Breast augmentation revision surgery Korea

'Anatomical type breast revision surgery' means that you will have a revision surgery with a anatomical type implant.
Today’s topic is the breast re-surgery with an anatomical type implant.





If you decide to have a breast revision surgery, then you would need to think about what type of implant to use.

There is no one absolute correct answer for this. One must choose from the various types such as anatomical type, round smooth, round textured, cohesive gel, etc by considering what is best for the patient and her body.




Below are the conditions that you need to use the anatomical type implants.

- Sagging breast, or breast that is located low on the chest

- Very narrow space between nipple and lower breast line

- Tight skin + not fully developed breast

- Asymmetric breast

- With abnormal chest shape

- If you want breast with perfect proportion

The list would apply also for the breast revision surgeries.

When do you need to use anatomical type in breast revision surgery?

If the patient does not like the breasts after the first surgery, and the result is one of the above, then the patient would need to have the breast augmentation revision-surgery with the anatomical type.

- If there is large round type implants in the sagging or lowly positioned breasts, then the breasts would look stretched downwards. In this case, one would need to use the anatomical type in order to fill the space on the upper part of the breasts.

- If there is large round type implants in tight textured breasts, then the breasts would look like up-side-down rice bowl. This would look unnatural causing revision-surgery with the anatomical type implants.

- If you already had mismatched breasts but if this got worse after the breast correction, then you would need to use the anatomical type implants. There are many types and profiles of anatomical type implants therefore it would be easier for you to choose the one that you want.

There are times when the saline type gets damaged and one need to change the implant to the cohesive gel type. In doing so, there is no requirement that this be done with the anatomical type. It does not matter if the implant is a round type or an anatomical type, the important thing is that the pocket and the implant match perfectly in the breast revision-surgery.

If there is stiff contracture and the breasts are contracted, it might be worse off if you use the anatomical type. In such situation, it might be better off if one uses round type implants instead. If there is a bad contracture then it is recommended that the patient takes couple of months off and then do the re-surgery. This breast revision-surgery can be done with the anatomical type.

breast revision surgery with anatomical implant

At times, there might be some problems caused after the 1st correction that require the second surgery. The problems can be such ones as contracture, different positioning of the implants, etc.

If there is a problem with the anatomical type, then this means that the pocket and the implant did not match properly.

Then, one must remove the old implant and replace it with the new anatomical type and also re-make the pocket.

If the old pocket was too large compared to the implant, then one should throw it away and make a new pocket. If the pocket was too small then one can make it larger.

Surgeon’s experience

A surgeon’s experience is very important in the breast revision surgeries with the anatomical type implants. It is very difficult to work with the anatomical type implants and if the pocket is already larger than the size required, it is difficult to match the implant with the pocket.

A surgeon with a lot of experience with the anatomical type can make the pocket size that matches properly. If the pocket size does not match, then there is a higher possibility that the implant would change positions / locations more easily than the round type.
 

Breast revision surgery

Thank you for reading.

Breast Surgery – To know list 5. Breast implants touch

Tactile sensation of the breast after the breast augmentation surgery is a natural problem associated with the surgery itself.

Whether the breast feels real or not when you touch it, is a big decision making factor for the breast surgery.

A to Z of have a good tactile sensation of the breast

There are few requirements for the good tactile sensation

First, there must not be any contracture
Second, there must be a balance between implant and the tissue
Third, the pocket size and the implant size need to match

The product or the product line of the manufacturer is not important for this matter.




Below are the detailed descriptions.

First, if there is a contracture, then the epithelium surrounding the implant contracts meaning you will not have a good tactile sensation.
Therefore, it is important that the contracture does not happen after breast augmentation.

There are some patients who ask if there is an breast implant that does not form the epithelium.
All the breast implants that are in the current market are composed of silicone with cohesive gel or saline water bag therefore, one cannot avoid the epithelium.
if you are a person with a normal immune system, then there must be epithelium. An epithelium is a barrier that blocks substances getting into the body, so this is not all that bad.

There is an implant with polyurethane that does not cause epithelium but this is not imported into Korea.
An implant with polyurethane may avoid contracture, but there are possibilities leading to other problems.

It is important to try to avoid contracture with the cohesive gel implant. This is the most important part of the procedure.





Second, when the implant goes in, the skin surrounding the implant must stretch out. The surrounding area of the original breast needs to stretch out as much as the surrounding area of the implant, but this takes some time.

Let’s say that you bought a tight leather jacket in a shopping mall.

When you wear it at first, your movement might seem unnatural.

But, as time flies, the leather jacket will stretch out. If you were to wear this jacket every day for one year, then the jacket will wear out.





The breast with an implant goes through these stages as well.

When you touch your breasts for the first time after the surgery, you might feel that you are touching the tight leather jacket.
Most people show sign of improvement on both look and touch after about 2 months when the skin stretches.
As time flies to 6th and 12 month, it will feel more soft and natural.

So if you are person who wants this good tactile sensation quickly, then it is important that you select an implant that is not too big.

But, most of the patients have big expectation for the breast surgery and want maximum sized implant, rather than a small sized ones.





Third, a good feeling of touch would be the feel that you had from touching the original breasts.
If the pocket is desquamated a lot, then the implant would be put into a very small sized area and would not be able to move around.
If you touch the breast with such sized pocket for the implant, this will not feel natural.

But if the pocket is too large then the implant would move around too much.
If you touch such breast, then you will know that there is an implant inside and this would not feel natural either.

No contracture,
Not using too big implant,
Appropriate desquamating of the pocket.

These three factors are important for a good tactile sensation, and what company implant you use is the least important one.




Some say that 410 water drop implant from Allergan is the most solid one  but if the 3 factors above are satisfied, then you would have a good tactile sensation.

In opposite, round type implant is thought to be soft but if the 3 factors above are not satisfied, then the breast with the implant would not feel natural.

Thank you for reading the post.

AlloDerm, MEDPOR,Donor Cartilage _Materials necessary for nose job

Nasal Implants for Rhinoplasty - AlloDerm

AlloDerm refers for skin graft. It combines two words of Allo = Thick skin of a human being, and dermis.
It is a donated thick skin that has been fabricated so that it could be used on another person. This is used widely around the world. There are other products of such with different brand name as well.

Rhinoplasty(Nose job) implants AlloDerm

Thick skin lies underneath the epithelium. If the epithelium is peeled off, there is an area with much blood, this is called the thick skin.
AlloDerm is mainly used for recovering a patient with a large extent of damage on the skin. It is mostly used for plastic surgery, especially the nose correction.

Nasal Implants AlloDerm

It gives volume to the skin, therefore is placed under the epithelium. AlloDerm is used to give volume but if you need to fill the volume of subcutaneous fat, transplantation is recommended. AlloDerm can maintain its form although the blood is not formed however there is a high possibility that it will lose its volume. There is much loss of volume in 2 to 3 months.

This is used to make your nose look higher, and also in other parts of the body that need volume.

Rhinoplasty(Nose job) Implant -MEPOR

MEDPOR is called “artificial bone” that has Poros polyethylene. It is a polymeric material that is used widely in plastic surgery.

Rhinoplasty Implant - MEDPOR

This substance has more solidity and hardness compared to silicone or AlloDerm and it also has some plasticity as well. It is not absorbed in the body but spreads out along with the surrounding cells.
This substance is commonly used for the ears and facial bones, but there are different opinions on whether it could be used on the nose or not.
I think that one can use MEDPOR after careful deliberation.
MEDPOR cannot be used all the time, and it would be recommended to use autologous cartilage but there is a limit to the amount that we can use therefore, we could use small amount of MEDPOR to make a nose that the patient wants.

Nasal Implants for Rhinoplasty - MEDPOR

Nasal Implants for Rhinoplasty - Donor Cartilage

Most of the Donor cartilage used in beauty clinics is costal cartilage. Many of them are imported from Germany. This also is AlloGraft, i.e. a homoplastic graft. We get cartilage from some person and use the technique that we have to make a product.

AlloDerm is completely dry when you open the package, but the donated cartilage has disinfectant in it when you open the package. The cell sap and all the traits of the cell are not fully awakened when the surgery takes place. This is not as complicated as skin transplantation therefore it is easily engrafted.

But it can be absorbed. We do not know exactly how much would be taken in and how much would be lost before the surgery. There is more absorption than the transplantation of the costal cartilage.

Also there is a possibility that there would be an inflammation. There are many reasons such as the defect on the product, carelessness of the surgeon, infection on the wound but the important reason can be the blood circulation with the substance, bleeding that cannot completely remove all the substances from the procedure.

It is not right to think about whether it is right to use the donor cartilage or not, but it is more important to consider a case that needs this donor cartilage and use is appropriately for the surgery.

It is important to change the original form and control the framework of the nose but there are some parts that require the usage of the substances mentioned above.

If you use just as much as you need, then it would become a medicine or a solution.
Thank you for reading.

Q. Should Breast implants be replaced every 10 years? 

A.



Before the FDA approval of cohesive gel in 2006, there was a time when we only used saline solution bag. The various rumors at that time are still on-line today.
What I am surprised at is that there are many surgeons who do not have sufficient knowledge about the breast implants but communicate some common sense knowledge to the patients.

Although many of these surgeons received license from the country, the surgeons, especially those who conduct breast surgery, should have updated knowledge at all times and study the respective field.

The statement that cohesive gel breast implant needs to be changed every 5 or 10 years is not true but there are those patients who ask this question saying that such statement would not have come out if it was completely false.

Rumors without any evidence tend to capture more attentions. The person who tries to communicate the accurate message may be judged falsely by the others. Today, I would like to share the FDA announcement.





In June 2011, FDA announced “FDA update on the safety of silicone gel filled breast implants”. Here are the details. (Source;http://www.fda.gov/downloads/MedicalDevices/ProductsandMedicalProcedures/ImplantsandProsthetics/BreastImplants/UCM260090.pdf)



[VII. Summary of Key Findings]

1. Based on the totality of the evidence, the FDA believes that silicone gel-filled breast implants have a reasonable assurance of safety and effectiveness when used as labeled. Despite frequent local complications and adverse outcomes, the benefits and risks of breast implants are sufficiently well understood for women to make informed decisions about their use.

2. The longer a woman has breast implants, the more likely she is to experience local complications or adverse outcomes. Women with breast implants will need to monitor their breasts for local complications for the rest of their lives.


3. The most frequent complications and adverse outcomes experienced by breast implant patients include capsular contracture, reoperation, and implant removal (with or without replacement). Other frequent complications include implant rupture, wrinkling, asymmetry, scarring, pain, and infection, among others. These observations are consistent with the local complications and adverse outcomes that were known at the time of approval.

4. Women with breast implants may have a very small but  increased likelihood of being diagnosed with anaplastic large cell lymphoma.

5. In the post-approval Core studies, between 20 ~ 40 percent of augmentation patients and 40 to 70 percent of reconstruction patients had reoperations during the first 8 to 10 years after they received  their implants. Although  routine replacement is not necessary, many women will  need additional surgery to modify, remove, or replace their implants.

6. There is no apparent association between silicone gel-filled breast implants and connective tissue disease, breast cancer, or reproductive problems. Associations that are very rare or that take many years to manifest may not be detected using currently available data.

7. MRI continues to be the most effective method of detecting silent (asymptomatic) rupture of silicone gel-filled breast implants.

8. Interpretation of the data from  the silicone gel-filled  breast implant post-approval studies may be limited  by low  follow-up rates.




As you can read in the 5th statement, there is no recommendation about changing the cohesive gel implant regularly


The rumor that one need to change the implant every 5 to 10 years comes from the time when the clinics used to use the saline solution bag implants and is still lasting today.

Also, this rumor is used as a marketing means in the clinics that recommend filler or fat transplantation for breast surgeries.




A scientific and accurate information is not “the information that I want” or “the information that I want to hear”. An objective information with numerical data that can be accepted by anyone would be the information that I need.

Thank you for reading the post. Have a great day.