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.

Lateral Canthoplasty that avoids the skin sticking back together

Asian people have eyes that are narrow, lower, and the eyelids are thicker compared to the Westerners. Such differences with the Asians lead to them wanting double eyelid surgery or blepharoplasty.

If the width of the eyes are short, and if epicanthoplasty is not enough, then, at times, we go with lateral canthoplasty as well.
There are many patients who worry that the separation from the lateral canthoplasty does not last making the skin come together again, and ask questions regarding the procedures that do not result on the re-surgery or the skin sticking back together again

So today, the post will have contents regarding the lateral canthoplasty that does not result in the skin coming together after the surgery.

[Lateral canthoplasty that avoids the skin sticking back] 

Many patients consider having lateral canthoplasty if they have narrow eyes or have sharp out corner eyes. These patients have concerns about the detached outer part of the eye sticking back after the surgery.

In Kies-U, we consider re-locating the (*)lateral canthus for conducting lateral canthoplasty.
(*) lateral canthus: Point where the upper and lower eyelids meet

Before and after Lateral Canthoplasty

Relocating the lateral canthus is a little radical method compared to the lateral canthoplasty. However, this is a very good method regarding the fact that there are many patients who are not completely satisfied with the result of the lateral canthoplasty. Also it is used as a part of the re-surgery.

[Differences from the standard lateral canthoplasty]

Originally, the first lateral canthoplasty introduced was targeted on the Western patients.




Westerners tend to have thin skin layer, and the eyelids do not cover much of the eye ball therefore we do a lot of geometric type design on the eyes and cut off then reattach the skin.

However, this technique is not applicable to the Asians who have thick eyelids as such technique would result in many scars and outer part sticking back together after some time.

Lateral canthoplasty that does not result in outer part sticking back together again involves not the removal of the skin but relocating near the periost to avoid scars and greatly reduce the possibility of the outer skin sticking back.

Procedure of lateral canthoplasty

[Who needs the lateral canthoplasty?]

There are many who ask "Can I get lateral canthoplasty?”.
Anyone and everyone can get lateral canthoplasty but the result of the surgery differs from person to person according to the sharpness of the eyes and the tightness of the skin around the eyes.

If the skin around the eyes are tight, then it becomes difficult to pull and fix the skin around the lateral canthus.
Also, we do not recommend lateral canthoplasty to those who have Western looking eyes.
The surgery is effective to those who have Asian looking eyes.

Lateral canthoplasty, lowering the outer part of the eye

[Problems with lateral canthoplasty]

The biggest problem with the lateral canthoplasty with the outer part that does not stick back is the conjunctiva edema.

Originally, the surgery exposed the conjunctiva so that it becomes a part of the eye making the eye look a little swollen and different from how the eye had looked before.

Also the eyelashes are removed as much as the incision so the eye may look unnatural, however, this can be avoided if the incision is done at an appropriate length.

Most important aspect of the overall approach is to interview with the surgeon and then make a final decision.

Today, we shared about the lateral canthoplasty. I hope the contents help you understand better about this topic.

Thank you very much.

Breast augmentation Surgery To Know List 2. 

Is the silicon implant safe to use?

Today’s post is on the safety of the silicone gel implant. There are many of those who are highly interested in this topic therefore; I will go over the details briefly.
 

1. Is there any relationship between the silicone gel breast implant and breast cancer? 

Since 1992, many plastic surgeons, and other scientists studied and gathered data on the safety and effectiveness of the breast implants.

The 7 years of work was put into a book, "Safety of Silicone Breast Implants", published in 1999;. (Washington DC, National Academy Press)

This book was complete through much effort not only from the plastic surgeons but with the efforts from other scientists as well. The book has a reputation for being one of the most scientific and reliable book of its kind. It also meant that silicone breast implant is safe.





Another acknowledged medical journal, New England Journal of Medicine, in its 1995 332nd edition, announced a finding by Dr. Guerrero, who studied the relationship between silicone breast implants and Autoimmune Diseases on 87,000 patients. The result showed a proof that the silicone breast implant does not cause any body illness.

Such reliable scientific findings were published continuously, and since then, many people in Europe and South America used silicone implants. The implants were restricted only in US and Korea.

FDA restriction of the silicone breast implant was set only for the beauty surgery temporarily. So if the surgeon thought that it was necessary, then he/she could make a request to the FDA so that the patient can use the breast implant.

But in Korea, the importing of the implants was banned. Korea bench-marked the restriction from the FDA and made the implant banned from the country without any logical reasoning.





In 2006, FDA finally approved the use of silicone implants and Korea Food and Drug Administration did the same copying the exact standards from the FDA. The importing and the usage of the silicone breast implants were opened up since 2007. In 2012, there was an approval in the import, distribution, and usage of cohesive gel breast implant such as water drop type.

Silicone gel breast implant is safe. There is no proof that the silicone gel breast implant causes breast cancer or other Autoimmune Diseases such as lupus, and rheumatism. The public news and opinions without any justification caused moratorium that restricted medical development.

2. Why do we use the silicone? Is there no substitute? 

Silicone is chemically a safe substance. There is a long history of using silicone in the medical industry and there have been many successful cases in the usage.

Silicone can be made in many different forms, and can be easily put into the body. The cost is relatively low as well.

But this does not mean that there is only good in silicone. The biggest problem with the silicone is the structural look. If the silicone implant goes into the body, the body starts to become immune to it. This happens to every person except for those who have problem with immune system like AIDS. If this immune activity becomes rigorous, then the skin that surrounds the silicone becomes thick and hard causing bad structural look and touch.

There have been many studies related to such problem with the silicone. In Europe, there has been a history of using polyurethane instead of the silicone. This implant has near to 0% of causing structural problem.

However, polyurethane cannot be imported to Korea. There is a complex reason for it.

3. What happens if the silicone gel breast implant burst? 

There still are some contents on the blogs and homepages of some individuals that if the silicone gel breast implant bursts, the silicone gel leaks and goes into the blood or lymph circulation causing various types of sickness.

These contents do not have any logical ground. There are some people who think that if they eat snakes, their body becomes more flexible. However, science should not be based on likelihood. There must be a solid reasoning behind any explanation. Also, there are no proofs or facts that the silicone gel goes into the circulation and that the silicone causes any illness.

There is still some coherence in the leaked silicone gel so the gel stays together. Also, the gel remains in the epithelium so there is no possibility that it enters the circulation.





If the silicone gel gets damaged, then the shape of the implant changes slowly causing the shape of the breast to change over time. If this change is observed, then it is recommended to take MRI or ultrasound test to get a confirmation on the damage and them replacing the old implant with a new one. Silicone gel breast implant does not get damages as easily as the saline type.

Today’s post was answering if the silicone breast implant is safe or not. I hope the post helped you out. Thank you very much. Have a nice day.

Pectus Carinatum Breast augmentation Surgery 

I have personally analyzed statistically that there are about 12~16% of those with Pigeon chest. This is rather a common form of chest cage.



Pigeon chest is when the chest cage is roundly shaped by ribs, and breastbones. We call pigeon chest medically pectus carinatum.

The shape is formed because costal cartilage and breastbone stick outwards. A bad case of pigeon chest comes with scoliosis but there is almost no case where pigeon chest leads to respiratory problems and therefore, this is not a type of illness.

I use the term pigeon chest on a situation where the middle part of the chest sticks outwards and does not look pretty or good physically. Of course, there are many with pigeon chest who receive a breast augmentation surgery.

In most cases of pigeon chests, there are situations where the breasts look far apart from one another. This is due to the location of the nipples that are far apart.
Also, if the upper body sticks out, there the breast augmentation surgery does not lead to a natural look but there might be a bad case of bad looking upper block.

Difference between normal chest and pigeon chest

So, we mostly recommend water drop shaped implant for the pigeon chest breast augmentation. This is more effective for the upper block. Also, it is not good to use a large volume implant. There is a high pressure on the mid part of the chest, therefore, physically there would be more pressure on the chest if the implant is larger therefore, causing a push outwards, making the breasts look even more far apart.

Therefore, you need to be more conservative in selecting the implant size and to select water drop shaped implant.

Breast augmentation for Pigeon chest

There are cases where the chest from top to bottom comes out for where only the upper part sticks out in pigeon chests.

In the former case, the breasts look far apart, and most of the patients who come in for an consultation know that they have pigeon chests.

For the latter, the breasts do not look wide apart, and there are many of those who do not know that they have pigeon chests. If a surgeon is unaware of the bird chest and just conducts the breast augmentation surgery with normal sizing and implant, then there might be a bad upper block on the chest.







So there are at times when I have difficulties when consulting. The chest look different from a normal person but this is not something abnormal. This is just s characteristics of the chest. This is something similar to a nose surgery. Your nose might be a little closed or lifted. The surgeon must select the type of the implant according to the type of the chest and decide on the surgical procedure. However, if the patient does not accept the characteristics of her chest and accept it, then we might have difficulties in proceeding with the breast augmentation surgery.


I talked about percentage earlier on, but there are many of those who have costal cartilage and breast bone that stick out. This is not something abnormal. It is important to plan out the breast augmentation surgery according to the shape of the chest to have most effective results.




This is for today. I hope you understood the contents. Have a nice week.
Thank you very much.

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.