Why is 24 hour recovery important?

My patients tell me that they come to me because of the quick recovery from the breast augmentation.
Today, let’s look at why quick recovery time is important and how this can be achieved.

Here is the summary of 24 hour recovery system so that you can understand it easily.




Whatever surgery it is, a good surgery is one that least bothers your daily routine. This applies especially well for the cosmetic surgery more so than other health or physical function related surgeries.

The discomfort and pain from the surgery should be minimized and the social or economic activities of the person should not be restricted.

A surgery that does not penetrate important parts of the body and that ends quickly so that the patient can get back to daily life quickly leads to less possibility of complications also. If the night is long, then you will dream more. If the surgery takes long time and is very complicated, there is much possibility of increasing problems.



A world renowned breast augmentation specialist, Dr. John B. Tebbetts from Dallas, US, first introduced up with the 24 hour recovery system.

24 recovery needs careful analysis of the surgery, clear understanding of the patients, good preparation of the anesthesia and the surgery, and well prepared manpower that helps coordinate the surgery properly from the start to finish without any hesitation.


 
In order for 24 hour recovery to be successful,

Accurate planning before the surgery is very important
Everything needs to be decided in the first meeting with the patient.
What type of implant to use?
Is the size appropriate, what spec or profile to use?
How the symmetry should be controlled,
What is the problem that needs to be solved foremost?
Where to approach for the incision?
If the wrong decision is made in any of the question above, the surgery will be complicated and the recovery would be painful and slow to the patient. There would be higher possibility of side effects as well.



It is better to choose the inframammary fold approach for 24 hour recovery. This applies more so if the anatomical implant is used.
The inframammary fold approach leads to accurate and no fault surgery.
In oppose to this, if the approach is made far away from the breast, the surgery becomes more complicating, longer and the number of variable for the surgery increases. There would be more pain and the recovery takes longer than 24 hours.
I approach from the armpit often, and there is higher possibility of fault with this approach than the inframammary fold approach.
There is no one who wants to take risk on the surgical bed. Accuracy and certainty are very important in a surgery therefore there are many doctors around the world who choose and apply the inframammary fold approach.



A doctor’s technique is important for the 24 hour recovery. The doctor should not give any trauma to the patient and have the skills to perform the surgery quickly and accurately. The procedure should be conducted according to the surgery plan and should not be influenced by any variables caused during the course of the surgery. In fact, this is what determines the result of the surgery.

Also, other surrounding variables such as the surgery environment, tools and devices, endoscope, anesthesia and the experienced nursing staff are all important for the 24 hour recovery

There are many who are misunderstood about the 24 hour recovery system.
A quick surgery and recovery are necessary to result in a beautiful looking breast with no complications.

Quick recovery is not the ultimate goal. Quick recovery is necessary for the good outcome of beautiful looking breasts. Quick recovery means that the surgery was done without any problems or hesitations. This leads to less side effects as well.

Today’s post was for those who perceive that the breast augmentation is something that is scary and painful. The recent advances in the breast augmentation is the 24 hour recovery system.

Thank you for reading. Have a great day.

Q) I have heard that if I get dual plane breast augmentation, my breasts would end up looking anatomical so I do not need to use the anatomical implants. Is this true?

There are growing number of people who ask me the question stated above. I do not know what to do if I get asked such question, but there is the answer first. Dual plane and anatomical implant breast augmentation are completely different concepts. This is similar to saying that you can taste watermelon when you are actually eating round shaped pumpkin.



Dual plane refers to the depth of the implant put in, i.e. the location that the implant is put in to.
Anatomical implant breast augmentation refers to the anatomical implant that is used for the augmentation.

These two cannot be the same. They have different objectives and purposes.






Dual plane is applied in order to reduce the side effects and improve on the disadvantages, and anatomical implant is used for cosmetic reasons.




Today, we looked at the two concepts of dual plane and anatomical implant breast augmentation and how they are different. There are many deceiving information in breast cosmetic surgeries.

 Thank you for reading. Thanks.

Choosing the right size anatomical implant for breast augmentation

This is another frequently asked question. Today, I would like to post an answer on “How to choose the appropriate size of implant when getting a breast augmentation?”











I think that you would be able to catch the point after seeing the image above.
You might also wonder how a large sized anatomical implant is put into a body of a patient who is very thin.

What happens when an implant that is larger in width compared to the breast diameter is used? If you have a narrow thorax, you might be able to feel the implant from the outside. If you are one with funnel chest, the implants on both sides might come and stick together in the middle. This is a high possibility for skinny and thin patients.

If you have more flesh, your skin would be thick, therefore you might not feel the implant although it is larger than the diameter size of your breast. However, in such case, the implant inside your breast might be folded or squashed.

Implant being squashed means that the outer layers are folded. This would lead to implant collapse.

This is why I mentioned an example of parking spot earlier. A car is limited in terms of width, but not in height or length.






The image below shows a very thin woman with 320cc cohesive gel anatomical implant.
Being skinny is one problem, but having a tight skin is another factor that makes it difficult to use large sized implant. A round type implant at about 320cc would need a diameter that is longer than 12.5cm. But an anatomical implant that is long and thick, for example, Optimom from Polytech, a company in Germany, has 320cc in diameter of 11cm.






The patient is very thin, therefore, the breast does not look big although a 320cc implant has been used. This is breast augmentation. For some patients, 200cc might be large enough. For others, 400cc might be small.

But in order for an implant to be put into the pocket size, it is more advantageous to use an anatomical implant that is designed 3 dimensionally and has more variety of choices. It is also better in using a large volume implant.

Today, we looked at the factors in deciding the anatomical implant size for breast augmentation. Have a nice weekend.

Thank you very much.

Q. Is it alright to have sedation or intercostal nerve block (ICNB) for breast surgery? (Anesthesia methods for breast surgery)

A. Yes it is. But the most secure anesthesia is the general anesthesia.



General anesthesia that we talk about in breast surgery mostly refers to inhalational anesthesia.
General anesthesia means intravenous anesthesia and,
ICNB refers to block anesthesia.

If we divide the anesthesia methods into two;

 - General anesthesia; no pain or irritation on the body
 (Anesthesia can be administered through inhalation and intravenous) 
 One loses conscious and goes blurry in this case.



 - Topical anesthesia; No pain or irritation on a particular part of your body
 (Anesthesia can be administered through topical infiltration method and blocking method)
One is conscious in this case.

We can apply any of the methods mentioned above for breast surgeries.
But the most common one is the inhalation, i.e. general anesthesia.
It is because the patient does not feel any pain, therefore the surgery procedure is secure and convenient as there is less reaction from the thorax or muscle when operating.

The sedation that we normally talk about (intravenous anesthesia), is done through propofol. The level of conscious is rather less secure compared to the inhalation types therefore, the body might move during the operation.

 
If the body moves and if the muscles contracts often, the surgery becomes difficult therefore leading to more usage of propofol. Too much usage can lead to the buildup of the anesthesia inside the blood and cause the respiratory center of the central nervous system to lose any senses, resulting in death or brain-death.

Blocking anesthesia such as ICNB cannot be used as a topical one without the drug that reacts on the central nervous system. The drug from sedation is put in with the blocking anesthesia simultaneously.




ICNB cannot be 100% reliable that it will work until the very end of the surgery therefore, one needs to add propofol or midazolam that may lead to similar outcome.



If inhalation anesthesia is used, one does not need to additionally use propofol or midazolam what remains in the body for a long time. Also, although the patient is in a deep physical decline, she will breathe through the respiratory tube therefore, she has the lowest possibility of suffering medical accidents such as death or brain-death.


Everybody wants to ‘wake up and feel nothing’ after a surgery.
When this is achieved, one can say that the most successful anesthesia / surgery has been completed.

But in order to achieve this ‘wake up and feel nothing’, one should not promote or advertise that the anesthesia is simple.

Simple anesthesia leads to more accidents in reality.

There was a known story about a middle school girl who suffered brain-death after the eye and nose cosmetic surgery. After this event, the number of advertisement about the sedation used for breast augmentation has been reduced. Breast surgery with general anesthesia and inhalation anesthesia leads to quick surgery time, and most comfortable state for the patient after the surgery to get back to her daily life.

Has this content helped you out? Thank you. Have a great day.

Breast Implant Size to Achieve Medium C Cup?

Today, I would like to talk about the one question that most of my patients ask. In simple words, the question is,
"Can I have a C cup breast (or a full B cup)?”
 
Two problems arise if a very thin, weak lady with narrow shoulders us large sized implants for breast augmentation. The first problem is that one can feel the edge of the implant when you touch the breast. Another is that you can make out the shape of the implant.

We call this first side effect, palpability (it is also related to refilling), and the second is called upper fullness.

Anatomical implant was developed for the safety and the secureness of the implant, and not to solve the upper fullness problem. However, the patients in our country who have very thin body but want large breasts use this anatomical implants and also avoid the problem of upper fullness.

There are many who say that one’s bust need to look good. There is a Y line that connects the collarbone and the midpoint of the breasts.

Y-line that shows the breast line

This Y-line is formed better with the help and secureness of the anatomical implant as well.
If you wear a short top or swimsuit, and draw a line that connects the collarbones to the nipples, this connected line would represent a meaningful purpose of breast augmentation. This line would determine how one looks good when wearing a particular clothes and also show where the breast starts.

If the breast is large and round, similarly shapes like a bowl, then there would not be a smooth line but a line that projects out. This line has to be smooth and natural to make the breasts look glamorous.



This is a popular model, Keeley Hazell from Britain. Where does her breast start? The line from her collarbone to the nipple looks astonishing and makes her body look captivating.


 

The width of the implant should not be larger than the width of the breast
The height of the implant can be extended in order to make the volume greater (although the width is small)

If you want to make your breasts look more beautiful and fitting with any type of clothes that you wear, then those in Far East who have narrow shoulders and narrow width breasts should use the anatomical implants that are long in height.
Let’s look at one anatomical implant, Optimam from Polytech, Germany, and compare it with others.
If the width (W) of the breast is measured at about 11cm, then the width of the implant should not exceed 11 cm.
Here are the implants with width of 11 cm.

Mentor Round	W 10.9cm	225cc
Natrelle Round	W 11 cm	222cc
Polytech Round	W 11 cm	255cc
Natrelle Anatomical FM	H 11.5  W 11	235cc
Polytech Anatomical (Round)	W 11 cm	220cc
Polytech Anatomical  (Oval)	H 12.8 W 11	260cc

As you can see above, a round type implant would have a volume of 225cc, but if you choose a oval type anatomical implant, then you would have an implant with a volume of 260cc.
Let’s look at implants with width (W) of 12cm.

Mentor Round	W 12 cm	300cc
Natrelle Round	W 12 cm	290cc
Polytech Round	W 12 cm	320cc
Natrelle Anatomical FM	H 12.5 W 12	310cc
Polytech Anatomical (Round)	W 12 cm	280cc
Polytech Anatomical  (Oval)	H 13.9 W 12	330cc

The same applies for this case as well. The implant with 290cc could be replaced with one that has the volume of 330cc. This is an advantage of oval shaped anatomical implants.

Of course, one cannot just measure the width in order to determine what size implant to use. We need to consider skin elasticity, pinch test, etc and there are also many with asymmetrical breasts therefore we need to use the sizer during the procedure.

However, it is a good thing that one can have a wide variety of implants to choose from in order to achieve that C-cup goal.
 

Before and after Breast augmentation

About 5 years ago here in Korea, it was difficult to find other types of implants, other than the saline bag type. But now, there are wide variety of implants available, and there would be even more variety to choose from in the future.
But, if there are too many choices, it becomes difficult to choose one.
If you have read all the articles in this blog, then you have been open to the most updated news in the industry, therefore you can say that you are aware about the most recent information.

This is all for today. Thank you very much.