Are breast implants safe for flight attendants (cabin crew)?

Somethings about breast augmentation and going on flights

Few years ago there was a very noisy, I do not know if you have seen many of these related articles. (An international flight interviewer touched the interviewee who had a breast augmentation)

Touched flight attendant (cabin crew) applicant’s breasts … Controversy on recruitment

A spokesperson from 000000 Airline stated “We already explained and received an agreement from the applicant for the body inspection. When a flight attendant (cabin crew) with breast implants get on plane, health related problem can be caused due to the low pressure. This is why we touch and feel the breasts.” “Also, our country has religious restriction on as to having tattoo on the body.” (Yunhap News)(Herald Economics)


This was a very ridiculous story. If the news agency accurately translated what the airline spokesperson said, then this is something that should have not happened.
It might have been a different story if they were selecting a pilot for a space ship.

An international flight normally flies at a height of 10,000 ~ 11,000 meters above ground level and the pressurization system within the airplane maintains the pressure that of 3,000 ~4,000 meters above ground. Therefore, the flight attendants would feel the pressure that of Baekdu mountain. It is difficult to understand that a silicone gel implant would collapse at this pressure level. It would be a different story if these flight attendants were in a space station. The offender of this sexual harassment event is giving a real stupid excuse.

There are virtually zero number of patients who worry about implant collapse in the airplane. They are aware that the airplanes have double or even triple layers of security system and the environment in the airline is not that different from that of the ground. Most patients are worried only about going back to their usual lifestyle after the breast augmentation.

-      I am a flight attendant (cabin crew), how many days do I need before getting back to work?







A flight attendant (cabin crew) is an occupation that faces a lot of face to face encounter with the customers therefore, requires high level of labor and also long recovery period.
Many patients go through much concerns after the breast augmentation therefore, they tend to take long vacation days off work. But hard labor occupations such as flight attendant(cabin crew) do not need to take much recovery period. 3 days are enough to get back to work.

But, if you have a double eyelid cosmetic surgery, it would be different. You would not be able to work with swollen eyes. There are many types of eye related cosmetic surgery, but 7 days are enough for recovery.

Also, there are many who are concerned about how to manage the recovery, what happens to the body after the cosmetic surgery, and what they need to do. I would like to introduce an instruction sheet for breast augmentation recovery that we use at our clinic.

 
Things to do on the first day after Breast augmentation surgery

Wake up, have breakfast, and then take the medication for the pain.
Take shower with warm water and also wash your hair.
Try driving, put on the seat belt, and also try closing the car door by yourself. It is important that you try to get back into daily routine and getting used to it. 
Take an afternoon nap if you can. Do not take a long nap but try again to move about your body. The more you move, the better you would feel about your body. If you do not move much, you will not feel good. 
As your day ends, you might feel that your body has swollen, but this is natural.
You might feel pain on the ribs and back. This is caused by the body fluid that is moving circulating. The pain would go away in about a week. 
It is not good to have your shoulders bent. Keep your shoulders straight and move them forwards and backwards. Get your shoulders relaxed. 
If the pain gets worse, take one more pill of the painkiller.

 
Things to do on the first day after the Breast augmentation surgery

You can go back home 2 hours after the breast augmentation. Take a nap for two hours once you get home and move about right away. (Get help from your family members or friends)
Try eating something. You will not feel sick or throw up when you eat 3~4 hours after the surgery. 
If you feel sick, you need to eat and drink better. Take the medication (painkiller) that has been prescribed. 
Exercise by raising your arms above the head. The more you do this, the better you would feel. Try doing house chore such as washing dishes, cooking and cleaning the house.
Attention!! It is better to move about and try to do something rather than just doing nothing after the surgery. (To prevent capsular contracture)
If you feel comfortable in moving your body, take shower, wash your hair, and dry your hair with the dryer. Call your friend and meet him/her outside somewhere, get some food and go shopping.
Lie on your chest for about 15 min before going to bed. Try this every day until you feel comfortable with it. It will be difficult for you when you try getting up from the bed. Turn your body slowly, sit up, and then stand up from the bed. Get up from your bed in this order.
Take medication before going to bed.


Patients of breast augmentation need to know that they need to move about a lot purposely to recover. If you have no problems with the body before and during the breast augmentation then you would be able to do – cleaning, laundry, washing dishes, cooking, driving, shopping, showering, moving things around the house, etc – within 24 hours.

One cannot say that you will not feel any pain. Total of 500 ~ 6000 gram substance has been put into your body just about an hour ago, therefore, if you do not feel any pain, then you are not feeling normal.

However this pain should not keep you away from your daily routine and should not restrict you from economic or daily activities. The more you move, the shorter the recovery period would take, and also lower the possibility of capsular contracture or any other side effects.

This is the overall concept of “breast augmentation 24 hour recovery.”

The 24 hour recovery system of breast augmentation has been introduced by a world renowned John B. Tebbetts from US and our clinic also follows such recent guideline. Putting 피주머니 and wrapping around with bandage, getting painkilling shots, using correction bra, and massaging are all old stories now.

A good breast augmentation would lead to the patient going home 2 hours after the surgery, and having her get back to daily life.

A good breast augmentation does not need any massaging or any activity that leads to pain. The patient does not need to come back to the hospital unless it’s only for a checkup. One does not need any treatment for the wounds as well.


Inflammatory fold method leads to quick recovery, but one can also recover within 24 hours with the axillary crease surgery.
 


-       Can I get on the airplane on the same day of the breast augmentation?

Yes, of course, you can get on the airplane on the same day of the surgery.
The flight attendants (Cabin crew) with the breast augmentation can get back to work within 3 days of the surgery.

If you need to go on the business trip abroad, you can leave on the day of the surgery but should come back to the clinic for a check-up.

There are many who are concerned about the pain. 3~4 pills of the painkillers would be fine for you. The pain would go one for about 7 days but the pain would not restrict you from doing any daily routine activities. If you need to do hard labor work, then schedule it for 7 days after the breast augmentation.

Looking at the status on the same day of the breast augmentation

Today, we looked at the flight attendants (cabin crew) with breast augmentation. The same applies to those who often go on business trips abroad and those patients who come to Korea from abroad by airplanes.

Have a great day and thank you for reading.

How to get a good touch feel after breast augmentation

Many people think that one needs to use soft implant to get a good touch feel after the breast augmentation.

When I talk to patients, I get surprised that there are many patients who say “I want to implant with a good sense of touch.”



First, let’s talk about what is natural touch feeling

A good sense of touch is that the breast with the implant should feel as soft as the original breast.

An original breast of a person is made up of cells that come together to form subcutaneous fatty tissue, muscle tissue, etc, and makes that sense of touch when you touch the breast.

Then, what forms this exact sense of touch?
It is your own skin.




When your own skin fills up the volume of the breast, you will feel the best sense of touch.
But this is like a story from a SF movie.

In reality, you cannot generate skin on the body part that you want like that of a lizard. This is not possible as of now. It might be possible in a hundred years or so.

So we use fat transplantation but the only a certain amount of fat transplanted remain. Most fat are absorbed by the body, therefore there is not much volume effect on the breast.

This is why the doctors have tried numerous substances (including soybean oil) on the breast augmentation.




In the end, only the gel type silicone bag is commercially used today.
It is safe, and not related to cancer or any other illness
It is cheap, does not alter, and is strong. There is nothing like it today.

Also the silicone is closest to our body tissue but does the gel type silicone bag feel the best? It does not.

The liquid type silicone feels the best when used.
Liquid silicone feels softer than the human skin, therefore it was very welcomed when used at first. However, there was no solution when the liquid silicone caused inflammation or necrosis or any other side effects on the body.




The liquid put in through the injection disperses everywhere, so it was difficult to remove the liquid when there was a problem caused.

A close to disaster problems was caused leading to the disappearance of its medical usage.

The cohesive gel that we use today feels much like a rock compared to the liquid silicone.

But there are law restrictions that limit our usage to the cohesive gels and therefore we do not have choices today. Liquid silicone should not be used and the cohesive gel has been chosen for safety issues.

What are the factors that influence the sense of touch in the cohesive gel implants?

1, The thinner the exterior skin is
2, The less amount of gel that the implant has
3, The less dense the gel is
makes the product soft.

If the thinner exterior skin, less amount of gel and less density lead to better sense of touch, why is such implant not manufactured and used?
If you think about it a little, you will know the answer. This definitely has some cons in usage.




1. Thin exterior skin leads to higher possibility of implant damage

This is obvious.
If the exterior skin is thin, it can be damaged as you put it into the body (especially if the inlet is small).

An implant with a thin skin can get scratched when putting into the body, and also the bag can be damaged. This will lead to the leakage of inner substance.

2. An implant is less amount of gel will collapse. It will not have good durability.

Let’s think about a bicycle tire. If the tire is completely filled with air, the tire would not bust. If it is not filled, there might be a lot of substance stuck on the tire fold leading to a damage.



The same applies to the implant as well. If the implant is mot filled properly, the durability gets worse. The implant will be folded inside the body, and the folded part would lead to abrasion and higher possibility of damage. There is a high possibility of rippling as well.

But completely filled implant would not have much fold and the surface would extend fully leading to stronger durability and less possibility of rippling.

3. Less density of gel leads to damage in shape

A human being walks around, and there is gravity pulling us down.
A silicone gel bag type implant needs to stay at a standing position at all times except when we are sleeping. The implant needs to maintain its water drop shape but it if doesn’t, it will not be able to feel up to volume of the upper breast and the volume will be concentrated at the bottom.



This is something that the young patients in their 20~30’s, before pregnancy, do not understand. Mid aged patients understand this concept easily. Losing elasticity on the skin and breast tissue makes the breasts sag. The implants need to maintain the shape and keep the volume on the upper part of the breast in order to make the breasts look young.


But the more important thing is that the commercially used textured and smooth type implants cannot be felt easily (especially when put in under the pectoralis muscle).
All these implants feel alike (because they all are cohesive gel types, not liquid silicone)




I, myself, cannot know if the patient has smooth, textured, or anatomical implant just by touching unless I see the patient’s chart although I work with breast augmentation patients all day and every day.

Then, how can the patients know the difference?
In conclusion, if the implant is located under the pectoralis muscle, one cannot know any difference in touch feel.

The more important facts are that;

First, there should not be any capsular contracture.
Second, when the implant is put in the body, it should co-exist and extent appropriately inside the body to maintain a good sense of touch.
Third, one should not use an implant that is too big.
And, soft feeling augmented breast would lead to sagging of the breast that would cause more dissatisfaction of the patient. Soft implant is not good if you look at it a long term.

Today’s post was on the sense of touch of implant.

Thank you for reading, have a great day.

Incision	Pros	Cons
Inflammatory fold	Most widely applied globally Applicable to any shape of the breasts Least skin damage during the surgery Least possibility of damaging important nerves and blood vessels Same location for reconstruction Applicable to all types of implants Quickest surgery time	Incision on the cosmetic part of the breast
Armpit	Incision is rarely visible Applicable on both above and below the pectoralis muscle Applicable for all types of implants but one needs to know a special know-how for anatomical implant	Directly visible when conducting the breast augmentation Need endoscope in order to see the axillary crease Can damage important nerves and blood vessels Possibility of lymph complication and bands Different incision part for reconstruction
Areola	Good visual for the augmentation Low possibility of damaging important nerves and blood vessels Applicable to all planes Applicable to all types of implants but require a large sized areola for anatomical implant	Very visible spot for the incision Possibility of tissue damage and bleeding exist Can be exposed to bacteria within the breast Not applicable to large sized implant (if areola is small) Difficult to apply if the areola color is dark
Bellybutton	Incision line is far away from the breast No important nerves of blood vessels	Directly visible to the eyes Low accuracy of desquamation, high possibility of tissue damage Only applicable for saline bag type Different incision spot for reconstruction

Size of implants

How should I choose the size of the implants? This is one question that the patients take long time considering when they talk to us.

The fact that saddens me is that it is really difficult to have the patients get away from the thought that a certain cc leads to a certain cup size.

Breast augmentation is to improve the upper body look.
The implant used in the breast augmentation needs to fit the upper body numerically. It is like fitting a dress to the body.

 

Luckily there are many types of implants that fit many different bodies.
The size in "cc" of the volume, is automatically decided as one chooses the implant spec according to the upper body shape.

Then what is an implant spec?



There are 3 types of spec in an implant.

Width
Height
Profile

When you decide on the three specs above, your decision for the implant is made. The volume (cc) is automatically decided after this.

Breast augmentation Korea KIES-U

If you have broad shoulders and long breast diameter, then you would need a wide implant.

If your breasts are small, then you would need implant that is high profile rather than something that is wide.

If you have an upper body that is long or have breasts that are positioned rather low, then you would need long shaped implants.

What if you have breasts that are different in sizes? For example, let’s say that your left nipple sticks out but your right nipple is short. Then you would need to use thick implant for the right breast and thin one for the left breast.

Breast augmentation Korea KIES-U

If your right nipple is faced upwards, and left nipple is aces downwards, you would need to use short height implant on the right, and long height implant on the left.

How about the sagging and less elastic breasts after giving birth or breast feeding? You would need long (height) implants. What if the sagginess of both breasts is different? The breast that sags more would need an implant that has longer height in order to fill up the empty space.

Breast augmentation Korea KIES-U

The fact that surprises me the most whenever I talk to my patients is that my patients do not know what type of problems they have regarding the breasts and they also do not know the characteristics of their breasts.

First step in deciding the type of the implant is to find one that fits the specifics of the patient’s body. Size is decided automatically. You would know that spec and size are different by referring to the image below.

Breast augmentation Korea KIES-U

If the implant is wide and long but has a low profile, the volume can be small. If the width is narrow but is long in height and has a high profile, the volume can be big. There also can be opposite cases.

Such three dimensional aspects of spec need to be combined together in order to find an implant that is most fitting for the upper body. This is the most important point in planning the breast augmentation.

It is important to find an implant with an appropriate spec that fits well with your upper body. The size, volume (cc), is decided after this fitting so you do not need to worry about or remember. (There are patients who do not remember what volume (cc) implant they have used one year after the breast augmentation)

It would be awkward to ask you tailor if you could have a 55 size dress, after the tailor takes measurements of your arm, waist, legs, hip, shoulders and chest.
It is wrong to ask for a certain size volume but right to ask the doctor to choose an implant that is most fitting for you.

Have a great day, thank you very much.

Polytech’s 2 Gel cohesive gel implant – Natural movement that feels the same as the original breasts

Today, I would like to introduce 2 Gel cohesive implant manufactured by Polytech in Germany but is not widely known here in Korea.

This implant is called Diagon gel implant but I would like to keep things simple and call it 2 gel cohesive gel.

The difference between the 2 gel and the conventional cohesive gel is that this product is formed in double layer of soft silicone gel and strong silicone gel.



As you can see in the image above, the back side of the implant is filled with the soft gel and the front side is filled with the hard gel. So we call this implant, 2 gel or Diagon gel sice there are 2 types of gel stuck together.
This 2 gel is Polytech’s independent and unique product.

The reasons why Polytech produced this implant are:
- To make the implant stick more naturally providing better support (compared to conventional one)

- To show natural movement such as the original breasts when the person makes much movement around the breast




As you can see in the image above, the 2 Gel implant has similar outer line formation as the conventional cohesive gel implants (round/water drop type). The only difference is the inside.

The soft gel at the back touches the rib bone softly to form molding. This is why the patient feels that the augmented breast feels much like the original one.

The hard gel at the front makes a projection that helps the nipple to find its position properly and also pushes the breast tissue up (Push up style).

Also, the strong gel helps to find natural movement, reacts slowly, and maintains shape stability (even for those patients who are really thin).



The patient with this 2 Gel implant will feel great sense of ‘wear ability’ and feel that the augmented breasts move naturally.


I am very amazed at Polytech’s developers who put much details into consideration when making this Diagon gel implants.



There are 4 series of products in 2 gel implants. These are oval shape, water drop, round textured, and microthane (polyurethane) coating. These are the core breast implant products that Polytech has.

The surface of these products helps reduce the incidence rate of the capsular contracture and is a technology that is well known of these products.

Diagon gel (2 Gel) implant is certified here in Korea but is not imported easily, so one needs to wait a long time after the order. It takes about 2 to 3 months. Also, the price of these implants are relatively high therefore the augmentation costs about USD 8,000. In Korea, it costs about 9 million won including VAT. This is a disadvantage. But if you are a person who wants more unique and natural differentiation, then this implant is the appropriate one for you.

This is all for today. Have a great day and thank you.