Spreading breast when lying down (natural breast) 

Do the breasts spread apart after textured correction when you lie down? (Natural breasts / unnatural breasts)

 

The question above is about the natural look after the breast augmentation surgery
Natural breasts tend to spread apart when lying down, but the breasts with implants do not spread naturally but stay stiff- therefore, there are many who are concerned about this unnatural effect.

To share the conclusion first, the textured implant closely sticks to the breast tissue and moves together therefore, it does not spread too much outwards but it looks quite natural.

In order to give you an explanation on this, we need to share the academic trend of breast augmentation surgery.
Before, the pocket for the implant was made so that there is much space so that the implant moves about freely. So a lot of the surgeons used smooth type implant so that the implant could move in all four directions.




That is why there were advertisements that the breasts look natural because the implants spread out. There were many massages in order to maintain this space.
Many thought that such correction would lead to smooth breasts, that move about easily, and also feels good because there is much space, and also minimized the risk of having epithelium.

But, the implants moving about freely means that, if you touch the breasts then you would know that there is something artificial inside.
The implants spreading outwards when lying down are different from how the tissue inside your body spreads out. Therefore, if you only focus on having breasts that spread outwards resulting in excess spread, there is no method to fix such problem.

 


Also large pockets led to bleeding, pain, and various other side-effects. Also massaging has become one of the inconveniences caused due to the correction.

The trend today is to have just enough pocket size fitting for the implant. This is to prevent any side effects that may be caused by limiting the size of the pocket. (The term “24 hour recovery system” came out from this aspect)

Textured breast implant is most appropriate for minimized pocket size. Also, you would not need any massaging after this
 



There are some internet advertisements that say that you do not need massaging because of the textured breast implant. This may lead to some misunderstanding.
Minimized pocket space for the correction leads to avoiding the massages. It is not because of the textured implant.
Also the textured implant sticks to the skin and moves together with the skin so one must avoid massaging. (Massaging is to separate the implant from the skin).

Therefore, minimized pocket size, textured breast implant and no massage have become a trend. In such case, you would have breasts that spread out as much as those on the picture below.




Also, the advantage is that if you touch the breast, the implant moves along with the breast so you will not be able to feel that you have the implant.

The extent to how much your breasts spread with textured would be definitely less that the smooth implants.

But, if you are concerned about
How long will the natural shape last?
Will the volume of the breast remain the same although I get old?
Is there no problem of defect?

Then, you would not have to worry as much. These are the contents that are more important. The cohesive gel product of Anatomic shaped textured implant is the one product most fitting.

Thank you for reading.

Safe breast augmentation, breast surgery without any defects

Q. People choose plastic surgery clinics considering the safety. So what do the patients need to check?

A. I think that all cosmetic surgery should not have any defects although you might not look pretty after the correction.

 

The safety and having no problem after the breast augmentation surgery is the most important factor as well.
A surgery involves incision to complete its goal. Once the incision is done, the body bleeds and there is pain. Also, much microorganism can enter the opening of the skin. In any surgeries, one uses anesthesia to kill the pain and sterilize in order to prevent bleeding and infection.

When these three, anesthesia, bleeding, sterilization (disinfection), are not done properly, a problem arises and the surgery becomes dangerous

There are three things that you need to check if you want a safe breast augmentation surgery.

Is there a proper anesthesia for the breast augmentation surgery?

Can the bleeding be stopped after the breast augmentation surgery?

Is there enough measure to prevent infection?

First, breast augmentation surgery requires general anesthesia. General anesthesia is broad in term, however it involves intubation, the suction of the anesthesia. There is another method called LMA but this also involves the suction of the anesthesia.
General anesthesia can be helpful in reacting to any unexpected situations.




We conduct blood test, x-ray, and ECG tests before the anesthesia and also check if there are any test results that are out of the normal figures. This process itself can prevent much problems and unexpected accidents.

There are some cases when the patients find some problems that they have through the blood tests that they have before the correction. There was a case where a patient found out that she had leukemia through the blood test before the correction.
However, there are some unexpected problems that arise during the surgery procedure. In order to handle such situation quickly, it is important to do intubation or LMA.

Second, if there is much bleeding then a good result cannot be expected. There are thick blood vessels underneath the pectoral muscle of the breast. If this is touched, then much bleeding can happen.

In order to conduct a safe procedure, the surgeon must be aware of such problem and also know the exact cautionary measures to react to such a problem. It is rare to have much bleeding that leads to severe threat on life when conducting the breast correction, but if the blood gets into the implant, required in the breast correction, then the implant may be damaged in shape and form, and also could be misplaced causing further problems such as pain or infection as well.

Therefore, a surgeon must be sure that he/she does not leave even a drop of blood near the implant during the breast correction. The best method that helps to stop the bleeding is inframammary incision.

If you conduct the correction from the inframammary, you can gain 100% vision of the operation therefore, a well-trained surgeon can also stop the bleeding quickly and complete the surgery properly.






Also, it is important that the surgeon does not touch unnecessary parts of the body when doing the breast augmentation surgery.

Third, preventing infection and inflammation requires much training for both the surgeon and the nurses as well. Also, it is important to do the breast augmentation surgery quickly so that there is less time for the implant locating part of the body to be exposed with the exterior environment.

The surgery room must be isolated from the exterior environment and also all the personnel in the surgery room must be sterilized.
There is a method called No Touch technique that I would like to introduce.



No touch technique is a technique that prevents any bacteria or microorganism entering the body during the surgery. It is important to maintain the clean status of the body from the incision up until the closing of the wound and also, one must not touch the pocket of the implant during the procedure. Only the tools are used.
It is important to complete the correction procedure quickly in order to prevent infection or inflammation. The longer the procedure takes; we are giving more opportunity for the contaminant to enter the body. Using drains requires the opening of the implant pocket and the exterior, therefore, it is better to prevent such activity, or do this in a very short time.

Those medical personnel who are well trained with no touch technique can prevent contaminants entering the body when doing the breast correction with the implants. One must absolutely close the incision quickly so that there is no exposure to the surgery room or the exterior environment.
Therefore, it is important that the overall procedure completes as quickly as possible.

The three issues stated today are
General inhaling anesthesia
Minimum desquamation, 100% stopping the bleeding
No touch technique, quick surgery time

These are the issues that one must first consider and examine when wanting a safe breast correction.
 
This is all for today.

Thank you very much.

Breast Surgery To Know List 4.
Deciding on the Breast implant size

There are many posts on how we can decide on the size of the breast implants. Today, I would like to summarize the core contents with this post.




Before the doctor would see the patient and say “You would need xxx cc.” This was about 7 to 8 years ago.
But today, this process is different. There are several stages on how we go about in choosing the right breast implant size.

We usually use the below 3 stages.
 
1. Upper body measurement
2. Implant fitting (T-shirt test)
3. Sizing while conducting surgery

I will go in detail for each one of them.

1. Need to get upper body measurements in the first consultation with the surgeon

You need to take different measurements but the most important one is the width of the original breast.
The average width size of those patients (those in 20’s ~ 40’s) who come to have breast augmentation surgery is about 11 cm. If the upper frame is big then this width size is big. If the upper frame is small then the width is small also.
The greater then growth amount in the breast, the wider the width is. So if the original breast is small then the width is small as well.




The width of the implant depends on the width of the breast. So if the width of your breast is about 11 cm, we would choose an implant with width of 11 cm or less.





But there is another part of the body that is as important as the width of the breast. It is the extensibility of the breast tissue
There are those who have elastic skin, tissue, muscle, fat that surround the implant, and there are those with less elastic parts of the body.

The younger the patient is, before giving birth, the skin on the breast does not stretch out as the skin is less elastic.
As you get older, and give births, the skin becomes easily stretches therefore, losing the skin elasticity.

If the skin is tight and does not stretch easily, then it is difficult to use wide implant.

In opposite, if the skin stretches easily, then a larger width implant can be used.





Therefore, we decide on the size of the implant by measuring the upper body, i.e. the width of the breast and the skin elasticity.

This is preliminary, and is not the final decision.

2. Implant fitting (T-shirt test)

 
How big should the implant be in order to make my breast bigger? A question as such can be answered easily by fitting the implant just as you try different clothes when you want to buy one.

The size of the breast is very subjective and also the satisfaction survey of breast surgery is very subjective as well. So, it is important to check the breast size after the surgery although she knows how much cc implant has been used. If the patient is not satisfied, then this is not a meaningful event for the patient.
Let’s imagine that you are buying a dress.
There are those who think that size 44 is too big.
There are those who think that size 66 is too tight and small.






This is the same with the size of the breast implants. There are those who think that 200cc is too big and those who think that 400cc is too small.

The subjective feeling in choosing the size of the breast implant depends on the size of the upper body, not the absolute number in the size of the implant (cc).

It is not always the case that the size of breast implant chosen at the first stage of upper body measurement would be the same as the size that the patient wants.

So the surgeon prepares the implant that is recommended size and another with the size that the patient wants. There are many variables during the breast augmentation surgery and the size might look differently while having the surgery.

3. Sizing while conducting the breast augmentation surgery

Final decision making is done during the breast augmentation surgery. The measurement size and the patient wanted size are just references sizes for the implant.
During the breast augmentation surgery, we make look for the implant and fit in the implant imitation to measure again which size is the most appropriate one. We call this, sizing.

If the diameter of the breast is about 10.5 cm, and the patient wanted 270cc implant however the recommended size was 290cc, we would prepare all implants from 250cc to 300cc before the start of the surgery.

During the surgery while we test different sizes and decide that 290cc is appropriate, we fit in the 290cc implant into the breast.

In opposite, if there is enough room for the implant but the skin does not stretch so that the 270cc implant cannot fit it, then we used 250cc~260cc implant for the surgery.





There are some patients who visit various clinics but decide on the one that will use the implant with the size that the patient wants.

But, this could lead to trouble in the future. The young patients are too focused in wanting larger breast compared to what the body can take therefore, demand more volume rather than what is appropriate for the body.

We cannot decide on the size of the implant with just the first interview with the surgeon.
As we have stated earlier, there are many stages that are involved in deciding the size of the implant and the final decision is made in the surgery room.

A patient’s opinion is a consideration factor, and the surgeon cannot do everything that the patient requests or demands........
Doing what the patient demands may lead to future problems such as refilling, being able to feel the implant, damage to the implant, unnatural look, etc.




Today we shared the fourth post on the ‘To know list of the breast surgery’ that covered details on how the size of the implant is decided.
Thank you for reading.

Have a great day.

When I meet patients for breast surgery, there are many frequently asked questions and there are some facts that the patients do not know well enough. I would like to post on these one by one.

Also, I would like to set facts straight, especially those wrong information on the internet.
If any of you have had thought about having a breast augmentation surgery even once, I am sure that you will be able to have more structured knowledge and have good interviews with the surgeons.

Breast Surgery To Know List 1. Knowing your body

The most important part of your body in breast augmentation surgery is the shape of your upper body.
When you interview with the doctor regarding the breast augmentation surgery, the whole process is a matching process that includes the implant and your upper body.
At times you may think that since “I am tall, I need a large implant.” However, the height of a person and the implant does not have any relationship.

First of all, we need to analyze the upper body then decide on the type and volume of the breast implant. Also, we need to go over some precautions before the surgery.




First thing that we check is the breast and the cortical organization – mainly how much of the subcutaneous fat and mammary glands you have.
In putting this in easier terms, we look at how thin you are, how much fat you have, and how big is your current breasts.

This is the most important factor in having a breast augmentation surgery. If the fat that surrounds your upper body is thick, then one will not be able to make out that you have an implant and there is less possibility of after-effects as well.

In opposite, if you have less fat then, one will be able to make out that you have had an implant. Also, there would be bad side-effects.

There is a paradoxical aspect here.
If you have thick upper body that means that you have a large breast. If you are a person with such body, then you might not need a breast surgery.
However, if your upper body is thin, then you would have small breasts, and may need a breast implant, but, this implant may not be good for you.




There are some people who say that “the rich get richer” and “the poor get even more poor” about plastic surgery. In some aspects, this applies to breast augmentation surgery as well. If you have a large breast then it is advantageous to have a larger implant. If you have small breasts, it is less advantageous for you to have large implants.
Those with asymmetric breasts need to be aware of this.

If your left breast is larger than the right, then a larger implant will go on the right and a smaller on the left.
However, in reality, a larger implant can be put into the larger breast (left) but the smaller breast (right) will not be able to take in a large sized implant.
An implant goes into a very closed and tight space therefore, the implant can be folded, or look unnatural.




A lot of the patients set a larger breast as a standard and think that “I might have to put this big implant.” In such case, a much larger implant needs to be used for the smaller breast.

If you want to lessen the possibility of side-effects then, you must consider the smaller breast as the standard one. First, you need to decide on the implant size of the smaller breast, then decide on the larger breast so that the two breasts look more natural and to minimize the side-effects.

Next, we need to consider the bones of the upper body.


Bones on the upper body are important because it becomes the framework of how your fat/skin is laid out. Therefore, it is important to see how the overall frame is shaped.
If the both ribs are shaped inwards, so that the breastbone sticks out, we call this a bird chest. The problem with the bird chest is that if we out in the implants, there is a high pressure in the center of the body therefore, the implants can be forced outwards looking far apart.

The number 2 ~ 4 ribs stick out so the upper body may look very thick.




If the breastbone is too low, we call this funnel chest.
The implants in a funnel chest act differently than the ones in the bird chest. The implants mover towards the center and make your breasts too large causing a problem.

As you can see, the cause of the asymmetric breasts is the shape and size of the ribs.

The surgery procedure will differ according to the shape of the upper body bones therefore it is important to check on the upper frame.


Third, we need to check on the location and the location and the placement (proportion) of the nipples.

This is one of the most common factors that I check when I analyze the breasts or upper body shape.
The core objective is to look at the upper body proportion.

All beauty surgeries are successful if the upper body proportion is good. The surgery becomes more difficult if the upper body proportion is bad.

Let’s call the middle inward part of the two collarbones, #1, and call the nipples on both your breasts #2 and #3. When you link the three points, you will be able to see a triangle.




If this shape is close to an equilateral triangle, then we can say that you have a good proportion.
If the triangle looks like an isosceles with tall height, then you might be having sagging breasts.
In such case, we need to select appropriate implant and plan the surgery accordingly.

If the triangle is wide, then the breasts are far apart, so we need to have surgery that will place the nipples closer or recommend short type implant such as water drop implant.

Fourth, we need to consider the skin elasticity of that which surrounds the breasts.

The size of the implants depends on the skin elasticity. If the skin is elastic then we can use a larger sized implant. In opposite, if the skin is less elastic then it becomes difficult to use a large sized implant.

Usually, as you age, or after you give birth, you skin becomes more elastic. Those in 20’s and 20’s would have tighter skin.


Today’s post was the first one for “Breast Augmentation Surgery – To know list”. If you have any questions, please feel free to ask me.

Thank you for reading. Have a great day.

Delivery, aging, and massive weight loss generally  changes the breasts.
They are going saggy.




This posting is a talking about the saggy breasts. What means saggy breast? and How can we improve it?

The first step is the downward movement of the breast parenchyma,
Meanwhile the lower breast envelope is stretched.

And the upper volume of the breast is shrank.

These changes, relatively early phase of the breast ptosis, is said 'Glandular Ptosis'.

The glandular ptosis is somewhat different from the 'real ptosis'.

In real ptosis cases, even the upper part of the breast envelope is stretched, and the nipple-areola will drop. So that is the Difference, the distance from the clavicle to the nipple is very long in real ptosis, and not that long in glandular ptosis.





And nothing is seen between the nipple and the lower margin of the breasts.

Another point is, the level of the under breast line.

If the nipple level is lower than the under breast line, then it is real ptosis.
If the nipple level is not lower than that, it is glandular ptosis.

Real ptotic breast needs lifting operation.
We call it 'mastopexy'.

Glandular ptotic breast usually do not need mastopexy. Generally they just need augmentation.




But the augmentation surgery for the ptotic persons are different from that of usual augmentation.

The surgeon has to have a good, detailed idea and knowledge about the augmentation surgery for the glandular ptotic breast patients.

The photographs of each surgery is as belows.





That's it for today. Thank you for reading and have a nide day.