How to get a good touch feel after breast augmentation

Many people think that one needs to use soft implant to get a good touch feel after the breast augmentation.

When I talk to patients, I get surprised that there are many patients who say “I want to implant with a good sense of touch.”



First, let’s talk about what is natural touch feeling

A good sense of touch is that the breast with the implant should feel as soft as the original breast.

An original breast of a person is made up of cells that come together to form subcutaneous fatty tissue, muscle tissue, etc, and makes that sense of touch when you touch the breast.

Then, what forms this exact sense of touch?
It is your own skin.




When your own skin fills up the volume of the breast, you will feel the best sense of touch.
But this is like a story from a SF movie.

In reality, you cannot generate skin on the body part that you want like that of a lizard. This is not possible as of now. It might be possible in a hundred years or so.

So we use fat transplantation but the only a certain amount of fat transplanted remain. Most fat are absorbed by the body, therefore there is not much volume effect on the breast.

This is why the doctors have tried numerous substances (including soybean oil) on the breast augmentation.




In the end, only the gel type silicone bag is commercially used today.
It is safe, and not related to cancer or any other illness
It is cheap, does not alter, and is strong. There is nothing like it today.

Also the silicone is closest to our body tissue but does the gel type silicone bag feel the best? It does not.

The liquid type silicone feels the best when used.
Liquid silicone feels softer than the human skin, therefore it was very welcomed when used at first. However, there was no solution when the liquid silicone caused inflammation or necrosis or any other side effects on the body.




The liquid put in through the injection disperses everywhere, so it was difficult to remove the liquid when there was a problem caused.

A close to disaster problems was caused leading to the disappearance of its medical usage.

The cohesive gel that we use today feels much like a rock compared to the liquid silicone.

But there are law restrictions that limit our usage to the cohesive gels and therefore we do not have choices today. Liquid silicone should not be used and the cohesive gel has been chosen for safety issues.

What are the factors that influence the sense of touch in the cohesive gel implants?

1, The thinner the exterior skin is
2, The less amount of gel that the implant has
3, The less dense the gel is
makes the product soft.

If the thinner exterior skin, less amount of gel and less density lead to better sense of touch, why is such implant not manufactured and used?
If you think about it a little, you will know the answer. This definitely has some cons in usage.




1. Thin exterior skin leads to higher possibility of implant damage

This is obvious.
If the exterior skin is thin, it can be damaged as you put it into the body (especially if the inlet is small).

An implant with a thin skin can get scratched when putting into the body, and also the bag can be damaged. This will lead to the leakage of inner substance.

2. An implant is less amount of gel will collapse. It will not have good durability.

Let’s think about a bicycle tire. If the tire is completely filled with air, the tire would not bust. If it is not filled, there might be a lot of substance stuck on the tire fold leading to a damage.



The same applies to the implant as well. If the implant is mot filled properly, the durability gets worse. The implant will be folded inside the body, and the folded part would lead to abrasion and higher possibility of damage. There is a high possibility of rippling as well.

But completely filled implant would not have much fold and the surface would extend fully leading to stronger durability and less possibility of rippling.

3. Less density of gel leads to damage in shape

A human being walks around, and there is gravity pulling us down.
A silicone gel bag type implant needs to stay at a standing position at all times except when we are sleeping. The implant needs to maintain its water drop shape but it if doesn’t, it will not be able to feel up to volume of the upper breast and the volume will be concentrated at the bottom.



This is something that the young patients in their 20~30’s, before pregnancy, do not understand. Mid aged patients understand this concept easily. Losing elasticity on the skin and breast tissue makes the breasts sag. The implants need to maintain the shape and keep the volume on the upper part of the breast in order to make the breasts look young.


But the more important thing is that the commercially used textured and smooth type implants cannot be felt easily (especially when put in under the pectoralis muscle).
All these implants feel alike (because they all are cohesive gel types, not liquid silicone)




I, myself, cannot know if the patient has smooth, textured, or anatomical implant just by touching unless I see the patient’s chart although I work with breast augmentation patients all day and every day.

Then, how can the patients know the difference?
In conclusion, if the implant is located under the pectoralis muscle, one cannot know any difference in touch feel.

The more important facts are that;

First, there should not be any capsular contracture.
Second, when the implant is put in the body, it should co-exist and extent appropriately inside the body to maintain a good sense of touch.
Third, one should not use an implant that is too big.
And, soft feeling augmented breast would lead to sagging of the breast that would cause more dissatisfaction of the patient. Soft implant is not good if you look at it a long term.

Today’s post was on the sense of touch of implant.

Thank you for reading, have a great day.

Size of implants

How should I choose the size of the implants? This is one question that the patients take long time considering when they talk to us.

The fact that saddens me is that it is really difficult to have the patients get away from the thought that a certain cc leads to a certain cup size.

Breast augmentation is to improve the upper body look.
The implant used in the breast augmentation needs to fit the upper body numerically. It is like fitting a dress to the body.

 

Luckily there are many types of implants that fit many different bodies.
The size in "cc" of the volume, is automatically decided as one chooses the implant spec according to the upper body shape.

Then what is an implant spec?



There are 3 types of spec in an implant.

Width
Height
Profile

When you decide on the three specs above, your decision for the implant is made. The volume (cc) is automatically decided after this.

Breast augmentation Korea KIES-U

If you have broad shoulders and long breast diameter, then you would need a wide implant.

If your breasts are small, then you would need implant that is high profile rather than something that is wide.

If you have an upper body that is long or have breasts that are positioned rather low, then you would need long shaped implants.

What if you have breasts that are different in sizes? For example, let’s say that your left nipple sticks out but your right nipple is short. Then you would need to use thick implant for the right breast and thin one for the left breast.

Breast augmentation Korea KIES-U

If your right nipple is faced upwards, and left nipple is aces downwards, you would need to use short height implant on the right, and long height implant on the left.

How about the sagging and less elastic breasts after giving birth or breast feeding? You would need long (height) implants. What if the sagginess of both breasts is different? The breast that sags more would need an implant that has longer height in order to fill up the empty space.

Breast augmentation Korea KIES-U

The fact that surprises me the most whenever I talk to my patients is that my patients do not know what type of problems they have regarding the breasts and they also do not know the characteristics of their breasts.

First step in deciding the type of the implant is to find one that fits the specifics of the patient’s body. Size is decided automatically. You would know that spec and size are different by referring to the image below.

Breast augmentation Korea KIES-U

If the implant is wide and long but has a low profile, the volume can be small. If the width is narrow but is long in height and has a high profile, the volume can be big. There also can be opposite cases.

Such three dimensional aspects of spec need to be combined together in order to find an implant that is most fitting for the upper body. This is the most important point in planning the breast augmentation.

It is important to find an implant with an appropriate spec that fits well with your upper body. The size, volume (cc), is decided after this fitting so you do not need to worry about or remember. (There are patients who do not remember what volume (cc) implant they have used one year after the breast augmentation)

It would be awkward to ask you tailor if you could have a 55 size dress, after the tailor takes measurements of your arm, waist, legs, hip, shoulders and chest.
It is wrong to ask for a certain size volume but right to ask the doctor to choose an implant that is most fitting for you.

Have a great day, thank you very much.

Polytech’s 2 Gel cohesive gel implant – Natural movement that feels the same as the original breasts

Today, I would like to introduce 2 Gel cohesive implant manufactured by Polytech in Germany but is not widely known here in Korea.

This implant is called Diagon gel implant but I would like to keep things simple and call it 2 gel cohesive gel.

The difference between the 2 gel and the conventional cohesive gel is that this product is formed in double layer of soft silicone gel and strong silicone gel.



As you can see in the image above, the back side of the implant is filled with the soft gel and the front side is filled with the hard gel. So we call this implant, 2 gel or Diagon gel sice there are 2 types of gel stuck together.
This 2 gel is Polytech’s independent and unique product.

The reasons why Polytech produced this implant are:
- To make the implant stick more naturally providing better support (compared to conventional one)

- To show natural movement such as the original breasts when the person makes much movement around the breast




As you can see in the image above, the 2 Gel implant has similar outer line formation as the conventional cohesive gel implants (round/water drop type). The only difference is the inside.

The soft gel at the back touches the rib bone softly to form molding. This is why the patient feels that the augmented breast feels much like the original one.

The hard gel at the front makes a projection that helps the nipple to find its position properly and also pushes the breast tissue up (Push up style).

Also, the strong gel helps to find natural movement, reacts slowly, and maintains shape stability (even for those patients who are really thin).



The patient with this 2 Gel implant will feel great sense of ‘wear ability’ and feel that the augmented breasts move naturally.


I am very amazed at Polytech’s developers who put much details into consideration when making this Diagon gel implants.



There are 4 series of products in 2 gel implants. These are oval shape, water drop, round textured, and microthane (polyurethane) coating. These are the core breast implant products that Polytech has.

The surface of these products helps reduce the incidence rate of the capsular contracture and is a technology that is well known of these products.

Diagon gel (2 Gel) implant is certified here in Korea but is not imported easily, so one needs to wait a long time after the order. It takes about 2 to 3 months. Also, the price of these implants are relatively high therefore the augmentation costs about USD 8,000. In Korea, it costs about 9 million won including VAT. This is a disadvantage. But if you are a person who wants more unique and natural differentiation, then this implant is the appropriate one for you.

This is all for today. Have a great day and thank you.

Q. I have heard that there are many who used Polytech implants for breast augmentation? Is Polytech trustworthy? How are the products?

This is my response. Polytech is a German company with 25 years of history. The HQ is in Dieburg, a small city which is not too far away from Frankfurt. A small lab and plant in this city provide breast implant around the world.




Polytech is not a large company but a mid sized one. There are mid sized companies in US such as Natrelle and Mentor. Natrelle has been acquired by Botox manufacturing company, Allergan, and Mentor has been acquired by multinational company, Johnson and Johnson’s.
Natrelle and Mentor are famous for making cohesive gel implants but this is caused due to the strong marketing power that they have. They have much capital, product and sell millions of implants around the world, so many people are aware of the products.
Polytech is comparably a small company but its products are certified by many doctors in Europe.




Mentor and Allergan, both received certification by FDA in US for their cohesive gel products, however, Polytech has not. Surprisingly, the very first water drop type implant (anatomically shaped cohesive gel) certified was Silimed from Brazil. Mentor and Allergan received their certification many days after.

No matter how much experienced a doctor is, he/she has not announced any paper regarding which company’s product is a good selection of implant that does not have side effects.

FDA certification is more about political, administrative and capital power game rather than the quality of the implant itself.

So the marketing efforts that are put into the sales of the implants are misleading. One can find the worst cases in US. The promotion war of the breast implants is very tense however, it is more important to have the doctors use the implants and compare the capsular contracture incidence rate.




Which company, Polytech, Mentor, Silimed, or Allergan, makes the best products? I have used round/water drop type implants from these companies, but I do not have the answer as to which is the best.
This is similar to asking which car, BMW, Benz, or Audi, is the safest car?
This answer would depend on the person who drives the car and knows the specifics.

I have observed that Polytech water drop type implant does not have strong sense of form stability, and gel intensiveness compared to Allergan and Silimed. But it has high level of fullness.





So it is rather easy to put the implant through a small inlet. Also this leads to less damage on the scar, in the case of water drop type implants. Allergan is the toughest one to do so because it is rather hard.

But Allergan’s stability is really good. Polytech has low stability so it is disadvantageous when used to fill up the volume in the upper part of the breast. However, the good level of fullness and cohesiveness helps the durability of the exterior and although the implant collapses, the gel does not leak easily. The durability itself is good.

Polytech implants have vertical line at a 6 o’clock direction that can be seen through the ultra sound test. So, one can easily find out if the implant has been turned around after the operation by the ultra sound test. This is one big advantage.

The details would go on and on if I keep on comparing the differences of all the implants so I will end it here for today.



Was this helpful? Thank you, and have a great day.

A brief history of breast augmentation Implants

Plastic surgery that includes breast augmentation is a medical science. There are many people who are curious about medical science, however, this field of study is very professional therefore, if someone who is not a professional, delivers undetailed information, that information may be wrong.

I have written a lot of contents in my blog and I have a lot of readers, however, I feel that those patients that visit me at the clinic get wrong information online.

Poly-dimethyl-siloxane (PDMS)

Media is a source that provides wrong information to people. Non-specialists such as reporters and PDs from newspaper, TV, internet gather superficial information, make an attractive headline and report it. This kind of scares me.

Such articles with wrong information existed long before the introduction of the internet, but it still occurs frequently.

If you know the history of breast augmentation, implant, water drop type augmentation and its implant, you would be able to understanding the overall procedure better.

There are few reasons on why I would like to write contents on the history of the implants today,

First, breast augmentation is a once in a life time activity therefore, the patient needs to know what is being put inside one’s body and plan on the surgery with the correct knowledge.

Second, implant and the surgery method should be decided under the academically and logical reasoning recommendation from the doctor, and not just by getting internet knowledge.

In one sentence, the history of breast implant was centered on the shape and marketability, however, the focus changed to safety after the recommendation from US FDA.

We will skip the details of the early ages and focus on the modern age where the silicone gel breast implant was introduced in 1963.

At the time, many surgeons used smooth type silicone gel implant and put it above the pectoralis muscle with inflammatory line incision. The incidence rate of capsular contracture was very high at the time at about 10 ~ 15%. However, the patients thought the breast augmentation was worth doing with such incidence rate.




The substance insider the silicone implant continually changed to provide better feel and natural shape by making the implant with smooth exterior until the mid-70’s.

If the patient needed reconstruction due to the implant collapse, the leaked substance would be gathered around the space near the capsula. There weren’t much data on what would happen to the body if the substance was absorbed, therefore, there were a lot of social issue regarding the side effect of silicone liquid in US.

Since then, the manufacturers focused on making not liquid but something sticky. In the 80’s, Mentor and McGhan competed in the implant market with the focus in avoiding any damage to the implant making the exterior thicker.

If you see an advertising statement on the internet that reads “new cohesive gel implant has a good feel”, this is false. Cohesive silicone gel was produced 20 years ago by a US company, McGhan, and this does not have a better feel than the liquid silicone charged implant which was used in the 1960’s.
Also, the correct name for the cohesive gel is ‘Silicone gel changed artificial breast implant’.

There were many implants introduced between the 1970’s and 80’s. There were implants with glue at the bottom so when the implant goes into the breast; the position gets fixed below the pectoralis major muscle. This was made under the concern that as a person ages, the breast might sag down with the implant but in reality, the original breast sagged but the implant did not making the shape look weird. Nobody used this implant with glue anymore.

There was an implant called double lumen with silicone gel on the inside and saline solution charged on the outside.

Silicone gel implants with polyurethane exterior was introduced during the 80’s. Since then, the incidence rated of capsular contracture decreased dramatically. Polyurethane exterior on the implant sticks completely with the skin. However, there were news that the polyurethane when exposed leads to high possibility of cancer, therefore, the sale distribution stopped in US. (It is still used in Europe)

Textured implant started on the basis of polyurethane exterior. But this textured implant does not stick completely to the surrounding skin and its substance is completely different from polyurethane.

PVP (Poly vinyl pyrrolidone) was made in the 90’s. There was a problem with it getting bigger once it gets in the body, so the doctors and the patients could not use the product.

Anyway, there were such variety of products in US and Europe, and in 1992, there was a big happening that influenced the manufacturers, hospitals, doctors, and even the surgery procedure.

In 1991, US FDA gathered PMA (Production and Marketing administration) to check and gather the information regarding the safety of the implants. At the time, the examining department in FDA temporarily seized all sales of silicone gel implants in US.
This examining department was headed not by plastic surgery specialist but by pediatrician. There were no medical record that supported this seize. There was no evidence that this silicone gel implant when absorbed by the body caused any harmful effect.

The moratorium went on for 14 years until 2006 and in that time, the doctors and the manufacturers all gathered data related to surgery, results, side effects, reconstruction rate, in order to submit to the FDA.

When McGhan made water drop type cohesive gel implant in 1991, its sales was stopped in US right away. The patients could only use the saline solution bag type implants so the purchasing power of the patients were hurt with having not much choice.

Anyway, after the introduction of the moratorium, many doctors in US gathered millions of data and published a book called ‘Safety of silicone gel implants’ in 1999. The conclusion was that the silicone gel inside the body did not cause any type of physical harm or illness.

This showed that the usage ban was under the social pressure and not by any medical reasoning.

US has a reputation of being very strict on the implant that is used inside the body. There are also many lawyers who earn much money from medical lawsuits. Our country does not allow what US FDA does not, and allows what US FDA does. However, in US the doctors, under their judgement, can use any type of implants for reconstruction and ribcage problem; however the Korean government restricts the import of the implants. Korean patients have very small variety of products to choose from. Our neighboring country, Japan, can select implants as those in US do, and it has 7 manufacturers that produce the implants.




This is a simple summary on the history of the implants.

Today, there are patients who require:
-       Please use the new cohesive gel, the one with a good feel
-       I want the textured 275, the one that does not cause the capsular contracture

The implant may be the cause of the side effects, but the side effects are caused due to the epidemiologic relationship between the human body and the implant. The core problem is how well the implant stays inside the body.

If the implant has some type of aggressive effect on the body, this leads to capsular contracture, and if there is no proper physiological and safe desquamation, then this leads to infection and inflammation.

If the body cannot take the large sized implant, there would be problems such as implant collapse, leakage, rippling, and unnatural feel.

Before 1992, the core issue with the implant was whether it collapses easily or leaks easily, and if the leaked substance harms the body. But this is all old news now. Today, the implants do not collapse easily. Also there are evidences that the silicone gel is not related to any type of physical illness and breast cancer. (This was proven 13 years ago)
The PIP news from France is a real fraud. This company’s sales activity was seized two years ago however they sold their products illegally and the news was just shared.

Such product was never imported to our country and it was the first time that I have heard of this. The news did not have any relation with us but there was a big fuss about it.


- Mentor breast implant, US
- Allergan breast implant, US
- Polytech breast implant, Germany
- Silimed breast implant, Brasil
- Sebbin breast implant, France

These are the products that can be used in our country. These implants have been proven that they do not cause harm to the body, but the most important thing is to find a clinic that has a doctor who can select an appropriate implant for the patient and give a proper explanation on the expected or not expected side effects and illness that may be caused.


 This is all for today. Thank you very much.

Korean made cohesive gel implant, Bellagel, and Motiva from Costa Rica 

Today I would like to introduce new implants that might be certified and distributed in our country this year.
One is made in Korea, Bellagel, and the other is from a company with HQ in Costa Rica called Motiva.





Currently there are 5 implants that are distributed and sold at our country.
Mentor from US was not a large company but it was acquired by a multinational company, Johnson and Johnson leading to a wide international distribution of its goods.






Allergan also from US was called Mcgan before and named its product Natrelle..
Mcgan implants also have long history as Mentor implants do. It produced silicone products and was acquired by many other companies in the past. Recently, it was acquired by Allergan that produces Botox. Currently it does not use the name Mcgan but uses the name Natrelle from Allergan.

Silimed’s Mentor was started in Brazil and is a top 3 company globally after Mentor and Allergan. In order to expand its presence in US, it moved the HQ from Brazil to US. Since, it has used the name, Sientra, simultaneously.

In 2012, Mentor received FDA certification on anatomical silicone gel implants before Allergan could leading to an upset over various US companies.





These are multinational companies. The rest are rather small sized.
There are various silicone gel companies in France such as, EuroSilicone, Arion, Sebbin, etc. Sebbin products are imported to Korea.




Polytech from Germany is also imported to Korea. Polytech is famous for its polyurethane coated skin (capsular contracture free) but this is not certified in Korea therefore only the silicone gel type implants are imported.





All these 5 implants are high quality ones but have their advantages and disadvantages. It is not true that a particular brand might provide continuous good result but another might not.

Getting a good result from surgery is like pressing on one side of the balloon that leads to bulking of the other side. If you focus on just one side of a problem, another side might have a new one.

I do not prefer a particular brand over another. I select and match an implant according to the body shape, and chest of the patient.



When the patients ask “which brand is good?”, I always give the same answer that one should choose the implant according to the condition of the breasts.

Local implant is produced by Hans Biomed and the developing time was about 12 years. Hans Bio is in KOSDAQ and is financially stable.

Bellagel is not in the market yet, but has been exported to Latin America and other countries for the past 2~3 years.

I have high expectation for Bellagel in that since the HQ and the manufacturing plant are in Korea, the company would be able to communicate a lot with the doctors that might help with the development of the product.




Also all of the products imported to our country have been from the western countries therefore it was not perfectly fitting to Koreans or other Asians. Now, more fitting implants can be produced on the basis of data of Korean patient bodies.
There would not be other problems such as A/S or stock due to different demand in size.

However, one concern is that the implant is put into the body for the lifetime therefore a doctor needs to have long enough experience with the product to recommend and use it. But, nobody has any experience with Bellagel.
The history of the product is rather short, therefore, require more time to be applied on the patients.




Motiva from Costa Rica is under the veil. We do not have any information on when the product was developed, which doctors have used it, and what the advantages or disadvantages are. I am not sure such a product needs to be certified at our country.
I think that some clinics would promote this product by stating that it has an indicator on the product therefore one can know right away if there is something wrong with the product.

But as stated earlier, Motiva is an implant that needs to be in the body for a lifetime, therefore, it requires much time and experience to know the advantages and disadvantages of the product.

It takes more than a day or two for the doctors to try different methods, apply the implant to a patient, gather structure data, to find out the advantages and improvement points.

If you say that this is a product from Costa Rica, that you have not used it in the past but recommend it to the patient, do you think that the patient would like to try it?
I would not. It would be difficult for me to recommend such a product.




Today we posted on cohesive gel implant Bellagel from Korea dna Motiva from Costa Rica. Thank you for reading.
Have a great day.

Do teardrop(anatomical) type implant rotate (turn upside-down)? 

I would like to quote findings of Prof. Heden from Karolinska University in Stockholm, Sweden.

"From 1995 to 2009 we implanted close to 12,000 (minimum of 6,000 patients) AHCSI implants (teardrop type implants)........ Infections were caused in 1.7%, seroma in 0.6% of the cases. Infections are found mainly in the combined mastopexy augmentations.

Rotations have been seen in the teardrop type implant at 0.42% but have been an uncommon complication."

Scott L. spear, Surgery of the Breast. principles and Art. 3rd ed. 2011. pp.1344




Prof. Heden is one of the most well-known experts in teardrop type implants. He perceives a technique in making accurate desquamating location for teardrop type implant to be very important. This means that if the “teardrop type implant pocket” is made in the correct position, there is no possibility of rotation.

Let’s refer to Prof. Elizabeth Hall Findlay as well.
Prof. Findlay is another expert in breast augmentation who has been in the field all her life time. Prof. Findlay found double capsule and late seroma, and studied them.

Breast augmentation Korea

When strong texture implant gets physical exterior trauma, late seroma is formed after a year of the breast augmentation. In this case, the breast would swell up severely and after an emergency surgery that involved removing the seroma, one found that there was a double capsule at the point where there was a water buildup.

Much seroma would stop the implant sticking on the surrounding tissue. Therefore, the teardrop type has higher possibility of rotation.
But, late seroma is not common. Infection, hematoma, trauma, or breast cancer would lead to such a problem.


If there is much space, then the implant would rotate. If the pocket fits the implant well, then the implant cannot change its shape or position. But, round type would still rotate.

Breast augmentation Korea

If the implant sticks properly onto the surrounding skin, it would not rotate easily. All implants are textured so that they do not move about. If there isn’t good texturing, or the implant is from some bad company, or if there is much blood around the implant, then the implant may rotate.

What is the problem in moving about frequently?
We looked at Prof. Findlay’s findings above that late seroma is caused when there is a trauma on the aggressively textured implant. This can cause the rotation or the movement but this is really uncommon.

If the breast with an implant gets a lot of trauma or physical irritation, the implant loses its stickiness therefore causing seroma or hematoma that leads to the rotation or the movement.

Breast augmentation Korea

There are some cases abroad where the husband touched the wife’s breasts too aggressively that has led to seroma formation and reconstruction. The doctor found that there was a rotation in such case.

But other than this, if the woman does not do any UFC like activity, or if she is not a stunt woman, there shouldn’t be any trauma that causes such problem.

Although there is much movement of the pectoral muscle, if the implant pocket is made properly and if the stickiness is appropriate, there shouldn’t be any problems of rotating or moving about of the implants.

Once the silicone implant gets inside the body, a strong and tense barricade is formed around the silicone exterior. This is due to the immune reaction of the body, therefore, one cannot avoid it. This barricade is the epithelium. The epithelium surrounds the implant in 2 to 3 weeks. This epithelium that surrounds the implant is very strong and tough. Therefore, it is meaningless to massage the breast after this epithelium is formed in 2 to 3 weeks of the breast augmentation. Massaging would not avoid the epithelium.
The width of the epithelium would influence how much pocket space is formed for the implant and the textured surface of the implant sticks to this epithelium. Therefore, one should not conduct any rigorous activity but restrain body movement for 2 to 3 weeks after the breast augmentation. Rigorous activity can obstruct the stickiness causing possibility of the implant rotation.

Breast augmentation Korea

There are many patients who are concerned about the rotation of the teardrop type implants before the breast augmentation.
But, if everything goes, well, the rotation would not happen.

First, the doctor’s technique in desquamating the pocket that fits the implant perfectly is most important.
 Pocket that matches the implant needs to be formed to order to avoid rotation or the movement of the implant.

Second, one must avoid any repetitive trauma on the augmented breasts. This is not any trauma but one that may separate the implant and the skin tissue..

Third, one must restrict body movement / activity 2~3 weeks of recovery. Basic normal activities and stretching are fine, however, one should avoid any activity that requires a lot of strength so that the implant positions and sticks properly.

Today, we looked at the cause and solution to how one can avoid implant rotation. I hope that the contents have helped you.

Have a great day.

Choosing your implant for water drop breast augmentation 

It is not easy to make a normal person who is not professionally knowledgeable in medical field to understand what a doctor wants to communicate. I get quite surprised that my patients do not understand me.

Today I look like to share something that the patients have most difficulty understanding, making it easier for you to understand. It is about selecting a water drop implant.

Water drop implant is 3 dimensional, so you can select the implant according to 3 stages.


There are those who are quick to ask “are you not going to decide on the volume (cc)?” If you think about the three stated above, you will be able to know the volume instantly.

You will be able to know what a diameter / height / thickness are with the help of the image below.





You only need 2 parameters for the round type implant because the diameter and the height is always the same.

But you need to decide on the diameter, height, and thickness for the water drop type.

First, the diameter refers to the width of the implant. The diameter of the implant should be selected first. It cannot exceed the diameter of the breast. If the diameter of the breast is 10.5cm, the diameter of the implant should be equal or less than 10.5cm. From the 3 parameters of diameter / height / thickness, the diameter should be chosen first.

Second, the height of the implant is related to the type of the implant. The one with short height would be the ‘short type’, mid height would be ‘Normal type’, and the long length would be ‘tall type’. So one would measure the upper body and if it seems long, you would select the tall type, or if it seems small, you would select the short type. The normal type is the most common one. You will be able to understand this more easily with the help of the images below.







Third, we refer to the thickness as ‘profile’. Low profile refer to the one that is really thin, Moderate profile for normal sized one, and the high profile for something that is thick. The volume of the implant depends on the thickness.

So, if you want a large sized implant with increased cup size, you would select the high profile.

If you aren’t too greedy about the up size and want something that is more natural, you can select the moderate profile. Low profile is used if you have asymmetric breasts or sagging ones.

But, there are some who are not satisfied with the new volume although they use the high profile. So there are some manufacturers who make Extra high profile, i.e. very thick implants. Extra high profile cannot be used without much thinking. It is used for those who have thick skin tissue and want large volume.



The sizing of the water drop type implant is selected according to the following order.

1. Measure the diameter of the breast then select on the diameter of the implant

2. Measure the distance from the collarbone to the nipple and the distance between one nipple to another. Decide if the upper body shape is wide or long in height. Then decide on the height of the implant

3. Ask the wanted cup size of the patient and then decide on the implant profile

This is how we select which implant to use.

Let’s try going through the three phases for an example.

Before Breast augmentation Surgery

Let’s analyze this patient.

First, the diameter of the breast is 11cm. We can use any implant with diameter of 11cm or less.

Second, the distance from the collarbone to the nipple is 17cm. if we draw a triangle, we can see a tall isosceles triangle. This means that we can use a round base type or the tall type implant.

Third, the patient does not want to increase the cup size much. The patient did not like to have big breasts originally, but as she gave birth and breast fed her child, her breasts sagged. Therefore she wanted the upper breasts to look bigger. In such case, the moderate profile would be appropriate.

This is it. We can select an implant that is 11cm in diameter, tall type and a moderate profile.

Polytech 260cc implant has a height of 12.2cm and a thickness of 3.7cm.
Natrelle 235cc implant has a height of 11.5cm and a thickness of 4cm.
SiliMed 275cc implant has a height of 12cm and a thickness of 4.2cm.
Servin 285cc implant has a height of 11.cm and a thickness of 4.6cm.

You can select one from any of the four above. But a patient should put each of the implant inside her clothes to see the volume and check on the size.
So it is better to see the actual size in person and then decide on the volume and the size. This patient liked the 260cc after the size test.

The implant has been selected and the result of the breast augmentation is as below.

Before and after Breast augmentation Korea KIES-U

The patient has a rather long chest but this is due to the sagging breast after giving birth. You can see that the upper part of the breasts have been filled up. The patient wanted more of a natural look so she was very satisfied with the result.
In summary, you need to measure the width of the breast and decide on whether to use the oval type or the round type and finally select the thickness profile according to the volume that you want.

In reality, the selection is not as simple because there are many patients with asymmetric breasts, and the tightness of the skin was to be known. There are other variables as well.

Therefore, the experience of the doctor is very important as well.

This is all for today, have a great weekend. Thank you.

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.