Q) Is there no problem with breast feeding after the breast augmentation?

The answer to this question is that there is no problem.
In addition, let’s look at some of the important facts that you need to know in breast augmentation.

Breast augmentation can be divided into two.

First is the ‘Subglandular’ – Above the pectoralis major muscle
Second is the ‘Subpectoral’ – Under the pectoralis major muscle





We call this ‘surface’.
There are surfaces above the muscle and below the muscle.
All the breast augmentations are depended on where the implant is put in.
This is why the surface is so important. Everything changes according to what surface is selected.

Then, which surface is closely located to the breast tissue that makes the breast milk.
It is the surface above the muscle.
You might think that the breast milk may not be good if the silicone touches the tissue.

But, if the implant is put in below the muscle, the implant would not interact with the breast tissue. This would have no effect on the breast milk.

If the silicone is put above the muscle, the epithelium forms after two weeks.
This epithelium completely separates the implant and the breast parenchyma.



So one can know that the silicon does not interact with the breast milk tissue.
There are many people who think that the silicone causes harm to the body. Of course, there aren’t all good things about the silicone.

However, the silicone is chemically stable substance. Also it is completely separated from the body therefore, it does not cause any harm to the body. Also there is no relation with cancer either.

The implant itself does not pollute or harm the tissue. This is a verified fact.
But, what if the surgeon is not experienced enough and causes harm to the breast tissue?

The breast tissue can recover but if the damage is severe then the amount of breast milk can be reduced and there may be limitation on it.

How can this happen?

Implant through the armpit and under the muscle does not cause any trauma to the breast tissue.
But, implant through the armpit but above the muscle can/


Incision on the areola has the highest possibility of the trauma. This happens often with the surgeon with not much experience.

Subpectoral has the lowest possibility of breast tissue trauma. The incision is visible to the eyes therefore, it is safe.
So this is the best method that does not cause any damage to the breast tissue.

This is just a principle in the breast augmentation.
But the surgery depends fully on the surgeon and his/her experience.
There are times when there is no damage to the breast tissue although the areola incision is performed.

Subpectoral is the safest method that does not damage the breast tissue.  Also is the surgeon is much experienced, there would not be any problem on the breast milk. Breast augmentation does not have any effect on the breast milk.

This is all for today,
Thank you very much for reading.

Breast Augmentation For Older Women [KIES-U Korea]

Q. I am kind of old, but can I get a breast augmentation?

A. Age is not important. The health status is.

This is a commonly asked question.
There are many who are about 50 years or older, and think that they have problems with the breasts. These women think “Am I too old to have a breast augmentation?”

In our country, there are many women who want their breast size to be larger in order to show their body appeal through swimwear. So there are many in 20’s ~ 30’s who are relatively interested in the breast correction.




But in the western countries, where there is more number of those having breast augmentation, the main patients are those aged 35 ~ 50 years old.

Most of them want the breasts to look prettier after pregnancy or diets. Also, there are some who think of the breast augmentation as antiaging surgery.




There are very few of those in our country who think that the breast augmentation is an antiaging one. The most important objective of the breast augmentation is that the implant goes into the breast in order to improve the shape of the breasts to make them more elastic and look younger.

It is not only to make the breasts look larger.

The oldest patient that I had was 65 years old.
She needed a revision surgery because the saline bag implant that she had from her previous surgery needed replacement.

She asked me whether it was better to remove the implant or replace it. My answer to her was that the old implant was fine before, there would not be much problem replacing the old ones.

So this patient replaced the old ones with the cohesive gel implants with the concern of the breasts collapsing without the implants.

Is age important? If a patient who is older than 65 years old wants breast augmentation, we must first check if she has any problems with her body.
She might have diabetes, heart problems, cancer, lung disease, etc. In such case, it would be difficult to have the breast augmentation

But, if the woman does not have any illness and wants the breast correction, she will not be able to give it up.

Health status is more important than age

If a woman in her 30’s has a severe illness, then I would recommend her to rethink about the breast augmentation. If she is in her 60’s but is healthy, then I would recommend the breast augmentation.

Most of the aged patients who come to our clinic have problems with the previous surgery (most come due to the implant rupture).

If there are not problems with the tests prior to the correction and the general anesthesia, then we go ahead with the replacement surgery. Also, the result of this is similarly good to that of those patients who are younger.

Is there any pain or inconvenience for the aged patients?

No, in fact, they recover with better conditions.

The younger you are, the tighter the skin and the tissue are therefore the implant is compressed and there is much friction. However, those who are older have loose skin and tissue.

KIES-U Korea Real-Time Operation Monitoring system

So, there is not compression on the implant.
The patients recover comfortably.

There are many aged patients who do revision surgeries, and there are many who have the first surgeries as well. Also most of the surgeries are inferior breast crease.

Thank you for reading this post.

How to reduce pain after breast augmentation surgery

There are many who are concerned about the pain after the breast augmentation surgery and therefore do not want to get it.

There are many around who suffer from the pain so the patients get scared about the breast augmentation surgery.

There are many internet advertisements that read “no pain breast augmentation surgery” or “no pain surgery” but this will not help you relax and stop thinking about such concerns.




First, let’s find out why the pain is caused.

Pain can be felt if you irritate the pain receptor.
If there is much pain after the surgery, then this means that much of the pain receptors have been irritated during the procedure, and vice versa.

The parts of the body with much pain receptors are skin tissue, fascia, and periosteum.
You cannot feel pain in the subcutaneous fat. Also in the muscle itself and the bones. If you break and bone and it hurts a lot, the pain does not come from the bone but the skin that surrounds the bone.




When you have breast surgery, the pain is caused when the implant and the periosteum interact with one another.

So the best method of avoiding this pain is to avoid going into the periosteum area.

We need to make the pocket at the position higher than the pectoral muscle.
If we do the surgery above a certain muscle, the pain is minimized. You can move about freely as you want without any pain. Normally, if you have a surgery on the belly button, there is no pain. This is because one uses the upper layer of the muscle for the procedure.



But, why is this method, putting the implant from the upper muscle area, not used widely?

This is due to the fact that a lot of patients who want breast correction are thin.
The patients do not have much fat and the original breasts are small therefore, if you put the implant from the top, you can feel that the implant is too close to the skin.
If you touch the breast, it will feel artificial. You might be able to see the re-filling or that the implant is there.

If your original breasts are comparatively big then you would not have any problems with this method. The breasts will look more natural and larger without any pain.

But there are many problems of those in 20’s and 30’s in Korea because many of the patients are thin.



Most of the breast surgeries are done under the muscle when the implant covers the pectoral muscle.

So in such case where you cannot avoid the pain, the homework would be on how to minimize the pain.

- If the implant is relatively big compared to the body, then there is much pain. The larger the implant is, there would be more pressure on the skin.

- There will be more pain if your skin is less elastic but tight. As the implant goes in, the skin needs to stretch but those with tight skin, especially those women before pregnancy, would have skin that press against the implant causing pain.

So in order to minimize the pain, it is important that you select an appropriate size of the implant. Mid aged women after pregnancy have relatively elastic skin therefore they feel less pain.

- There is less pain with less inflammation and less bleeding. Although the surgery is same, there are some patients with more bleeding than others. Also, there is much bleeding the inflammation if the surgeon destructs more skin and fat.
There are patients with much bleeding more so than others without any reason or cause. If there is an inflammation, the breasts swell and the swelling leads to continuous pain.

- If the surgeon is more careful during the surgery, there would be less pain. If the surgeon is aggressive, there would be much pain. The aggressiveness leads to much movement therefore, the pain will be caused from the surgery tools used. So there are some patients who say that they do not feel pain because of a certain surgeon and those who fell pain because of a certain surgeon as well.

- Pain comes from sensitivity.
There are some people with developed pain receptors, and those with less developed ones. If we eat same type of food, some might find it hot or spicy, and some who do not. This is all personal sensitivity issue.


Below is the summary on how to minimize the pain with doing the surgery underneath the muscle.
1. Choose an implant with an appropriate size
2. If your skin is tight, use a smaller sized implant
3. A surgeon must be careful and minimize the bleeding

Above are important as well as,

If the surgeon is much experienced and the surgery planning is perfect, then the pain that the patient feels can be decrease by 90%.


Thank you. Have a great day.

Let’s look at in details about the most important substance in nose job (nose surgery), the nasal septum.

There are many substances used in order to change the shape of the nose. The most common ones are the ear cartilage, nasal septum and the costal cartilage.



T
here are many who ask this question. “Do you use ear cartilage here or the costal cartilage?” I usually answer “nasal septum”. Then these patients make note of my response, and compare it with those from other surgeons.

This is same as asking a restaurant owner, which beef he uses. “Do you use beef from area A or area b?”


Of course the owner will answer with sincerity. He would answer that he uses beef from certain area and he would also share the reasons why such as that the customers like the meat and the taste, etc.

But then the owner might think that the area is not important but how you cook the meat is.

Much of the things happening around are the same. It is what you do on the inside, where other people cannot see you, is important. From the restaurant case, it is what you do in the kitchen that is important. What people say by what they see and feel from the outside is not as important.




It might be weird comparing the surgery with the restaurant but it is the same.

It does not matter what substance a surgeon used for the nose job or nose surgery. The important thing is the planning of the surgery, and how well the surgeon carries it out.

This is a skill from the experience of the surgeon. The surgeon has the knowledge and experience therefore; much of this experience is used for the nose surgery.

If the surgeon has much experience with the ear cartilage, then he or she would be most skillful in doing the surgery with it. Those with much experience and knowledge with the nasal septum would use the nasal septum to get the best result possible.

Let’s take a look on the nasal septum now.

If you put your finger insider the nose, there will be a pillar that separates the two nose hoes. The strong substance inside that pillar is called the nasal septum.

As you can see in the image above, the nasal septum is around the upper jawbone, and the nose bone. If you remove the cartilage then the nose will lose its shape. Therefore, you can only use so much in order to do the nose surgery.

The characteristic of the nasal septum is that it is less stiff compared to the ear cartilage and more smooth compared to the costal cartilage. Overall, it is flat, and smooth.



Ear cartilage looks more roundish (because there are more curves around the year), and the costal cartilage is thicker and stronger. Nasal septum is flat and has certain level of stiffness so it is used a lot.







As you can see in the images above, there are two types of procedures that you can do to change the shape of the nose tip. For both, you can use the nasal septum.

The biggest reason that the nasal septum is used is that you can get this cartilage under the same view or sight as the actual nose surgery(rhinoplasty). If you use the costal cartilage, then you need to cut and get the cartilage from the lower line of the breasts.

If you use the ear cartilage, then you need to cut the ear, and the recovery takes about a day or two. If you use the nasal septum, you do not need to work on other part of the body other than the nose itself, so both the patient and the surgeon can feel more comfortable.

There are many substances used for the nose surgery(rhinoplasty), but the most important one is the nasal septum. Today, if you do not use the nasal septum, this means that you do not know how to do the nose surgery.

This is all for today.
Thank you for reading.

Breast Surgery To Know List 7. no touch technique breast augmentation

How to prevent capsular contracture?

This is a frequently asked question.

There are many who are concerned that the breast implant in the breast becomes stiff and strong.



I have shared many times about the reasons behind the capsular contracture, but we do not know the reason for sure.

However we assume from various data from tests on animals that the skin resonance such as staphylococcus epidermidis surrounds the implant which makes the epithelium thick and contracts causing the capsular contracture.

Therefore, the initial prevention of the capsular contracture could be the surgery under condition where there is absolutely no germ around. One must be sure that the implant does not interact with the breast tissue and the skin does not get infected during the surgery.




I use sterilized clean wrap type of film that I put on the breasts for the surgery. (This is called clean draping)

 
We may not be able to see the germs on the skin so we do the surgery by avoiding the process of touching the skin.

The cohesive gel implant that you put into a small inlet cannot lose its form, therefore, we put in the implant by using the funnel and pushing in the cohesive gel. In this way, we can avoid touching the skin and the glove that could be infected.



We call this a “No touch technique”.
When we use this no touch technique, we can minimize the infection on the implant and also minimize the chances that the skin resonance getting in also.

Areola incision can cause the skin strain getting into the pocket. But if we use the “no touch technique” then the implant can get into the pocket without being infected.

We must minimize the chance of the implant touching the outer environment even after we have put the implant into the pocket. The best method for this would be minimizing the surgery time.





If the wound is open for longer time, then the germs, virus, etc in air can infect the implant. This too can be the cause of the capsular contracture.

There is another frequently asked question such as what type of implant avoids the capsular contracture.

This is not a correct question to ask, because if there is a type that avoids capsular contracture and another type that causes capsular contracture, people around the world would only use the type that avoids the capsular contracture.

The polyurethane coating gel of the implant must dissolve completely into the skin in order to avoid the capsular contracture, but we do not know for sure if the polyurethane is the cause. We have to wait for the announcement of the FDA in order to know this for sure.




It is not the type of the implant but how the surgeon does the surgery that determines whether one avoid the capsular contracture or not.

Another concern on the capsular contracture is bleeding.

If there is much bleeding during the desquamation, then this means that the skin is suffering much stress.
We believe that such stress on the skin causes the capsular contracture by causing more epithelium.





Can you avoid capsular contracture?

My answer to this question is that we can try the avoid it therefore we must try to avoid it. I think that a quick “No touch technique” can minimize the chance of this trauma.

There are many who say that the massaging and the preventing medicine could minimize the chance of capsular contracture but there is no data that proves this. This is just a thought of some people. It is important to conduct a very clean status surgery.

Thank you for reading.
Have a great day.