Spreading breast when lying down (natural breast) 

Do the breasts spread apart after textured correction when you lie down? (Natural breasts / unnatural breasts)

 

The question above is about the natural look after the breast augmentation surgery
Natural breasts tend to spread apart when lying down, but the breasts with implants do not spread naturally but stay stiff- therefore, there are many who are concerned about this unnatural effect.

To share the conclusion first, the textured implant closely sticks to the breast tissue and moves together therefore, it does not spread too much outwards but it looks quite natural.

In order to give you an explanation on this, we need to share the academic trend of breast augmentation surgery.
Before, the pocket for the implant was made so that there is much space so that the implant moves about freely. So a lot of the surgeons used smooth type implant so that the implant could move in all four directions.




That is why there were advertisements that the breasts look natural because the implants spread out. There were many massages in order to maintain this space.
Many thought that such correction would lead to smooth breasts, that move about easily, and also feels good because there is much space, and also minimized the risk of having epithelium.

But, the implants moving about freely means that, if you touch the breasts then you would know that there is something artificial inside.
The implants spreading outwards when lying down are different from how the tissue inside your body spreads out. Therefore, if you only focus on having breasts that spread outwards resulting in excess spread, there is no method to fix such problem.

 


Also large pockets led to bleeding, pain, and various other side-effects. Also massaging has become one of the inconveniences caused due to the correction.

The trend today is to have just enough pocket size fitting for the implant. This is to prevent any side effects that may be caused by limiting the size of the pocket. (The term “24 hour recovery system” came out from this aspect)

Textured breast implant is most appropriate for minimized pocket size. Also, you would not need any massaging after this
 



There are some internet advertisements that say that you do not need massaging because of the textured breast implant. This may lead to some misunderstanding.
Minimized pocket space for the correction leads to avoiding the massages. It is not because of the textured implant.
Also the textured implant sticks to the skin and moves together with the skin so one must avoid massaging. (Massaging is to separate the implant from the skin).

Therefore, minimized pocket size, textured breast implant and no massage have become a trend. In such case, you would have breasts that spread out as much as those on the picture below.




Also, the advantage is that if you touch the breast, the implant moves along with the breast so you will not be able to feel that you have the implant.

The extent to how much your breasts spread with textured would be definitely less that the smooth implants.

But, if you are concerned about
How long will the natural shape last?
Will the volume of the breast remain the same although I get old?
Is there no problem of defect?

Then, you would not have to worry as much. These are the contents that are more important. The cohesive gel product of Anatomic shaped textured implant is the one product most fitting.

Thank you for reading.

Power ptosis correction - Korea

Many patients ask how KIES-U Korea’s power ptosis correction is. The explanation can be provided with images below.

A normal person’s eye looks as below.






[Location and the structure of the muscle that opens the eye]




Power ptosis(eyelid) correction is an advancement on the muscle (2 layers) that opens the eyelid (Levator palpebrae superiosis muscle on the upper side and Muller muscle on the lower side)

[Power ptosis correction: Pulls and fixes the 2 layer muscle that opens the eye] 

Power Ptosis(eyelid) correction

As you can see in the image, the muscle that pulls up the eyelid moves towards the inner part of the eye making it shorter. Although the strength required to open the eye is stable, the eyelid moves more upwards if you open the eye. The side vies of this activity can be seen in the image below.

KIES-U Korea - Power Ptosis correction

Usually the ptosis correction only involves changing the levator palpebrae superioris muscle but there would be no changes before and after the correction and you may need to have a second correction.

The most effective way would be to pull the Muller muscle and levator palpebrae superioris muscle together and fixing the position so that the eye becomes bigger.

Kies-U’s power ptosis correction is fixing the location of the double layered muscle so that the eye would remain bigger for a longer period.

Thank you for reading.

Breast augmentation massage 

Massaging is to maintain the large space around the breast implant

Many surgeons believed that in order to reduce the capsular contracture, the pocket needs to be larger than the necessary size so that the massaging would be able to maintain the large space of the pocket in order to move the breast implant.

This would prevent the breast implant being adhesive, minimizing the risk of epithelium tightening.
Also, when the patients lies down, the surgeon think that it is good if the breast implant spreads outwards so that it looks natural on the person and the patient would like this.

However, having this large space leads to much problems.
1) The range of the surgery becomes larger causing that much more wounds, pain, inconvenience, and other complications while recovering.
2) At times, when a patient lies down, the implant spreads more that it is supposed to.
3) It looks better if the two breasts come together closely when standing up, but large space might lead to wider separation of the breasts.
4) Also there is no clinical data that massage leads to less capsular contracture. (It means that massaging has no effect)
5) The most important fact is that one cannot control the implant to be at the most appropriate position. The large space makes it difficult for the implant to be located properly leading to deformation of the breasts.





In other words, if the pocket space is large, then the correction must be done on the larger space than anticipated, leading to higher possibility of side effects, and lower accuracy in estimation of where the implant would be located after the correction.

It is not always the case that the breast implant has to be placed in a large pocket in order to look natural and feel good. Although the space is not large enough, the implant can feel more natural just by the movement in the area where epithelium and the tissue meet.

The large space does not minimize capsular contracture and does not lead to greater satisfaction of the patients.

Clinical results from the implant positioned exactly in the appropriate space (diameter)
 

Type of Implant	Duration	Possibility of Capsular Contracture
Natrelle textured water-drop type saline solution bag implant	7 years	0.7%
Natrelle textured water-drop type silicone gel implant	3 years	0%
Round smooth saline solution bag implant	5 years	Similar to large dissection

There is no difference in the possibility of capsular contracture between small pocket size that leads to less bleeding, and more accurate correction compared to that of large space.

Also, the small space leads to accurate firm positioning of the implant avoiding any movement of the implant and reducing the recovery period.




Today, many clinical results show that whatever type of implant is used, it is important to do the necessary and accurate amount of dissection, and not massage unless it is needed. This applies to both textured and smooth types.

Thank you for reading, have a good day.

Breast fat transfer [KIES-U Korea]

Q. Is it effective to do fat transfer for the breast augmentation?
A. Yes, it is.
Q. Is the breast fat transfer safe?
A. Yes, it has been determined that it is safe.
Q. Which is the better method? Breast fat transfer or the implant?
A. It is difficult to say which is the better of the two. It depends.





The questions above are the frequently asked questions. Today, we will talk about the fat transfer breast augmetation.

When did the fat transfer breast augmentation start?

First, let’s talk about the history. Some people would be bored with this term, “history”, but you would be surprised to know this history of beauty surgery. You will be able to know that a lot of what we do today, has already been done in the past.
 
People do not think much differently.
In 1890, somebody started a surgery that required the usage of liquid paraffin. This was the beginning of the breast augmentation surgery.

Of course, there were a lot of problems. Infection caused inflammation and necrosis. People said that none of such this happened, but you could feel lumps on the body.
This method disappeared after the 1920’s.



 
Fat transfer breast augmentation started in the 1920’s. It was not much different from what it is today. You take the fat from the abdomen or the buttocks and transfer the fat to the breast. This fat did not cause infection like the paraffin but the problem was that the fat dissolved quickly. The result looked good however, the result was not maintainable. The number of people who wanted fat transfer decreased after the 1920’s, but this number started to increase as those patients who needed reconstructive surgery after the breast cancer surgery increased.

In 1987, US Cosmetic Surgery Association objected breast fat transfer because it perceived that the scar tissue caused from the breast fat transfer and calcification caused difficulty in examining the breast cancer through x-ray. There were many doctors / surgeon who are concerned about this, therefore, agreed to the objection.

Introduction of structural fat transfer

Then in 1990’s NYU’s Dr. Sidney Coleman introduced a new idea of “Structural Fat Grafting” and stated that the newly transferred fat with good technique would lead to good grafting and longer maintaining period of the fat.

Also, Dr. Coleman proved that the fat transfer did not cause any problem in examining the breast cancer.

There was no problem with this theory and many doctors agreed to the theory as well, leading to a big expansion of fat transfer. US Cosmetic Surgery Association backed off from its objection and accepted the fat transfer as a good method. (This happened in 2007)

Dr. Coleman is perceived to be an expert in the fat transfer sector. Most of the fat transfer originated from this “Coleman technique”.

Dr. Coleman stated that each surgery requires about 300 cc of fat. If more fat is used then this would lead to necrosis and he also stated that the fat transfer is a good alternative to solving breast size and form problems.

Limitation on fat transfer
 

Then, let’s look at some limitation on Dr. Coleman’s breast fat transfer.

"For those who want very big breast, it is recommended to use the breast implants rather than doing the fat transfer". This means that the fat transfer breast augmentation is not effective to product a large volume on the breasts.

Another limitation is the body type. Those with thin body would not have enough fat to transfer to have large breasts.
Usually, we would need to transfer 250~400cc of fat on each breast for other people to visually recognize that the breast has become bigger.
So, approximately, 800cc of fat would be needed for both breasts.
In order to get 800 cc of fat, we would need 1600 cc of fat from the abdomen or thighs.
This much amount of fat is not possible from a thin person. Also, fat transfer is not a one-time procedure. It requires 2 or 3 procedures.
If you take the fat from the stomach or thigh that do not have enough fat, it would lead to uneven shape of the stomach or the thigh.



It is important that the breasts become bigger. The fat that has been transferred properly to the breast leads to better feel than any other implants that have been used and also there are no problems with shape or structure. But, if you compromise on your thigh or abdomen to make the breast look better, you might want to reconsider this.

This is the biggest limitation of breast fat transfer. This is only recommendable to those patients who have enough fat.

To whom is the fat transfer breast augmentation applicable?

If there is a limitation on the amount of fat used in one procedure, then you might need a second one.
There must be about 4 month term between the first and the second procedures. We must check if the fat transferred remains or not after 4 months.
Therefore, fat transfer requires patience.

All the surgeries that have originated from Coleman technique must be done 100% by hands. There are many advertisements that the clinics have certain tools or products that lead to better results but these tools or products have not been verified. Fat transfer takes about 4 to 5 hours therefore, requiring a lot of labor.
You might think that your breast look larger after the long surgery, but this could be a hallucination. About 50% of the fat disappears at that moment.
Most of the patients are not satisfied with the loss of volume after 4 months. Most patients give up rather than asking for the second fat transfer.



There are some requirements for those who want breast fat transfer.
First, do not expect to have large breasts
Second, you need to have the patience to do this 2~3 times for a period of 6 months or more
Third, you need to have enough fat on your body. Your weight needs to be more than a certain level.

You need to be familiar with these three points and find an appropriate method. Breast fat transfer is a very good method but this does not apply to all patients.
Thank you for reading.