Q&A on breast augmentation

How do the augmented breasts change after giving birth?

I would like to answer on the title of this post.

The answer to this question is that the breasts will sag whether you give birth or not. The sagging breasts cannot be avoided by anyone.

The sagging breasts happen to even those who do not get breast augmentation after giving birth and this is natural to those with breast augmentation as well.



How about the degree of sagging? This is something impossible to measure.
The degree of sagging differs from one person to another.

It is alright to think that one with breast augmentation cannot avoid the sagging as a person with naturally big breasts cannot avoid sagging as well.

Then comes another question in mind. I got a breast augmentation before marriage.

Do I need to get another one (example, breast correction) after giving birth-breast feeding?

This is a really difficult question to answer. It is difficult because one cannot estimate how severe the sagging would be so that the breast correction is necessary.

Let’s think about the process of breastfeeding. You tend to gain weight when you are pregnant. Nobody loses weight during pregnancy. Hormone secretion takes place for breastfeeding and tissue cells develop as well. The fat cells also increase. The skin also extends due to this increase in volume.

The first breast milk comes out after giving birth. The breasts change according to what is good for breastfeeding. After the breastfeeding is complete, the milk gets dried and the tissue cells contract that leads to the loss of weight. The fat tissues also contract. The skin that extended, contracts in a very short period of time.



The skin loses elasticity because of this extension and contraction. The skin gets wrinkled in a severe case. The ligaments that hold up the breasts also extend and contract losing elasticity and therefore leading to sagging breasts.
This makes the upper breasts look small.

In summary, your breasts change in the following way after giving birth and breastfeeding.

1) Loss of skin elasticity
2) Sagging breasts (nipples are positioned lower)
3) Loss of volume in the upper breasts

The three points stated above are applicable to everyone, but the degree is different.

Some people have a severe loss of skin elasticity, some not.
Some people have a sever case of sagging breasts, and some do not.
Some people lose a lot of volume on the upper breasts but some look less.

But these changes are all subjective therefore people take the severeness differently, such as “my breasts are sagging this this much”.



There are those who lose and gain a lot of weight before and after giving birth. There are those who suffer much change in the breasts. There are those who suffer less. we cannot estimate the degree of these changes.

The patients who suffer severe change in the breasts may need a correction surgery for the sagging breasts. However, if the patient already had a breast augmentation and the implants somehow support much of the loss in elasticity, she may not need a correction. If you do not suffer much from such problems, then you might not need to have much interest about the correction surgery or what happens to your breasts.

Although we cannot estimate exactly what happens, we may be able to have an idea about what could happen.

If you have large original breasts, and have a lot of fat tissues on the upper body, you will suffer severe case of sagging breasts after giving birth-breastfeeding.

If you are one who had small sized breasts before augmentation and had less fat tissues, then you will not suffer a severe case of sagging breasts.

This is what happens.

I have large breasts and I plan to have a baby next year. When do you think it would be good for me to get the breast augmentation?
I would answer “give birth to the baby first, finish off the breastfeeding, and then come again”.

I have small breasts. People say that I am flat. I don’t know when I will have a baby but I will at some time in the future.
If you are in a similar situation, I would tell you to get the breast augmentation without any hesitation.

But, these are some typical situations. These typical situations do not rise in clinical testings.

My breasts are reasonably sized. I am going to get married soon and have a baby soon after. But, I do not know exactly when.
In such case, we would have to wait upon the necessity of breast augmentation and decide on it.



Breast augmentation is conducted due to cosmetic reasons. If you have a complex on your looks then you need it.

If you are in doubt, “Do I really need it?”, then it is better that you don’t get it done.

You cannot foresee the future and make decision for it, therefore, if you want to get the breast augmentation, then you should go ahead.

There are some who ask if only the skin sags and not the implant. This is applicable if the breast augmentation is done below the pectoralis muscle and capsular contracture is caused making the epithelium too strong. But if an appropriately thick and strong epithelium is formed with dual plane procedure, such incident is less likely.

In any case, what is certain is that the implant does not interfere with the breast in any way when considering giving birth and breastfeeding. There were many who questioned that silicone could pollute the mother’s milk but now this is not the case. We can think that it is medically safe.

Today, we looked at what happens to the augmented breasts after giving birth. Thank you for reading.

Today, I would like to share about breast augmentation for male to female (MTF) transgenders (TG) and questions related.

1. What are the differences in breast augmentation between females and MTF TG? 

From my experience, TG patients have wider and thicker pectoralis muscle compared to female patients. Also, they have more tissue cells near the breast that may be due to the hormone treatments.

If the TG patients were treated for a short period of time or the treatment was not as effective, then there is not much difference in the breast tissue compared to other female patients.

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Therefore, all the TG patients need to talk in depth with the doctors for several decision makings and here are some examples.

Long surgery time is required if the pectoralis muscle is thick (Fascia is tight, therefore it is difficult to get visibility. A lot of energy is spent on retraction)

If the pectoralis muscle is on top of the implant, it can limit the volume enlargement effect, therefore, we need to consider breast augmentation above the pectoralis muscle.
If you have a lot of subcutaneous fat, then augmentation above the pectoralis muscle is recommended.

If you do not have that much subcutaneous fat but a lot of pectoralis muscle, then dual plane is recommended.

The original breasts are less female-like, therefore volume enlargement is a priority in making the breasts look normal.

2. Is there any relationship between hormone treatment and breast augmentation?

Female hormone treatment does not cause any problem when conducting breast a breast augmentation surgery. But, theoretically, hormone treatment with breast augmentation can cause bleeding, so it is recommended that you stop hormone treatment one week before the breast augmentation. You can start the hormone treatment again after a few days of breast augmentation.

3. Are there any complications that you can find specifically for MTF TG?

Capsular contracture, implant collapse, moving of the implant, rippling, being able to feel the implant, bleeding, hematoma, etc are all common complications but the incidence rate is not higher because you are a TG patient.

TG patients have larger upper body therefore we need to desquamate more for the implant pocket. This may lead to more bleeding and hematoma. TG patients have wider breast width therefore they use larger implants that require larger pocket leading to higher chance of bleeding. But this is only a possibility.

There is no statistics that TG patients suffer more cases of bleeding or hematoma.

4. What procedure is recommended to MTF TG for breast augmentation?

First, dual plane is preferred over below the pectoralis muscle. If you have enough subcutaneous fat and tissue, then above the pectoralis muscle can be considered, but the dua plane is recommended.



Most of the TG patients do not have properly shaped breasts therefore, shaped implant, ie. anatomical implant is recommended for better outcome. Usually, when we talk about yoyo-syndrome, we share that the skin elasticity worsens really quickly therefore it is not good for cosmetic purposes.

But the TG patients have strong breast skin layer that influences the implant acceptance. The yoyo-syndrome for TG patients do not always have a negative effect. If TG patients try to control their weight, they should do it continuously and slowly. Repetitive yoyo effect of weight leads to negative effect on the health as well.

Today, we shared contents on the things that MTF TG patients are curious about. I hope that this content has helped you out.

Thank you and have a good day.

I have collected my own data for three years regarding breast augmentation and not I would like to share some statistical findings on the width of the breast comparing with the size of the implant here in Korea.

When we decide on what size implant to use, we need to measure the width of the patient’s breast and the width of the implant. If the width of the patient’s breast is 12cm, then the width of the implant should not be larger that that. Of course there is a problem with extensibility (but this applies more to those who give birth) but the main issue would be that the size of the implant should not affect the thickness of the outer breast layer and should not lead to complications.



Anyway, the easiest measurement would be according to the size of the width. In my past 3 years of experience, they average width size for those who wished to get breast augmentation was 11cm. Also, if I look at the data of the 3 implants brands that I have used, the average volume is 284cc and the width of the implant is 11.4cm. The data is a little different according to the brands and the yearly distribution is also a little different but we can see that the width of the implant is little larger than the width of the breast.



There is difference between the implants used in Seoul and other cities as well. Some prefer round type, others prefer anatomical type. The preferred sizes are different also so we cannot say everything with just the average numbers. Those who come to Gangnam are prefer large sized implants. Those in the rural areas are very conservative on the implant size (both doctors and patients). The younger the patient is, she prefers larger sized implant for visibility reasons. The older the patient is, the requirement is different. In the past (2011~2013), those who preferred anatomical wanted large sized implant but this is not the same any more.

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There are patients who have same width size in both their breasts but are asymmetric and the two breast volumes are different because of the bone structure. In such case, we might have to use large implant for the small volume breast and smaller implant for the large volume breast. This would decrease the overall average of the implant size.

When I interview the patients I find out that those who want large breasts want their breasts as large as they can get without any severe complications. Those at the opposite request so that the augmented breasts are not too large. The size of the implant decides on the breast volume nowadays. I am currently in Kangnam so I feel that there are many young women who want large sized implants. Whenever such requirement is made, I tend to talk a lot with the patients. In overall, Korean women do not require a large sized implant, but those who come to Kangnam require large sized ones. I hope that they can step back a little and be less greedy.

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Today, we looked at the data of the implants used and the characteristics of different patients in finding out if the appropriate sizes of implants have been used.
Thanks and have a great day.

 

We call augmented breast that is too large, an overaugmented breast. Today, I would like to share about using a large implant that is too big for the body of its owner.
Most of you know that the implant is made of silicone. But, why is the silicone used? I have not seen any patient ask me about this. The implants used on the breast augmentation, whatever the brand or type it is, are all made of silicone. I would have been amazed if there was a patient who asked me about the procedure of the implantation.



This is the core activity of the whole process. The brand or the type of the implant is not important. There are various reasons for using the silicone and here are a few;

1. The form does not change with time (It is semipermanent)
2. It is cheap and is easy to purchase
3. It has that soft feeling similar to the skin
4. It can be formed / processed into different shapes

These are some important factors, but you should be more interested in no. 1.
Silicone does not change its form. However, the long the implant stays in the body, the silicone does not change its location or the shape. We stated before that the skin is similar to clothes with spandex and the pressure goes against the silicone. The silicone can resist this pressure.



365 days a year, the outer layer of the breast pressures the implant, but the silicone can withstand this pressure leading to the outer layer extending. The collagen fiber restructures making the skin extend. Other outer layer that cover ligament, fascia, etc of the breast all extend. Also the rib cone and periost start to erode. The bones get dug out.

The restructuring of the collagen and the eroding of the bones do not happen severely if the implant is not too large.



But, what if there is a too large sized implant that goes into the pocket with much pressure? The skin and other parts of the breast would extend a lot. This is natural for adaptation to the surrounding environment. Also, there would be a sever case of erosion and the bones will be dugged out. a lot.

The biggest problem in using a very large sized implant is the extension of the outer tissue. The breast would not be able to withstand the weight of the implant and the breast would fall downwards. The breast would sag and the overall shape would be worse.

If you have breast augmentation before marriage, your shape would not be affected because you would have good enough skin elasticity. However, this is not the same once you get married and start to breastfeed. Another problem that may arise is the contraction of the breast. As the implant pushes up the breast, much pressure is caused on the breast making it thinner. The implant blocks the blood circulation leading to shortage of oxygen and nutrition, making the tissue amount less. We call this breast contraction.



Let’s say that a person with A cup size uses 400c implant and makes her breast size C cup size. The volume of the breast would be original size + the volume of the implant. As time passes, this volume changes. As the implant pressed against the breast, the original volume decreases. So if you measure the size after 2~3 years, the cup size changes from C to B. This change is not from the silicone implant but the change takes place with the original breast. So, such person would have an effect similar to that of another with 300cc implant in a few years time.

The problem does not end here. There are other complications related to using a large sized implant.

Due to the contraction of the skin and its thin layer, one can feel the implant easily, which leads to big dissatisfaction. If you give birth at this point in time, there might be a yoyo syndrome that makes the breasts sag or contract. This is an even worse case.

Two problems that can arise due to usage of large sized implant are
(1) Outer skin extending, low skin elasticity, misshaped breasts
(2) Breast contraction. There may be more problems generated from these two such as rippling, being able to feel the implant, being able to see the implant and breast boundary, low durability of the implant, etc.



So if you are the one who thinks that 400cc is necessary because others used 300cc, you need to change your mind. You might feel good about driving high displacement car but this does not apply to something that goes into your body. You also need to trust the doctor’s experience.

Today, we share about the problems that may arise in using too large sized implant. Did the details help?

Thank you and have a good day.

Plastic surgery Korea KIES-U

First, I would like to share about constricted breasts. (Today’s topic is a little difficult to understand. Please ask me any questions after reading the contents)

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Constricted breasts happen inherently. There are different cases. In one case, your breast might look like it only has a root. In another, you might see a breast that is shaped upwards only. I think that the connective tissues (collagen fiber / bundle) have some influence on the structure and formation. The tissue that shapes the breast become tight and pulls the breast making it look constricted or conical.

There are other terms such as tubular breast, snoopy breast, and conical breast. We also call this subformation of the bottom tissue of the breast.

Most of the patients with constricted breasts do not know the exact characteristics and think that it is caused due to subformation.

Common characteristics are wide and swollen looking areola, widened separated breasts, small breast tissue, high inframammary fold, small area at the bottom of the breast. Severe case can hinder breastfeeding as well. But there is no influence on pregnancy and giving birth.

Those with constricted breasts have short distance between the nipple and the inframammary fold. The skin on this part is tight as well. This is why the bottom part of the breast cannot be visible and one cannot look glamorous.

The solution for constricted breast is breast implant. Implant can be used to disperse the tightness of the breast.

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If you skip this stage and just use the implant, the tissue at the bottom part of the breast do not get improved. Therefore, this results in worsening the constricted breasts.

The surgeon needs to hold onto the bottom part of the breast, cut off enough fiber and other tissue so that the breast can intake the implant with enough extendibility. This requires dual plane augmentation.

If the implant is located under the pectoralis muscle, there cannot be enough gravity or pressure on the bottom part of the breast, therefore the dual plane procedure is necessary.

Also, the sagging breast can be corrected as well. As I have stated in other posts earlier, dual plane makes the pectoralis muscle lift up improving on the sagging breast.

This was a brief summary on the constricted + sagging breast. I hope the contents are clear.

This is all for today. Thank you.




Breast augmentation Korea KIES-U
Contact us  WhatsApp +82-10-2687-4790
http://kiesu.com/

- Food can get spoilt due to the temperature and humidity. Can the temperature and humidity affect the breast augmentation wound as well?



According to medical basic knowledge, if the body’s metabolism functions properly then it cannot get attacked by the germs easily Therefore, the person’s physical body status is more important than temperature / humidity. So the hot weather cannot have any influence on the wound of the normal healthy person unless you put some rotten food on the wound.

However, one cannot say that the temperature / humidity does not have any influence on the healing process. Warm temperature leads to better blood circulation therefore, this is more positive for the healing of the wound. Also, an appropriate level of humidity can help generate the skin quicker therefore this level of humidity is necessary.

In opposite, the blood vessels tend to retract in the cold weather, limiting the blood circulation and leading to the blockage of immune cells supporting the wound. Physiologically, the healing process takes longer during the cold weather than hot.

Also, the dry conditions do not provide enough liquid on the wound that is already dry. You might think that wet scar might lead to more discharge of substance from the scar but the scar needs more liquid in order to heal quickly and better. Scar treatment patches help the scar remain in humid condition.




The incidence rate of inflammation / infection does not increase due to hot and humid weather. Not enough provision of oxygen and nutrition can lead to worsening effect. However, this becomes a whole different story if you consider freshness. If you have compression bra on for a week with taping on the scars, you might feel uncomfortable and it is suffering to maintain such dressing on you the whole time. You might want to take off the tape quickly or even your compression bra off. You might also want to take a shower. Such factors make you feel really uncomfortable.

If it is possible, it is best that you avoid any work that you might sweat on during the hot weather for at least 3 days after the breast augmentation. You can undress the compression bra and take shower once you get off the early stages in recovery, therefore the healing process is not so different from other times.


If you have plans in going to the water park, it is best if you put some water resistant taping to cover the wound for at least a week after the augmentation. If it has a month after the surgery, it is ok to go inside the water without any taping. But is would consume some more time for you to go scuba diving, etc.

Today’s topic was on breast augmentation during the summer. Hope it has helped you out.

Thank you. Have a good day.

There are those, with scars after breast augmentation on armpit, inframammary fold, and areola, who are curious about “when to start treating on the scars.”

Today, I would like to answer this question.



We put scalpel on the skin for incision and this is called and operation. Incision to look inside the body is necessary for an operation.  The skin is like clothes with spandex. Can you imagine cutting this spandex clothes with scissors? The clothes would spread away from the incision line. If you put a knife onto the skin, this would lead to forming of the scar. The degree of the scar is different according to different situations.




The skin with the scar goes into healing effect instantly. This amazing healing process is still not analyzed or understood properly in the medical world. Which cells what type of substance? What stops the bleeding and what covers up the scar so that the body is protected from outside pollutant? These are some things that are really complicated and something that happens which we cannot control.



One thing that a doctor can do is to close the scar as much as possible so that the healing process becomes quicker. we call this stitching.

Now many know what stitching is why it is necessary. Stitching makes the scar heal quicker than when it is not applied. But, there is another difference. If the scar is not stitched, new skin would form between the scar, ie. the scar becomes wider. Stitching would gather the skin therefore, there is less room for new skin formation. Therefore, this makes the scar as minimal as possible.



Stitching in cosmetic surgery makes the wound heal safely but another important purpose is the avoiding of the formation of the scar and making it less visible as well.


Then, here is the answer to your question.

The first two weeks after the breast augmentation is important for healing. It is best that you do not touch the scar at this point in time. If there is no problem such as the stitch breaking up, then you should just leave it as it is. Nothing can make the healing process better than just leaving it when there is no problem.

If the thread does not melt in 2 weeks, we will remove it manually. The thread will remain but the tightness disappears within the two weeks. So whether the thread is there or not, we need to dress up the scar so that the skin does not widen again.




There is a paper tape called steri-strip. It helps out alot if you use such tape for about 2 months. There are many who ask how long the tape should be used. It is good to use it for as long as you can. If the scar widens due to the pulling pressure of the skin, the scar would get bigger in time.




You can know if the scar is healing properly or not in 2~3 months. Although the wound is healed, the skin surrounding the wound is weak. This part of the skin remains red. There is not much blood circulation in this area and the blood vessels are not healed properly therefore it is best to spend this time concentrating on how to protect the skin. If you apply laser on the skin, it would damage the skin.

Then, when do we apply laser treatment and other types of treatment?

It’s about 6~8 months later when the skin comes back to it complete state and recovers its original condition. It is best that you take care of the skin as much as possible by rubbing ointment and etc, during this time. You can apply the paper tape or patch (such as cica-care, f-sheet) and get laser treatment if necessary.

Detailed laser treatment method according to different types of scar will be brought about in another post for your reference.

Thank you and have a great day.

Things to consider before a breast surgery

There are many who are curious about our real time minotoring system, therefore I would like to introduce the system to you all.



Although the purpose for it’s application is saddending, real time monitoring system was applied to build up the trust between the patient and the clinic. The patient’s trust on the doctor is strong in developed countries such as US or Japan and such trust was not built up in a day or two but in many years.




Our country has developed really quickly and the idea of capitalism entered our country really easily. This is why the hospitals are also focused on earing money and expansion leading to bad perception from the patients. The patients think that the hospitals are only concerned with making money and power hungry doctors.

Also, national insurance cannot be applied to cosmetic surgeries therefore cosmetic surgeries tha consume much money have lost more trust of the patients.

There are many patients who visit 5 to 10 clinics before coming to us, as it is located in Gang-nam. As I see more of such patients, I think that the doctor and the patient have been distanced very far apart.

We used to call such behavior “doctor shopping” when I was in school. It is not the doctor who decides on the proper procedure and method for the patient, but it is the patient who chooses the doctor and the clinic just like when they are shopping for something.

Doctor shopping can be one of the characteristics of the IT world that we are living in today, but there has been too much commercial influence on this. The consumers are searching for cheap surgeries, and the clinics are marketing on low cost as well leading to a fierce price competition and what we call low price, high volume strategy.
Low price, high volume is appropriate if you conduct many surgeries. If one doctor has to take care of treatment, surgery, post-surgery treatment, the hourly cost would not be higher than the profit earned.



In order to get to the break even point, there are many clinics that use a “shadow surgeon” method. This method includes different person for each process. A consulting staff before the surgery, a doctor for pre-surgery treatment, and a doctor dedicated to only the surgery itself. This helps to save time, as the patient can move onto the next process without any boundaries. It would be more time consuming if one doctor has to take care of all these processes. This woul lead to low price, high volume and highest hourly revenue as well.

The first doctor to think of such process should be acknowledge in economic world but this is ethically and morally wrong for the doctor. Surgery should not be perceived economically. The management has to hire shadow surgeon at low income to save costs. This would not gurantee quality. Also, one person has to repeat his/her task one after another, therefore, a loss in concentration could lead to medical accident. Also, the surgeon would be somebody absolutely new to the patient therefore, the surgery itself could be a lie and a cheat to the patient.

When I was in school, the students would take care of the pre and post surgical treatment with the professor perfomrning the main surgery. This might have been right at that time, but when I come to think of it right now, it might not make sense. However, the residents spend more time with the patient in the university hospital more so than the professors. This is different to that of shadow surgeon in a small clinic.
There are xx clinics that are opening in all districts today. These are more of an “office clinics” that are focused solely in making money and appropriate to the system today. A person (not a doctor, but a business man) with marketing ability sits as the persident and manages the hospital. The clinics can only be opened by those with medical license so the beginning doctors or very cheap income doctors are hired to sit in such position. Such clinics have never ending medical accidents. There are lots of personal and civil complatins, but those presidents with much know-how can still bring in more patients.




Such clinics disappear in 2~3 years and the doctors are changed as well. This is one way to avoid taxation, medical inspection, etc. The patients who have suffered damages during this time cannot be compensated properly because everything has changed and the owner of the clinic is hiding behind somewhere.

Anyway, how do you think that we can differentiate such clinics from proper ones? I think that this is nearly impossible. There is no way if the owner is hiding or not, if the president of the clinic is fake or not or when the clinic will disappear.

Real time monitoring system is applied to cover up the mistrust between the patient and the doctor. This is just a policy. This system might temporarily make the patient to trust you but it cannot change the root or the origin of the mistrust.

I feel sad that I have to share what is happening int he operating room through the CCTV> However, this is the only method that can help the patients at the present moment. I don’t think that there is no other way to slowly build up trust between the patient and the doctor without this.

Thank you for reading. Have a good day.

Managing breast augmentation and its side effects

There are those who are ask questions such as “How do you take care of capsular contracture in this clinic?” when I talk to the patients.

I have felt that many patients are unclear about what the hospital can do if the patient suffers side effects or other complications after breast augmentation as they gather information on the hospital.

Today, I would like to share about a complication that patients are most concerned about, capsular contracture.

1. Can it be avoided? Why does it happen?
Let’s first look into this and then carry on.
Capsular contracture is something that the doctors are still not biochemically clear about to this day.

It happens to some, and it does not to others. It gets formed to some within 6 months and disappears. One might not have any problem for 5 years but then suddenly it gets formed. What is the reason for this? We still do not have an answer.
The incidence rate, referred to a publishment and FDA report, is found to be at less than 20% but Tebetts and others have stated that it is less than 1%. The fact is that the incidence rate of capsular contracture is dramatically low at present than that in the past.

In the past, there were much bleeding during breast augmentation, and it was done above the pectoralis muscle. There was no method or concept such as dual plane. Also, not many textured implants were used. The doctors may not know the cause of the capsular contracture, but they have built up knowledge on how one could avoid it, therefore, limiting its incidence rate. However, we cannot make the incidence rate 0% with the usage of silicone implants. It can be formed although you take much care of your body.

One common cause that most doctors agree on is that the capsular contracture gets formed with infection in the part of the body that we cannot see and the inflammation that is caused. When substance such as an implant goes into the body, it gets polluted with air outside. Such pollutant reacts with the body and the matabolism system causes a capsule that is strong and hard. This capsule which makes the breast hard is called capsular contracture.

The most effective method in preventing the capsular contracture would then be to prevent pollution as much as possible. There are techniques for this, and these techniques are shared in my other posts.

2. Who is responsible for capsular contracture?
Unwanted happening after a surger is called “side effects” or “complications”.
One would argues if complications such as capsular contracture after breast augmentation is medically responsible or if it is something that happens naturally. It is difficult to say that this is something that is caused through medical reasonsing based on the sources and experiments conducted so far. This means that it is not caused due to the surgeons’s act, misdirection, or any other related actions.

Then, can the patient not have the hospital responsible for capsular contracture?
This is not true either because a doctor has a responsibility to do the best he/she can to achieve best result for the patient.



Although, there is no medical fault, the doctor needs to be somewhat responsible for the result. Therefore, he/she has the responsibility to make things right. Therefore, is the capsular contracture is formed, there are invasive methods such as correction, or non-invasive methods such as massaging that can be conducted. We, at our clinic, provide non-invasive methods for free of charge. If correction is necessary, it is free also. However, we charge for anesthesia, medication, and other material costs.



The gel within the implant gets dispersed and at times may feel that it gets folded
If there is malpractice or medical fault such as leaving the gauze near the implant, not knowing about it, and causing inflammation, I think that the hospital cannot charge the patient for breast augmentation. If the hospital does not react to such problem quickly enough leading to worsening of the inflammation and implant collapse, then this is a medical accident and the hospital must be reliable for compensation as well.
However, this is not the case for capsular contracture. That is the solution to it is vague and the hospital cannot give a clear answer.

3. Does correction help recover from capsular contracture?



When corrrecting a severe case of capsular contracture, we open up the epithelium. A complete removal of the epitheium might be necessary at times. The implant can be replaced as well.

There are patients who ask if the recurrence of capsular contracture can be completely avoided. The recurrence is avoided 90% of the times after the epithelium is opened up.
There are many who search for “capsular contracture” on the internet and think that it is the scariest complication. From my much experience, I believer that it is not the worst complication that one can suffer. Also, your interview with the doctor is very important before the surgery.

Therefore, you do not need to worry or be scared off capsular contracture. This applies to those who are waiting for the breast augmentation and those who already have got one. The assumptions from the internets are much different from statistically known facts.

I hope that today’s content has helped you. Have a great weekend. Thank you very much.

Getting to know about breast augmentation

Whoever gets on the surgical bed would be scared to get a surgery. This is something normal. The biggest reason for such fear is the pain that you would feel after the surgery.

Today, I would like to share about few things that you can do in order to prevent the pain and achieve a comfortable surgery for the breast augmentation.



There are those sho feel much pain and those who do not. There ar enot who do the feel the pain at all. You need to know the difference between these patients in order to know why there is a difference in pain level.





First, it is the pressuring strength of the implant. The pain is caused through the pressure that the implant sets on the skin and the bone that it is located on. The implant is made to put more volume to the skin but it causes pressure that leads to pain. It is know that the most pain is caused in the periost. The pain recpetors that cover the periost make you feel the most pain.

Second is the trauma or the external injury.In order to get a clear vision, the doctor uses retractor, endoscope and other equipment that physically tough the patient’s skin leading to much pain.

Third reasons is due to the breast skin that wants to resist the strength that make fascia-muscle-tissue strech. If the implant goes into the breast, the input area gets larger. The skin is similar to spandex that resist the power of the person wearing it. Therefore there are many sensing receptors that make you feel the pain.

The fourth reason, is the difference int he level of how each person feels the pain. A hit on the forehead might make some people feel a lot more hurtful than others. To them, it is not right to explain that they would feel less pain with the surgery. Each patient would feel different level of pain.



The first type of pain would be severe with larger implant, and less with smaller implant.
The second type of pain would be severe if the doctor is harsh and not careful. It would be less painful if the doctor is more careful.

The third type of pain would be more severe to those patient that are young because they have tighter skin. The skin sags as you age, therefore the pain would be less for older patients.

If you know what type of person you patient is, you would be able to know what to do so that she feels less pain when conducting breast augmentation.

You should avoid using an implant that is too large. The doctor should be careful when conducting the surgery. The patient’s skin needs to be less tight and she needs to feel less pain.

The third and the fourth reason for the pain are those that we cannot control. But the first and the second reasons are those that we can control.



The doctor should use an appropriate size implant and should be careful not to touch too much on those spots that have pain receptors.

If these directions are met, then the patient does not need to worry about the pain as much.

This the is answer for how to make the breast augmentation not painful. Today, I shared a brief content on the reason and the solution for this.
Hope this has helped. Thank you for reading.

There was a person who asked about the seroma that could arise after the breast surgery using an implant. I would like to share about this today.

If you put blood sample in the test tube and leave it for a while, the liquid rises and the blood cell stay at the bottom. The clean serum gathered together at a particular place is called seroma.

Small blood vessel damaged leaks plasma and cases seroma. Infection can cause seroma as well.



A hermatoma containing red blood cell is wrong and an abscess containing pus is different.



Seroma is formed due to some kind of trauma on the body. It gets sucked into the body as time passes. This may take days or even weeks. Calcification can be cause after the seroma disappears.

This happens a lot during the breast surgery (mastectomy), abdominal surgery, and reconstruction.

More the difficult the surgery gets, there is a higher possibility of seroma and the more larger the seroma is, it takes longer time for it to disappear.

Also, there is a possibility of second infection as well. Such a large seroma can take years to go away.



In 2012, there was a plastic and reconstructive surgery journal article written by Spear and others. They analyzed 28 cases of late seroma after breast implant. The seroma was formed at an average of 4.7 years after the surgery and most of the cases used biocell textured implant, Allergan’s textured implant.
One can remove the epithelium or replace the implant in order to cure this. There are cases where only the seroma was removed as well. Some used antibiotics for the cure.



96% were found to be cured properly, however we do not know the cause. There were no cases of infection or malignant altercation in the journal that Spear and other wrote.
The first scholar to mention about seroma in breast augmentation was Elizabeth Findlay. Dr. Findlay reported that all cases of seroma were found with the usage of Allergan’s textured implants. The reason for this is that all Allergan’s textured implants have a surface of Biocell that have strong friction and this causes trauma damaging the blood vessel - causing seroma. The seroma found by Dr. Findlay was found 6 months after the surgery (This is why the term ‘delayed’ was used).

From my experience, I think that it is more common to find seroma right after the surgery lasting for 6 months, which is different from what Dr. Findlay found out.
We, at our country, use Polytech, Mentor, Allergan, Silimed, Cervin, etc implants and I don’t think that the seroma formation only applies to Allergan textured implants. There were such cases found in Polytech and Mentor implants as well. Smooth round type implants had the same problem also. There weren’t any cases found in Silimed implants as of yet.


So, I think that instead of calling this “late seroma”, it should be called “Nonabsorbing seroma”.

If the pocket for the implant is larger than the implant itself, the contract-union of the implant and the pocket is not be conducted properly causing much space in between. There would be liquid formed in this space that do not get sucked in for a long period of time leading to the seroma formation.

A certain type of implant from a certain brand do not fit in with the size of an average Korean woman’s rib size therefore there can be a mismatch and empty space between the implant and the body. I think that this could also be a cause of seroma formation. Of course, there needs to be more cases gathered and experiments conducted to know about this with certainty.

Today, I share content on the complications that can follow after breast correction.
I hope that this content has helped you enough.
Thank you for reading and have a good day.

There are many athletes who visit our clinic.
Today, I would like to share few tips for those who enjoy sports, those who are professionals or do sports for living.



1. Weight control
This is the first topic that I share with, with those who enjoy working out. This is very important for such people. There are many who lose weight in a sudden before an event or a tournament.
Once this is passed, they tend to become less sensitive on the diet.

This type of weight control repetition is not good for the breasts. Gradual loos of weight is better. You should not try to lose much weight at once. If such gain and loss of weight is repeated, you will tend to lose elasticity on the breast tissue, and your breast would age.
Breasts that lose elasticity, cannot be recovered. The problem is here. Also, the breast correction required for this is very complicated and risky.

Health instructors, body builders, fitness, ball-related athletes, Yoga/Pilates, and Jazz/Belly dancers all needs to avoid sudden loss of weight when considering the beauty aspect of their breasts.
Anyway, there are those who ask if they should lose weight before or after the breast augmentation. There is no answer to this question. One cannot know how much weight would be lost, and how much influence the weight would have on the changes made on the breast.


There is homeostasis in our body.
When you shake a water bottle, the water inside makes waves, but as time passes, the water calms down.
When there is such a shake or complication in the body, it takes some time for the body to get used to the different environment and get back into stable condition.
It is important to control body fat, weight and rhythm before the surgery in order to minimize any chances of complications that may be caused after the surgery.

2. Harmony in the breast
Breasts have been one of the core parts of the body regarding a woman’s body beauty.
A good, healthy looking body would include breasts also.
The muscle volume and edge would be important for male fitness athletes, but for a woman, it would be important to have good looking breasts along with developed muscles on the body.



The lines formed by the breasts need to be in harmony with the upper body shape and size. A high volume breast would not look natural on an average body.
The position of the nipple is related with the cup size but is not related to the beauty of the breast. A breast without symmetry, balance, and ratio would not make the body look good.

3. Selecting surgery method
There are many who ask where the incision should be when considering problems caused when exercising. But I don’t think that this is an important factor to consider. The plane where the implant lies is more important. Deciding if the implant room should be above the pectoralis muscle or below the muscle is more important.

If the room is formed above the pectoralis muscle, there would be no pressure on the implant and no problem with the implant moving to another location. However, if the skin becomes thin, then one would be able to see the implant and feel the edges also.
If the room is formed below the pectoralis muscle, then the contraction on the muscle would pressurize the implant. The repetitive contraction leads to movement and rotation of the implant. However, there is low possibility of capsular contraction and low possibility of being able to feel the implant.


I have been thinking a lot about this problem with athletes.
In conclusion, I think it is better to conduct the surgery under the pectoralis muscle. (Below the muscle is a popular spot for dual plane as well)
When I observe the results of dual plane surgery, the movement of the implant has been less severe for athletes who conducted vigorous activities. These athletes tend to reduce fat and gain muscle. If the implant is place above the pectoralis muscle and can be felt, there is no way to solve this issue.



For athletes, the best plane for breast implant would be the dual plane. The incision location of the armpit / areola / inframammary fold are less important than this.

4. Cautions to take after the surgery
When can I start working out?
You would need some time to recover to the state before the surgery.
You should not start exercising at same density as before the surgery.
Simple stretching and light workout for one week would be good enough to bring up the pace however, the recovery time period is different from one person to another.
Also, it takes about 3 ~ 4 weeks for the capsule to form around the implant, in order for you to start exercising.
After 3 months, there is nothing that you cannot do.



Athletes do not have subcutaneous fat and have tight skin therefore it takes much time for the breast to get into proper shape.
Massaging and using correction bra helps this process. Sport activities are not restricted during this stage

Today, I shared few tips for those athletes or related personnel who want breast augmentation. Thank you for reading.