Plastic surgery Korea | The dark side of breast surgery

7:59 PM

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.

 There was a pain from within, it felt like something was pulling real hard 

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.

Ms. Choi, Suffering from capsular contracture
I think it took less than a week after the surgery that the breasts became hard.

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.

2016 Reports of the side-effects of medical equipments 
Artificial breasts (silicone cover and gel) 61.1% 
Everyday soft contact lens
Equipment to build up cells (Filler) 3.7%
Tooth attachment 3.0% / Others 28.3%

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.

Ms. Kim’s state at the time 

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.

The refrigerator where the fat was stored 

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.

They say that the storage method was the problem
That could be the problem but.. 

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.

We use certified filler that has been proven to be not dangerous on the body, not causing any reaction or inflammation.
Hospital promoting the safety of the filler. 

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.

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