Consumer Report : The dark side of breast surgery. Hoping for a TV program that provides the essence of the problem

I would like to share my reviews of Consumer Report on KBS that was aired on March 3rd titled ‘The dark side of breast surgery’ as a cosmetic surgeon.

The first story was about a lady named Ms. Choi who suffered from capsular contracture.


The lady got breast augmentation with saline bag type implant in 2012. Within a week, the breasts became real hard. The clinic where she got the breast augmentation, decided that it was due to capsular contracture and conducted correction. The implant then collapsed so she visited another hospital to replace the old implant. The new implant used was a cohesive gel type. However, the pain still existed and she finally decided to have the implants removed. In september, she got the implants removed, but the pain did not go away.


The Consumer Report also showed that Ms. Choi did “think about suicide” and “that one out of every 4 patients get correction. There is more behind all the sweet talks about breast enlargement”.

The program says the Ms. Choi get contracture within the first week….

This is something really difficult to happen.

Capsular contracture is formation of epidermis that becomes really thick and strong due to metabolism. It takes about three weeks for the epidermis to completely surround the implant. . Having felt something similar in 1 week seems that this is not a capsular contracture, but a mis-match of the pocket size for the implant and the implant itself.

Wouldn’t you understand better if I said that the pocket was too small for the implant to go it therefore the breast became real tight because the implant that is larger than the pocket?


If the patient’s breast skin became thinner then maybe the epidermis was removed by too much force due to the judgement that there was a capsular contracture. I think that the skin stuck on the epidermis was removed togethers. (This happens a lot when the correction is done through the armpit)

In the meanwhile, a nerve might have been damaged so that there are no senses. The patient might feel like she got burnt while bathing in a sauna - A burn can lead to contracture as well - and the 4 or 5 corrections could pull on the scar a lot, making her feel that kind of pain. I think that Ms. Choi’s case is all due to the problem of the surgeon being careless.

There was a snapshot of 2016 Reports of the side effects caused by medical equipments. I do not think it is right to show such simple data and make the viewers thinks that implants are dangerous.



This is like saying that there are 100 times more cold patients that cancer patients therefore cold is 100 times more dangerous than cancer. I think it would be better to compare medical equipments used inside the body such as dental implant, artificial valves, artificial neves, artificial joints and artificial breasts and seeing how many reports each of these equipments get.

Also, the statistics that one out of every 4 breast augmentation patients need correction looks wrong There is no such data or statistics in our country. FDA in US gathers such data. In 1993, there was a ban on silicone implants and the data then was about 20%. This was 24 years ago. That is a long time. What do you think it is like now? (This was US not Korea)

American Society of Plastic Surgeons (ASPS) gathered reports from 4990 plastic surgeons on reoperation rates of breast augmentation. This data was published in PRS 2011 October edition. .



The reoperation rates announced by ASPS was 1~5%

The second most common reason for reoperation was to change the size of the implant and the most common reason was capsular contracture.
We cannot neglect even one patient who has side effects. But because of one careless mistake, we cannot judge that these surgeries are really very dangerous. We cannot make the patients feel concerned because of this. I am also not sure whether this is something that journalism is to take account for.

The second story was about Ms. Kim who received fat transplant on the breasts. It was about getting fat transplant twice with frozen fat leading to a flare in the breast and opening up the stitch causing exudation.
The program stated that the fat stored was in a real bad condition that led to inflammation which could also lead to severe damage.




I have studied science. Science starts with rational doubt and analysis on the doubts. So I had much doubts when I was watching the program. Is this true? Can the fat of bad condition cause inflammation and infection making the patient suffer that much?

The first and the second story from the Consumer Report put much focus on the medical equipments. This is the approach that non-professionals take on some professional area. Equipments are something that are visual. Implants, fat, etc. But the specialists focus on something that are not visible, like what did the doctor do?

If the fat became bad because it was stored in the residential refrigerator and was used for transplant causing infection, why did the exudation only come out from the right side?

It was the same material. The fat with same materials was used on both breasts. Then why wasn’t there infection on both sides?

Actually, it is difficult to analyze the details with the contents provided in the program. We cannot know what caused the infection. If the nutrition from the good fat did not spread out properly into the breasts but died out, we could still have the problem of infection.



It seems like much fat was used. We need metal cannula in order to use this much fat. We cannot ignore the mechanical trauma that may have been caused.

The cannula has to move in order for the fat to enter the breasts. This may damage the cells and cause bad environment. Such could result in infection as well.



I always think like this.

All complications and side-effects are related to how careful the surgeon was.

Fat transplant on the breast is not something that is bad. The fat needs to be stored carefully, the input process should be done carefully, sterilization should be done, the patient needs to take antibiotics, there should be proper dressing for the wound, proper monitoring to lead to good result for the patient. This is all done by human.

The third story is a lot worse.

It is about a filler used on the breasts. There is no details on the safety of the breast filler in any journals published around the world.

I still think that this should not be conducted in some cases. If there is a problem with the breast regarding shape and you want to make it more contour, then we can consider the filler.
But, if you want to change the size of the breast in terms of cup size (it said 700cc in the program) then I would oppose the idea of using the filler.

There was a small detail about UK gynecology journal in the expert interview. The substance in the filler was liquid silicone which has been banned in usage for a long time. (Today hyaluron is used)

I think that what Consumer Report is trying to say was that the practice of plastic surgery for commercial reasons can be dangerous. I agree with this effort.

But, the program kind of got out of hand in sharing about the danger.

I feel kind of empty after seeing medical related programs (including dramas)
There is no essence in the program but only non-important contents.

The most important thing is whether the patient met a good doctor or not. Everything is done through the hands so one must be very careful because something that has never happened before, could happen. One should not be too greedy but be satisfied with the current status. I think that this is the essence.



My hope is that we abandon consumer targeted promotion in plastic surgery. I hope there is a medical law or regulation for this.

Thank you and have a great day.

Sociology of plastic surgery

Langlois and others conducted an experiment on 3 month old babies by giving them 2 pictures and observing which they like more. Although these babies could not speak, they look at the picture of the one that the adults judged to be more attractive.

Couple of years ago, there was a TV program that tested which teacher the kindergarteners liked more, a pretty looking teacher and the ones who is not. The kids concentrated more in the class thought by the teacher who was more attractive and they thought her to be more professional.

Based on such experiments and information, we can think that the want for beauty is gained through learning and also something that is innate.



A human’s stand towards beauty is both longing and a desire, and at the same time something that is artistically wanted for.
Sophisticated, noble, smooth, attractive, lovable, enticing, etc, words such as these show how much us human being long for beauty.

In this regard, our society too is very and overly interested in plastic surgery. The plastic surgery in Korea is very famous throughout Asia.

I always think about how our country has become so famous in plastic surgery globally in its technique and culture. I would like to share about this today.

 


Plastic surgery is a behavior that is highly related to a person’s needs and wants towards beauty.

We all have our want of beauty but we are in a culture where we cannot be open about it. Things have changed a lot, but not this.
If a celebrity has a plastic surgery, this becomes a gossip but he/she and the management make it untrue or are hesitant to talk about it.
This is because many people criticize the person who look better through plastic surgery. This is especially so with mid and old aged men who are the backbone of our society.
This shows that neo-confucianism perspectives still remain as a part of our society. Such culture can bring out absolutely different perspective of plastic surgery.

These mid and old aged men set priority on the root and are trapped within the idea that “although she got pretty because of the plastic surgery, the root does not go away.” In opposite, young ladies are too concerned about looking good and they want to look good through whatever way possible.

As such, we can see two opposing views regarding plastic surgery according to social class and age.
 


We need to talk about this as well.

This happened couple of years ago. An announcer in KBS came out on TV and looked as if she gained more weight than before. The viewers criticized her by saying “how can she come out TV looking like that?” There was a lot of criticism that our country was too much focused on appearance.

Ability, skill, and experience should be more important than appearance but we are too focused only in the appearance. So there are many critics that say that our society not only judges ability but also beauty.

I had a conversation with the head of announcer academy. I asked him if he could know that the student could become an announcer just based on the looks. He answered that the student needs to be “Pretty, Being pretty is good enough. You can’t be selected if you are not.”
Beauty can be more important for visual area… but I still had some questions. This is maybe why our society is too appearance oriented.

But in overall, I don’t think that our society is that much appearance oriented. There are times that we spend much focus on the beauty but it is not the most important factor.

In Brazil, South America, it is known that 18 year old teenage girls go to the banks to get loans. They want to get cosmetic surgery on the hips and breasts. The girls here, when they become legally adults, do not go for a drink or have a date night with their boyfriends. They get money to get a cosmetic surgery.

Our country is perceived to have many who want cosmetic surgery but it is not comparable to Brazil. It is not perceived that majority of the society is focused in cosmetic surgery.

I don’t think that the problem lies because we are too centered in beauty, but the problem is because we are obsessed by it. This is highly influenced by the marketing activities of cosmetic surgery clinics as well.


There is a famous portrait named “Gangnam Beauty”. I think that many of you have seen it. There are number of ladies with same faces in this portrait.


Those from the rural areas when visiting Gangnam say one common thing, “all women in Gangnam look the same.” I don’t think that they all look the same based on my 10 year stay here in Kangnam.

There is a trend toward a standardized beauty in cosmetic surgery.

But this trend changes little by little with time.

The number of cosmetic surgery clinics in Kangnam are reduced with time as well unknowingly. People are starting to be aware that cosmetic surgery if resulting in bad outcome can lead to a loss of personality and attractiveness.

There was a TV show called Let@# that was on air until last year. It was one of the most effective means of promoting cosmetic surgery clinic of which the topic that the viewers were mostly interested in was bimaxillary surgery.

At one time, bimaxillary surgery was The Cosmetic Surgery.

The actual name for bimaxillary surgery is bimaxillary concurrent surgery. Tooth correction is carried out simultaneously therefore careful decision making is necessary. Many viewers thought that their faces could become smaller through bimaxillary surgery and invested much money just by watching the TV program.


These people have suffered from many complications after the surgery. The doctors did not ask or judge anything but just received money as they conducted the surgery. This has led to various complications and side effects resulting in legal claims and suits. There were some celebrities who came on TV crying and saying that there are at difficult times.

As people saw these things, they became to realize that cosmetic surgery is not something that can be done lightly. They also realized that bimaxillary surgery did not make their faces smaller. They also because aware that following others who look pretty and getting a cosmetic surgery is a dangerous thing to do.

In the past there was a standardized beauty, but today, consumers are aware that beauty does not come down from heaven just with money.


Complication of bimaxillary surgery… “Hospital to pay KRW 60 million”
There was a judgement that if there is not sufficient information of bimaxillary surgery then the hospital must be responsible for the complications that arise. On the 18th, Seoul district court ruled that the hospital must compensate for the complications caused through bimaxillary surgery. The ruling also included that “plastic surgery is not an emergency one, therefore the result can be different from what the patient expects, Therefore, the hospital needs to share about the treatment methods, improvements in detail to the patients”. “Also it should be noted that B did not provide enough information.” It was added that “B seemed careless and also damaged some parts by forcing this surgery.” “However, the surgery itself has some dangers therefore, B’s responsibility is limited to 60%.” “B must provide punitive damage of KRW 61 million to the patient.” A visited B’s hospital in 2007 for bimaxillary surgery but A did not see any positive effects but only got more complications that led to trial in court.



The Korean cosmetic surgery market grew with much focus on beauty. There was no individualism and personal standards. Just common beauty was required that led to much problems. But I think that today, we have different standards of beauty and there no one specific standard.

This is a time of change and I knew that this time would come soon enough.

Beauty cannot be judged instantly. Beauty at first sight only is a thing of a past. Beauty is something continuous and attractively felt. “You become more attracted to it as you see more of it” is the new perception now.

Thank you for reading. More of the related contents will be shared in the near future.
Have a great day.

Solution to problems, accidents, complications, and aftereffect caused after plastic surgery | Knowledge on plastic surgery

There are times when the patients are not happy with what results in after the plastic surgery.



There are several reasons to this. The patient might not have had enough information on the surgery, too much advertising / promotion has blind-sided the patient, maybe the clinic or the surgeon was not skilled enough. Also, I think that there was not enough communication between the patient and the surgeon that could have led to the outcome.

In the neighboring country of China, there are cases where the patients physically abuse the doctors because of the negative outcome. Is there no solution to the dissatisfaction caused on the patients? I would like to share about this today.

First, I would like to look into a situation that is normal.

1. At first, the patient notices a problem in her body and wants it to be taken of. She starts to search for hospitals/clinics that can provide a treatment for her problem.

2. The patient visits the appropriate institute, meets the doctor and talks about related topics. She also gets information on the problem that she has and aftereffects of the plastic surgery. Then we would contemplate with all these information and decide on the surgery.

3. The patient shares everything that she feels such as physical problem, inconvenience caused after the surgery to the doctor. If these problems are minor, the doctor will monitor the situation. If the problems are severe, recorrection could be considered.

4. Long term monitoring is necessary after the surgery. The monitoring on the patient status, examination of x-rays, photos are conducted for minimum of 1 year. The patient and the doctor communicate on the changes that took places and other problems that arose after the surgery.

There is a reasons why I mentioned the term “normal case” above

In reality, the activities mentioned above are not followed. There are many, many cases where something abnormal happens. Let’s talk about these.

1. Cosmetic surgery could be perceived in both medical and business aspect. There is much capital involved with it. What I mean to say it that...

Medical actions are undertaken in order to protect the health of our people and this is why the government has great interest in it. There is a National Health Insurance, where all the Korean people are registered into. Also, this National Health Insurance is applicable to all the hospitals / clinics at our country. But cosmetic surgery cannot be covered by this insurance. It is not related with the health of our people.

Then, is cosmetic surgery absolutely not related to medical treatment? (Is it same as going to a parlor and getting your hair dyed?) We cannot say that it is because we use a knife for cosmetic surgery.

The government needs to intervene so that the cosmetic surgery is not done only for business purposes. It needs to check if unqualified doctor is putting a knife onto the body, if inexperienced doctors spending much money are advertising heavily, if there are many incidences of complications or not. Someone needs to monitor and overlook these activities.

Surprisingly, there is no entity that does this in Korea. The patients are exposed to these much invested advertising by the hospitals and leads to encountering the medical entities without any subjective reasonings. This first encounter is important because the patients could make a decision with false or wrong information. She would not be able to understand and accept what happens after the surgery and could lead to much conflict with the medical institute.

2. Although this might happen, there can be a way out of it. The patient needs to meet the doctor no matter if she got false or wrong information from both on and off line. Therefore, she has a chance to talk with the doctor appropriately.

This is why I think that the conversation between the patient and the doctor is the last bastion. This is the final chance that a doctor can meet and explain to the patient, the circumstances of putting a knife onto the body and correcting the false information that the patient has.

But, there are times that such an opportunity goes to waste.

The patients register into large hospitals that do heavy advertising, get counselling from 2-~30 hospitals to gather information. They also compared the specs of these hospitals.

Medical treatment is a connection of one person to another, to find out what problems can be treated and if there are any aftereffects in the process but this concept has been long been changed to a product that patients shop for.
How much do you think that such a patient, who tours around different hospitals and makes a choice, can trust the surgeon?
If you are going shopping to a Walmart, you can pick up an item and throw it away or not buy it the next time if you do not like it. But you cannot throw away your body and buy a new one. This is the biggest difference and the biggest problem.

3. Now, the patient pays her bills and completes the surgery in the hospital
This is the point where the problems begin.
As the swelling goes away, the patient should be confident about her looks, show off her looks, have no problems with the surgery and have her body as perfect as she saw in the advertising.

This does not happen in reality.

No matter how interested or caring the doctor is, if the patient does not listen to the doctor or even remember what the doctor said due to the much and mixed information that she got from the different hospitals, the doctor and the patient would not be able to communicate with one another on the expected problems that arise after the surgery.

4. Whether it is minor or not, there is always a problem with plastic surgery. As long as a person has a greed to look better, the dissatisfaction rate cannot be 0%.

Generally the complications should not be looked at with the patient’s subjective eyes but with objective sense and see how dissatisfied the patient is.
There are many cases where the patient is not satisfied with the size of the breasts after the breast augmentation although the size of the implant had been decided together prior to the augmentation.
Then, now the priority is for the patient to spend much time with the doctor and share all the dissatisfying points that she has. The information related with this surgery and dissatisfaction can only be collected from the doctor.

The more complain the patient has, such conversation between the doctor and the patient would be difficult. The patient has much expectation before the surgery and if this expectation is not fulfilled, she would be very resistant to the hospital personnel and the doctor would defend his/herself by saying that “this problem could not be avoided”.
If there is no proper conversation, then there would be many conflicts. There are organizations for solving such conflicts, but these does not help that much.
The legal confrontation or conflicts between the hospital and the patient takes much tiring time. This also shows that our medical system does not have developed policy.

5. The biggest problem with the cosmetic surgery is that this is no warranty, ie. No insurance coverage for it if there are any problems.

A problem would lead to legal confrontations, and whether this is solved or not, there would be much money involved with it. In most cases, the patients already have spent much money on the surgery therefore they do not have money to spend elsewhere.
Such reasons make the patients react physically on the hospital and the doctor.

This could be an unnecessary comment, but I think that the government needs to step up in such situations.
Whatever the percentage is, whether it is 1% or 0.5% or 2%, the patient should be able to collect some amount of the related cost from the patient or the hospital. This collected money should be spent on the problems that may arise after the surgery. (This is just my own wish....)

All policies or laws are unnecessary if the doctor and the patient cannot come to an agreement. If things do not work out, then we should complain about the law.

But if you talk to the surgeon properly before a surgery and expressed all your feelings, then do you think it would be difficult to talk about the problems that arise after the surgery?

You should have realistic wants
You should open up and have a structural talk with the doctor
You need to have an objective understanding of the surgery
You need to continue to talk with the doctor after the surgery

I think these are more important than any other policies or regulations.

This thought came up to my mind when I read thousands of words on medical conflicts stated on Consumer Protection Board homepage.

This is all for today. Thank you.

Knowledge on plastic surgery

Today, I would like to think about our culture regarding plastic surgery and share about it.
I have not been to all the different countries around the world, but I have been to a few and met many foreigners. There is an interest on plastic surgery all over the world.

KIES-U Plastic surgery Korea

Then, which country is most interested in plastic surgery?
Korea could be that one, but I think that Brazil is one of the top countries.

Girls in Brazil are treated as adults at the age of 18. They can borrow money from financial institutes at that age. The money borrowed is used for breast and hip augmentation. This is really something.

I don’t think any other teenagers in other countries can do this. Brazil is famous for its advanced technology in plastic surgery and I think it is due to such interest from its people.

US is another country known for plastic surgery. People are interested about their looks. Then which are is popular? Breast augmentation is the most popular surgery followed by fat transplant. Midface lifting is also popular.




How about in Korea?
It starts right after College Scholastic Ability Test. The teenage girls visit the plastic surgeons with their moms. The most popular plastic surgery would be the double eyelid surgery. Some also prefer nose jobs.

There are a lot of differences in the plastic surgery items, timing, age, etc according to different countries. Plastic surgery in Korea has become generalized and so its culture is also important. I think that it is important for someone to talk about it as well.

First, let’s talk about the culture roots of westerners and easterners (referring to Korea). Westerners (Americans for example) are individualistic. There is a reason for everything. Other people are other people. Everything is centered around “me”. Although they act as a group, the core is the individual. This is American culture.
This is why the Americans respect different personalities, and do not pay too much attention to what others are thinking.
American ladies enjoy wearing bikinis in beaches no matter how their body is. Even the aged ladies enjoy the bikini.

How about the ladies in Korea?
The women do not wear bikinis unless they are confident about their bodies.
I have never seen an aged woman with a bikini in my 46 years of life in Korea.

Group is more important in our country. Group has a priority over an individual and this is why we tend to focus on how and what other people are thinking about. This is where the concept “nunchi” comes in. (Nunchi is a Korean word for senseless, no tact, clueless)
Westerners do not understand what “nunchi” refers to.
Some people say that young people these day do not have “nunchi” and they are individualistic. But, there is a little difference here.
If a young person think that he/she is more outstanding than others in a particular area, he/she will have no “nunchi” regarding that particular area. It’s the opposite if he/she is inferior to others.

Let’s say you bought a nice car. You would want to expose it as much as possible. You will put up a picture of it on the sns. Let’s say you bought a small sized car. You will not want to show it to others.

If you are pretty and have a good body, you would want to show off. But if you are a little fat or not pretty, then you might lose confidence. People today, still have that “nunchi”.

There was an announcer in KBS, who appeared in a program in another channel (not news). She gained a little weight. People criticized her by saying “doesn’t she have “nunchi”? Why is she on TV?”  This is something not right. Gaining weight is a personal problem, and not one that other people should point out.

Of course, priority in a group over an individual is not always the right thing. But, I think that people at our country should consider what the westerners are doing regarding plastic surgery. In Korea, it is easy to standardize what beauty is.



There is a web toon called “Portrait of Kangnam Beauty”. Someone drew a portrait that became really famous. If people do not understand that outer looks are “different”, then they will think ‘superior = pretty’, and ‘inferior = ugly’. If they want to have plastic surgery according to this, then we would have standardized form of beauty.

Is high nose pretty and low one not?
Are big eyes pretty and small ones not?
Is an angular face, an ugly one?

This is a perspective based on a group and this is derived from our culture. We cannot define beauty in such a way but people do.

There is a variety in beauty and there is a multi-aspect to it as well.

A person might think something is beautiful but others might not.
A person might think someone is ugly, but other might not.

We need to approach beauty be defining it through our personality and value. This is what I feel all the time when I talk to my patients.

This is all for today. Thank you for reading.

Propofol_ is it necessary? (IV sedation for Plastic Surgery)

There are many negative articles on the propofol these days. It has a nick name “milk injection”.

People who are addicted to propofol, hospital that black-markets the propofol, criminal activities that take place in plastic surgery clinics with the usage of propofol are some contents that are on the news. Today, I would like to share about the use of propofol that is necessary in the plastic surgery clinics.
 
What is IV sedation.....?????

I have heard that IV sedation is dangerous. Can I not do it? There are some patients who ask such question. Also there are those who ask me to put them to sleep completely so that they do not know what is going on. Let’s looks at different anesthesia methods that are used in the cosmetic surgeries.


First, local anesthesia
We do not inject the anesthesia for the whole body but for a particular part. For example if you are having an eye surgery, the anesthesia would be injected on the eyelid. This is widely used when we conduct scar / wound reduction, skin tumor removal, or such surgeries on small parts of the body.

Second, Spinal anesthesia 
This is widely used in the obstetrics. The anesthesia is injected in the spines paralyzing the lower body so that the pain cannot be felt. This is used for abdomen / thigh fat transplantation in the plastic surgery clinics.

Third, General anesthesia 
General anesthesia paralyzes central nerves therefore requires breathing tube during the surgery. Therefore, the anesthesia and intubated. One can use the ringer solution but the breathing tube is safer.

Fourth, IV(intravenous) sedation
We use the intravenous injection with sleeping drugs for anesthesia. The most representative substance used is the propofol. If there is a respiratory problem, there would be big trouble. There is no breathing tube used. therefore, one must be aware of the anesthesia usage during the surgery.



As you can see in the graph above, if you go from sleeping stage to no breathing stage, your life becomes dangerous. This is IV sedation. So if the surgery is not a major one, then is would be safe to perform the surgery during the light sleeping stage. If you think that the surgery would be too painful and you want to sleep completely then general anesthesia is recommended.
You can find many articles to well know celebrities who abuse the usage of propofol. Actually, today, one cannot discuss about the IV sedation without the propofol.

Characteristics of propofol

1. Quick and smooth
2. Long lasting effect
3. No displeasure when awake

One can easily know why propofol is sued a lot. It has a quick effect on the body, lasts long and once you are awake, you do not feel bad.

If you watch the movie, Hannibal, there is a scene where an injection is used to make a person unconscious but there is no problem with breathing. Of course, such substance does not exist today. It would take another few decades for such substance to be made. But one can say that propofol is one that is really close to this substance. Therefore it is used a lot.

There are disadvantages of propofol as well. 
1. The injection is painful
2. Too much dosage can stop breathing (Dangerous to life)
3. Anesthesia status is not stable

However good a medicine is, it can be good or bad according to the person who uses it. Drinking can kill if one drinks it too much. It can be good for the body if you drink appropriately. Propofol is similar to drinking.

There are people with misperception. Propofol is not always good for the patient. Some do not remember anything and some feel unpleasant after using it. There are those who feel good after drinking and those who do not feel good as well.

All the substances that human make act differently from one person to another. However, there is one majority opinion.

Propofol being used as a drug to feel pleasantly good is wrong. Whether you are addicted to nicotine or drug, a human being has an ability to control one self. It is dangerous to think that one can escape the reality with the help of a medication.

Propofol is perceived to be a devil’s medication but if you manage and control the
usage properly, it is something necessary and useful. Actually, all medication are like that.

Today, we looked at IV sedation and propofol.

Thank you very much.

The types and differences of breast implants II 

Plastic surgery Korea KIES-U

Which implant looks and feels the most natural? This is a frequently asked question. My answer is always the same. There aren’t many differences in the 5th generation cohesive gel implants.

If you put a smooth type and a texture type implants on top of the table and touch them, you would feel a lot of differences. Also if there is less substance in the implant, it would be feel softer and better.

Some consultants train the nurses in such aspect and say that the smooth type feels better.

	If there is less gel in the implant, it may cause a rippling effect

 But the result of the breast augmentation is different from what you think.

The Allergan type that is perceived to the hardest one becomes soft once put inside the body. Therefore, it is difficult to make out if the implant feels good or bad by touching it from the outside.

I cannot know that implant had been used on the patient unless I look at the patient’s chart.

Breast Surgery Korea KIES-U

The softness of the breast is not depended on the type of the implant that you use, but by the skin that covers the implant. Although you use jelly like implant, but you have a hard skin covering the implant, you would feel that the breast feels hard.

So it is wrong to say that you need to use the smooth type for better sense of touch.

The answer to the good feeling breast is not to choose a soft implant, but to conduct a smooth surgery so that there is no bleeding or no trauma on the body. This would lead lower possibility of stronger epidermis.

The sense of touch is not depended on the manufacture but how the doctor performs the surgery and how the patient’s body reacts to the surgery.

Problem of durability

Which implant has the best durability?

There is no answer to this question as of yet. One can estimate it but there is no statistics to prove it. We can compare the implant not collapsing easily and lasting longer to that of a bicycle tire.

If you are riding a cycle on a road with a lot of substance on it, and you have a high pressure tire on the cycle, the small sized substances bounce off easily having less possibility of the tire being punctured. In opposite, if you have a low pressure tire, it would step on the substances directly leading to a higher possibility of a puncture.
If the implant is filled up with silicone gel there wouldn’t be any folds leading to no friction therefore leading to no breakage. But if the implant is not filled up, there would be many folds leading to more friction and higher possibility of breakage.

Breast augmentation Korea KIES-U

Also the gel has strong agglutinability therefore if the implant maintains its shape there would be no folds whatsoever avoiding any damage. But if there is less agglutinability meaning that the implant cannot maintain its shape, many folds are made leading to damage on the implant.

The implant with the most agglutinability is Allergan’s water drop type implant. I cannot say for sure but I can estimate that it as a good durability. SiliMed from Brazil has high agglutinability but not as much as the Allergan’s. The other implants are much alike.

Sadly, all the round type implants that are imported to Korea do not have high agglutinability.


In all cases, the water drop type (ones that are imported to our country) have stronger durability than the round type implants. 

Which implant leads to better shaped breast?

This is the part that bothers me the most. All the water drop type implants imported to Korea have the same level of durability, sense of touch, and side effect incidence rate. The biggest problem would be which implants is the most appropriate one according to the body type.

KIES-U Plastic surgery Korea

There isn’t much to think about when considering the round type. They are all the same. Whatever the manufacturer is, the shape and the volume are all the same. But the water drop type is made 3 dimensionally therefore there are a lot of differences.

There are two types of patients who want breast augmentation that requires implants.

First are those who want to look good and thin.
Second are those who want to fix the sagging breasts after giving birth.

For both the groups, it is better to use long height implants.
The think patients usually have long torso.
Therefore, it is more appropriate to use implants that are thin and long.

Also sagging breasts have empty upper part therefore it is good to use oval type implant that fills up the upper part of the breast. If you look at the breast, you would know that the breast is not shaped in perfect round shape. It is closer to long oval shape.

Germany’s Polytech oval shaped implants are long shaped that are fitting to the Korean women. Brazil’s Silimed water drop type has a good shape but does not export oval water drop type to Korea. If all the products from Silimed are imported to our country, I think that there would be a good market response to all the products.

Breast surgery Korea KIES-U

Sebbin from France has strongly filled implant that is round and thick. So the patients who have thin breast and cannot use wide implant but want to increase the cup size can use this implant.

The cancer causing agent from PIP in France that was reported early last year is not related to Sebbin implants.

Allergan implants have best stability and durability but have wide width when concerning the profile. The patients in Korea have narrow upper body, so they need to use rather small volume implants.

Conclusion

In conclusion, there has been many implants in the market, but there isn’t one that is 100% fitting. Also, one cannot say one manufacturer product is better than the other therefore it is important to find an implant that is most appropriate to your body.

Also, whatever implant you select, the skill of the surgeon is the most important factor.

We looked at the type of implants imported to our country and their differences. Has the post helped? Thank you.
Have a nice day.

Teenagers need “cosmetic (plastic) surgery” education
KIES-U Plastic surgery Korea

If I recall correctly, I think that I received sex education in 9th grade.
My teacher played a video in the AV room at our school and the teacher explained on the difference between a man’s and woman’s body, how the hormone secretion takes place, secondary sex character, differences in the body, genitals. It wasn’t so bad talking to our teacher about those lower parts that we as boys used to giggle about. I think this education was rather meaningful.




I am aware that this sex education has become more advanced with growing interest and I am also aware that there are many programs related. The society knows that hiding this would only hurt it therefore, people are opening up more towards this education even at schools.

I think that these teenagers definitely need sex education

My reasoning is that the teenagers, especially those girls in middle school, are at an alarming stage regarding their perception on beauty, and plastic surgery. Also, this perception can have great influence on the rest of their lives.
 
 

1. Our children’s perception on cosmetic/plastic surgery

Middle schools talk about this area a lot and already are much aware of it so that their parents cannot even say a word about it. Some middle school girls come with their friends to talk about the plastic surgery and I have recognized that those who are 14 to 16 years old already talk much about plastic surgery with their friends.

This might be too early for them. They are at a stage where they cannot objectively talk about plastic surgery and that is why they easily say “I do not look good here so I need a plastic surgery on this part.”

But it is not right to conclude that “kids today have a lot of problems.” Our society such as the TV and other mass medias have made our kids think in such way. Our society is too much focused on the outer looks and this has been communicated without any means to the teenagers.
 
 
The perception of our children on cosmetic / plastic surgery starts as they go online looking at all the pretty looking male and female celebrities and comparing themselves with these celebrities.

All dramas or movies have an ending where a pretty main actress has an happy ending.

- I am not good looking
- Things get bad if you don’t look pretty
- So bad things happen to me

This is the result.
 
And so this conclusion naturally moves on to the next.

- I get look pretty if I get a plastic surgery
- I will be happy if I look pretty
- So, I must get a plastic surgery

The reason why our children’s perception is serious is,
They do not know about their attractive points and characteristics but also think about their negative points and are focused in trying to fix those negative points.

They need to those that their outer look is just one small part of what their identity is.

- I have certain positive points
- Those with positive points are loved by others
- Therefore, I can be loved by others

If our kids can think in such a way, they will have more rational perception on cosmetic surgery.

They will realize that the outer look is just a small part of “me”, and not everything.

If you have too much expectation on cosmetic/plastic surgery, you will rely on it even more. Such a teenager when grows up to be an adult, would have more dependence on the outer looks and also suffer from outer look complex.

2. The right perception of your looks 

The way, attitude of how you look and perceive yourself is very important. You need to have a balanced perception of your looks and should be able to judge the looks in such a way.

When you have this mature perception, you will be able to talk and think about cosmetic surgery.

I believe that each individual woman has her own appealing points.
But most women do not know what it is.

The more surprising fact is that the more beautiful a person is, she does not know what her appealing points are and what her weak points are.

Those who are not confident about their looks are not confident talking about it as well.
They just hope that they could look pretty, and do not know where the real problem is.

It is concerning that many women get an expensive plastic surgery by looking at falsely made advertisement on plastic surgery in such situation.

Cosmetic surgery only makes one of many problems that I have, better.

Therefore, one must know what my positives and negatives are by taking a step backward and observing oneself. Once you have this rational attitude, you will be “ready” to get a cosmetuc surgery.

I look so bad, I need to get everything fixed.
Why do you think that our kids think in this way?

There are three things in our society’s outer look centralism that influenced our children.

Parents criticizing the looks of the children since when they are small.
Things about the outer looks that their friends tease about such as “You, pig”.
Outer look centralism in the mass media such as TV or internet.



Just like any education, the right education needs to start at home.

"My baby, you are so cute and lovely "
This might be a start, but,

"Your eyes look so pretty, I used to like people with similar eyes ever since I was young."
"Your smile makes those who see you happy." If you say such detailed word repeatedly, your children will know that you mean it.

I think these expressions are more necessary during the maturing stage. Then your children would have more confidence about their looks and those appealing points.



"Then what can I tell my kids about plastic surgery?" This is a question that you might have.

It is difficult for the parents to be the main source information on plastic surgery to the middle school girls. It’s because the parents do not know about the plastic surgery well enough. The information that the kids get from the internet is very much comparable to what the parents have.

It is necessary that the mothers get on line and start studying about beauty surgery as well. This will help maintain subjects to talk about with the kids.

Sense of one’s identity needs to be formed,
And one should know her own appealing points,
Then, she needs to have self confidence,

in order to have an accurate, balanced, objective thinking about one’s outer looks. I think that the responsibility of the parents is the most important factor.

Today, I talked about why the teenagers need cosmetic surgery education. This is something that I felt strong about as I consulted many middle school girls these days. I hope that my thinking has been agreed by most of you, readers.

Thank you very much. Have a nice day.