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.

[Breast augmentation Korea]
Wound/Scar after breast augmentation

There are certain things that patients worry about on breast augmentation in such order,
First, do I really need to do this? How much does it cost?

When the above questions are answered, the patients look for how long the recovery period is.

Finally, they worry about the scar that is caused by the breast augmentation.

Today, I look like to review on the scars that are caused near the inflammatory fold and axillary crease when performing breast augmentation with water drop type implants.
As you have visited my blog and have noticed, the contents here are those that you cannot find on any advertising contents online. I like to blog in order to correct the wrong information that the patients have and ask when they visit the hospitals and also to be a communicating bridge between the surgeon and the patient.

First the scar near the axillary crease disappears after 6 to 12 months.

Breast augmentation Korea KIES-U

This is a photo of the breast augmentation on the axillary crease after 8 months. The wound is becoming lighter without any problems. Maybe the doctors would not realize that a surgery was done on it if they look at it.

Breast augmentation Korea KIES-U

 This is a rare case. This is called hypertropic scar. (It is different from keloid). A hyertropic scar was formed about a year and a half after the surgery. It is difficult to forecast if such a scar would be formed or not in advance.

Breast augmentation Korea KIES-U

This is a picture of the scar after the scar removing injection. The scar is getting lighter but this injection is needed again in the future. I have only seen one of such cases until now.


For your information, there aren’t many who can differentiate hypertropic scar and keloid. Keloid does not have any limitation on the location that it can be formed and it is formed largely without any control. Hypertropic scar can lead to swelling but stays at one position.

A scar from the breast augmentation is rarely a keloid and I have never seen one as of now.

Let’s look at a scar on the inferior breast crease. This scar is different from the one on the armpit in that the scar can be formed on the breast, therefore, this is rather scary. But let’s see if this scar is indeed scary or not.

Capsular contracture Level 3, revision surgery patient Photo after the revision surgery KIES-U

This patient changed the saline type implant and then faced capsular contracture. In the past, the saline type was put through the armpit but the reconstruction was done on the inferior breast crease. As you can see, the incision line is very clear on the inferior breast crease.

6 month after revision surgery It is difficult to find or see any scar from the front view.

Let’s look at another patient’s photo.

Breast augmentation Korea KIES-U

The above and below photos are those of a foreign patient. She did not like the size of the implants and therefore wanted to change then. This is a phots taken after 6 months, and as you can see, there are no scars that you can see from the front view.

Breast augmentation Korea KIES-U

Scars cannot be seen easily from the side view as well.

Breast augmentation Korea KIES-U

 The scars can only be seen if the patient cups her breasts to make the scars be shown easily.
(Normally, one would not be able to see the scars....)

This is a photo taken 4 months after the surgery. I think that the scars will completely disappear in a year or two.

Inferior breast crease scar is more advantageous when you go swimming. It is a place that the swimming suit always covers. In fact, the armpit would be more suspicious to others if you go swimming.

If you are the one who likes public bath, then you might be worried about the inferior breast crease. But you would have to lie down on the ground for anyone to see and notice the scar.

A scar cannot be a decision making factor. The surgeons agree that the major claims after the surgery are shape, symmetry, and volume. There are very rare number of patients who are unsatisfied with the scar.

Today we looked at the scar formed from the best method, inferior breast crease incision, with the help of different photos..
Have a nice day. Thank you.

Incidence rate of capsular contracture

 


The implants in Tebbetts’ article were textured water drop type saline implants and the implants tested by the manufacturers were mostly smooth type saline implants. Also the writer is an advocate of 24 hour recovery system, and he enforces that the surgery must be performed without any bleeding and no damage to the tissue.


Capsular contracture depends on


Here exists the core problem.

How can you avoid the revision surgery due to the capsular contracture?

Here is the summary.

-  The surgeon needs to take care of the implant and not damage it when inputting it.

-  Do not use less than full filled implant, use filled and secured implant. (Water drop, textured, silicone gel bag implant)

- An experienced surgeon should not damage the tissue and not cause any bleeding during the surgery. (24 hour recovery system)

- Double plane surgery or sub-pectoral surgery has lower incidence rate than sub-glandular surgery.

What can I do if I have a capsular contracture?

An internet popular “Baker method” has 4 types. But, this is something that is decades old. I do not think that this is necessary now.
The bottom table is useful.


Cases when you need reconstruction when there is a capsular contracture
- Very hard breast
- Awkwardly shaped breast, or implant moving to a different position
- When one can notice that the breast looks awkward when wearing everyday clothes
- Capsular contracture caused when there is an infection


You should not have a revision surgery because you have a capsular contracture. There is no guarantee that you will have a good result after the revision surgery. In conclusion, it is best to try and prevent the capsular contracture.

I would like to share something obvious before I finish off.

What can you do in order to minimize the possibility of a side effect?



- Get a surgery from a doctor who is well educated on the breast augmentation (beauty surgeon). (Be careful of similar titles such as International beauty surgery specialist, Beauty surgery specialist, etc)

- Go to a hospital that has a quick recovery system.   A recovery must take place within 24 hours with pain and bleeding so that you can get back to your everyday life. This will minimize any possibility of implant collapse, and capsular contracture.

- Go to a surgeon who can explain properly about the side effect. An experienced surgeon would have experienced many side effects as well. Those who say that there is no side effects is not an experienced surgeon.

-  Go to a hospital that charges an appropriate amount of surgery cost. Breast augmentation cost includes implant cost, surgery facility and personnel cost, testing expense, material expense, anesthesia, recovery and monitoring expense, surgery expense, unexpected cost, VAT, etc.

Very cheap surgery would leave out one thing from the above list. This means that you will not be guaranteed on what would happen to your body and would not be able to solve any problem you’re your body might get into.


This is all for today. Capsular contracture is the most important side effect, and there needs to be more explanation on it but I will have to end for now.
Thank you for reading.

Side effects of breast augmentation -What is capsular contracture?

Many people around the globe are interested about breast augmentation and breast augmentation is one area that a lot of people are researching on in the medical field.

So there are fast developments in this area and the doctors seem difficult to catch up with all the new information and research if they are not interested.

In US, there are about 400,000 implants used in a year. This is comparably different from Korea where we use about 50,000 implants a year.
Also most of the data on the side effects come from US. Today, I would like to use this data to share some information. (There aren’t much data in Korea)

Patient with breast augmentation side effect (Source: MBC)

 
This might be out of line, but let’s compared the airplane accident rate to breast augmentation side effect rate.

According to IATA, the accident rate of planes manufacture in the western countries was 0.71%. This means that there was 1 accident in every 1.4 million flights. Those people who died on flights are 685 (Yunhap News)  

 
A plane with 0.71% of accident rate, is it safe to ride on it?
This depends on each individual who knows about this rate. I usually use the planes, but there must be some who do not use the planes because they think that it is not safe.

I will ride the plane. I will not. As you know about the safety and decide on whether you would ride the plane or not, one must be aware of the incidence rate of capsular contracture, implant collapse, etc related to breast augmentation and decide on whether you would need breast augmentation or not.

Breast surgery Korea KIES-U

 
MFDS has data that says that there were about 98 cases of capsular contracture last year. But this number does not have any meaning to the patients and even the doctors.

Epidermis is formed naturally on anyone, but the real problem is when this squeezes. We are interested about what number of capsular contracture leads to reconstruction, what type of implant was used, how many implants were used, and what manufacturers made these implants. However, these type of data do not exist right now.

What is capsular contracture?

This is a term that many patients know and one that a lot of doctors use as well. However, capsular contracture is not an appropriate term to use.

An exact expression would be epithelium contracture. If an outer substance enters our body, our metabolism system forms a wall around this substance. We call this wall, capsule.

The capsule takes a few weeks to be formed. The wall is formed and grown, squeezing the substance but this is different from one person to another.

If it is tightly squeezed, much pressure is formed on the implant making the implant as strong as a stone or it can even change the shape of the implant casing discomfort.
We call this capsular contracture. Capsular contracture is similar to healing of a wound. All mammals including human have scar when there is a wound. This scar can be big or small on a person. As for a scar from a surgery, the scar would depend on how the doctor performs on the surgery.

Capsule formation is normal on the body, ‘but the problem exists when there is much pressure on it.  However, this cannot be known before the surgery.
If the capsule becomes very tight at the bottom of the breasts, the implants would be pushed upwards and the upper breasts would stick outwards.
 

Breast surgery Korea KIES-U

If the capsule is very tight on the insider, the implant would be pushed outwards and the breasts would look far apart.

If the capsule is tight from all sides, the implant would become as hard as a stone. If the tightness comes all around the breast, and changes the shape of the implant, we call this capsular contracture. The 98 cases announced from the MFDS can and cannot be this type of capsular contracture.


In the next posting I will continue writing about the 'incidence rate of capsular contracture'.
Thank you

Does the textured implant have more rippling effect than the smooth type?

Rippling is similar to waviness. For those of you who are searched on the internet a lot, most will think that rippling is caused on the saline bag type and also on the textured type.

Today I would like to share on the two side effects of rippling and feeling on the implant on the outside.

Why is rippling caused? Let’s look at the cause first.
The first cause is because there are much substance around the implant.
The second reason is because the skin does not completely cover the implant.


Rippling cause by less fill is caused when the saline or cohesive gel is not filled up to the actual volume. Liquid is filled up in the saline bag type therefore many causes can lead to incomplete filling. But cohesive gel is made in a plant, so why is it that the cohesive gel is not filled to the maximum level?

A person walks straight forward. So the implant does not lie on the body but it stands up.




The standing up implant would have more balance at the lower level. This bottom level would have more silicone gel centered on it and the upper part would have less silicone gel. This causes the under-fill effect.

This under filled part would have wrinkling effect as well and this is the cause of the rippling. There are many types of cohesive gel implant that are under filled.
Textured water drop type silicone gel implant standing up in the body would be the most secured type with less under filled parts.





Under filled rippling can be prevented by filling up the volume more. If the saline type is 250cc, it can be filled up to 260cc.
 
If you want to avoid rippling on a cohesive gel type, you need to select one that is well secured like the one in the photo above.

If you feel that you have a rippling effect on the saline bag type, then you need to fill up the implant more. Or you can change it to a cohesive gel type.

Second reason that causes rippling is not how much the volume is filled up but whatever the type of implant it is, the surrounding skin needs to cover up the implant completely.
Therefore, rippling is caused easily on those with thin breast skin, or small breasts, or those with very thin subcutaneous tissue.
The skin that covers the implant is very thin therefore the weight of the implant pulls down the epithelium causing wrinkles and rippling effect.

One needs to plan out the procedure properly so that the skin covers the implant completely in order to prevent such a problem.
More padding under the muscle would help out such patients as well. Double plane would be good also. Subglandular would be lead to rippling.

There are those who say that rippling is caused more easily on the textured type compared to the smooth type. But there is no evidence to this according to 2002 Mentor and McCann PMA report to FDA. Textured having more rippling compared to smooth type is a wrong information.



Also, rippling is a problem if you can see it when standing up. It is not a problem when you can feel it in a certain position.

A specific part might feel wavy after the breast surgery but one cannot say that this is a side effect. However, if you can visually see that the breast is not looking proper due to rippling, then you can say that there is a side effect.




One last word.
It is wrong to think that the side effects are caused by bad implants and that one can avoid side effects when using good implants. This all depends on whether the surgeon has accurate knowledge and performs on the patient. Whatever surgery it is, the outcome is depended on the surgeon.

This is all for today. Thank you.