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.

Implant profile in breast augmentation, KIES-U breast augmentation Korea 

Implant profile for breast augmentation (water drop type)
I have shared the below image below, let’s look at it again.




All breast augmentation implants, for example, when are all cohesive gel 300cc, i.e same volume, have different diameter (bottom length) and height (thickness). We call this profile.
 
Let’s compare 275cc implants of a low profile from Mentor, and THS high profile from PolyTech.

Mentor’s low 275 has base diameter of 13.2cm and height of 2.9cm. Polytech’s high 275 has a base of 10.5cm and a height of 4.5cm.

What would happen if you put in Polytech’s high 275? The nipple would stick outward. The cup size would increase a lot. A person with AA size would have C size. However, the breast would not look to have a large volume.

What about Mentor’s low 275? The nipple would not stick outward. The cup size would not increase much also. However, the volume would increase a lot and the breast would look wide.

How about Mentor Mid 275cc? The base diameter is 11.7 and the height is 3.5. The cup size would increase with more volume.

Breast augmentation Korea

In reality, a lot of the patients use low or mid profile when getting breast augmentation. Korean patients do not have wide enough chest to use low profile high volume implants. Also, there are many of those who want high volume compared to the past.

Therefore, in order to use a larger size, there are many who choose mid-high profile over the low ones.

Extra high is only used in special cases. For example, if you have very narrow chest but want large breasts, you need to use the extra high profile.

Let’s say that there is a patient with a breast diameter of 11cm and want large sized implants. 250cc would be appropriate for 11cm. But large size refers to 300cc. This should not be used but the patient insists.
Natrelle’s high profile 300cc implant has a diameter of 11cm and height of 4.2cm.

The diameter is appropriate so the patient can use the 300cc that she wants. (Of course, the diameter is not the answer to everything. The doctor makes the final decision by considering skin elasticity, sagginess, etc)

Such implant might be able to satisfy the patient at the current moment, however this changes over time.
The implant continuously pressurizes the original breast. The breast contracts and after a year or two, the breast becomes smaller than the original size.
This breast pressure and contraction makes people avoid using high profile implants.

Another core factor is how tight the breast skin is. If the skin is too tight, the patient cannot use high or low large sized implants. If one forces such large implant into the breast, then the contraction of the breast leads to change in shape of the ribs as well.

Following is the summary of the core points on today’s post. (Point Up!)

- The size of the implant is one-dimensionally determined by breast diameter in cm.

- If the skin of the breast is tight, then smaller size is used. If the skin is loose, then a larger sized one can be used.

- If the patient was larger volume, then +30cc can be applied.

-  If the patient has broad chest and shoulders, she needs low profile. If the patient has narrow shoulders and chest, she needs mid profile. High profile is only used during special cases.




I think this is enough explanation on the implant size for now. If you have understood the contents of this post, I think that you can say that you know much about breast augmentation. Have you all understood the contents?

This is all for today. Thank you very much.

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.

Implants for breast augmenation [Cohesive gel breast augmentation] 

Today I would like to write up details about frequently asked questions on cohesive gel breast augmentation. First, let’s discuss about the cohesive gel implant.


1. Can I use cohesive gel for my Breast augmentation surgery? 

Currently, anyone can use the cohesive gel. Saline bag type is used when inputted through the belly button or in some special cases.

Actually, cohesive gel is a product name. It has been developed long time ago. It refers to sticky silicon type implants.

Many companies are making silicone implants that remember or memorize the shape. Mentor and McGhan in US call these implants Memory gel or Cohesive silicone gel bag. Since then, many companies in Europe and South America have made such silicone gel implants that remember and maintain the shape.

Cohesive gel implant have become famous because it is made of silicone substance that is sticky therefore does not leak out if the exterior of the implant is damaged.

The cohesive gel implant was certified in 2007 by Korea’s MFDS and has been used ever since. However, it was used 10 years prior to Korea’s certification in Europe and South America.

Breast augmentation Korea KIES-U

2) I have heard that capsular contracture is not caused and one does not need any massage if she uses textured implants. Is this true? 

Mentor and McGhan (currently known as Allergan), both have textured and smooth type implants.

It is known that if the textured implant is put in above the pectoralis major muscle, there is a less possibility of causing capsular contracture when compared to the smooth type.
The incidence rate of capsular contracture when put below the pectoralis major muscle is similar for both textured and smooth type however, this rate is lower than that of above the pectoralis major muscle.

Surface of the textured implant seen through the electron microscope.

 However if the textured type is put above the pectoralis major muscle in a person with small breast or thin skin, one can feel the implant from the outside. So if a patient has small breasts, it is recommended that the implants, whether smooth or textured, be put in under the pectoralis major muscle.

Strong massaging on the textured implant can lead to soft tissue damage, therefore, this is not recommended. Dr. Findley, a well-known breast augmentation specialist in US, stated that Biocell texture that has rough texture when applied frictional force can lead to the formation of the seroma.

Mentor calls its textured implant, Siltex and Allergan calls its product Biocell
.
3) Is Mentor the better when compared to Allergan (Natrelle)? 

It is difficult to say which is better. Whatever seems familiar with the surgeon’s hands might be the better one to use.

Products from Mentor are produced and sold in sizes of 225cc, 250cc, 275cc, 300cc, categorized by 25cc.

Allergan makes its midrange profile in sizes of 222cc, 253cc, 272cc, 290cc, 322cc, categorized by 20cc.

All are good products but there aren’t enough evidence that prove the products in Brazil, Germany, France are better that US products that are used in Korea.

There are various types of cohesive gel, ie. Sticky silicone gel products, in neighboring countries of Japan, Hong Kong, Singapore and other 7~ countries, however it is sad to know that there are very limited number of products in Korea.

Mentor 275cc round smooth moderate profile put in from the armpit

Today we looked at what a cohesive gel implant is.

Thank you.

Can you see the implant in the x-ray after the breast augmentation? 

There are many of those who ask if one can see the silicone implant through the x-ray after the breast implantation.

The answer to this is, “Yes”. You can also see the saline bag type implant as well.

X-ray is a line that penetrates through the body, and the amount of penetrability determines the shade or shadow that comes out finally as the x-ray film.




Doctors are well aware of how the x-ray penetrates through a normal person’s body.
If there is a substance in the body, the shade looks different therefore, one can know that there is something different than that of a normal body.




But having a silicone implant in the body does not mean that there is something wrong with the body itself.

X-ray specialists receive training on how to look and examine the x-ray of those women’s chest that has implants.



It is very rare that they misjudge heart or lung disease, or trauma such as a break on the one because the implant covers those certain parts.

In case of CT, one discovers the implant coincidently as he/she looks for heart or lung illness, or clinical stage of the lung cancer.



One cannot get detailed information of the implant through the CT.

If you find that there is an implant rupture through the CT, then you would not need to get a MRI.

However, although you get positive result from CT, this does not mean that the implant is at a normal status.

If you want an accurate examination of your implant, MRI is the one that you need to take.





Many women are concerned about implants getting damaged due to the mammogram (i.e. x-ray) pressing against the chest as they get an examination for breast cancer.

The answer to this is that there is no actual problem in this. Such pressure has 0% chance of rupturing the implants. You do not need to worry about this and so you can go on and take the mammogram.

There are those who are concerned about one’s privacy being scrutinized as the implants may show up during the mammogram or ultrasound test.





But this is something that you need to compromise.

The reason is that there is nothing more important than health to any human.
One should not try to hide that there is a substance in the body from a doctor who needs to examine, find, and treat an illness.

If is necessary for you to let the doctor know that you have implants in your breasts whether you are being examined or treated by the doctor.

Also, there are many women who had breast augmentation with implants therefore, it is rather not awkward for the doctors to treat or examine a woman with implants.

This is all for today. Thank you for reading. Have a good night.