.