Q&A on breast augmentation | Plastic surgery Korea

Should you use anatomical implant or the round implant?
The answer to this differs from a doctor to a doctor and even the hospitals.
There is no 100% correct answer, so the patients think the implants are chosen based on preference.



I have used anatomical implant for the past 5 years, and used round type and saline type from earlier period. I cannot exactly say that anatomical and the round type lead to differently shaped breasts, but I can say that there is a certain situation when the anatomical type must be used.

This has been agreed by many doctors.



1. When the patient wants a natural look (and if she likes anatomical type a lot)

Dr. Bronze took x-rays of anatomical and round type implants placed above the pectoralis muscle and showed them to many doctors. The doctors who saw the photos could not find any differences between the two.

This means that the doctors cannot distinguish the anatomical implant from round implant. This is the same for me as well. I cannot know whether the patient used anatomical or not even though I conducted the procedure
At times I think that it would be better to use anatomical implants on those patients who have small orginal breasts and used round type implants for breast augmentation. The augmented breasts look unnatural.

Anyways, in most of the time, the patient gets to decide on what type of implant she wants to use. If she prefers to use the anatomical type implant, we do not necessary feel that we try to change her mind.

2. Constricted breasts ; 

I have shared on this in the past. Constricted breasts are usually when the area from the nipple to the bottom of the breast is very tightly close together.
In order to put volume onto such breasts, there must be much tension on the bottom part so that the skin in that area can stretch out easily. For this to happen, anatomical implant would be useful.


You can refer to more information on this by clicking on the link below.
http://drleebreast.blogspot.kr/2016/11/breast-augmentation-for-constricted.html

3. Thorax hypoplasty

If there is no proper or clear ratio of the upper body, and if your original breasts are not shaped right, anatomical implants would be recommended.
If you have a Poland syndrome where one side of the thorax looks lower than the other, anatomical implant with larger size can be inserted to the lower side.

4. Breast ptosis or sagging

In case of sagging of the mammary glands, what is the best implant to use when wanting to avoid Mastopexy (lifting)? An implant with stability would be good. An implant that does not collapse and maintain its form would lead to high level of satisfaction. Anatomical is more stable compared to round type, so there are many who prefer the anatomical implant. Also, if we select tall anatomical implant, it would help add more volume on the upper breast as well.



Current trend is that there is no one appropriate implant for all causes. Different implants are used for different situations. Therefore, it is wrong to say that anatomical implant is good for everything. But I have shared cases where anatomical could be more effective in usage.

Thank you for reading and have a great day.

Breast augmentation methods

Everyone dislikes scars. Many patients expect small incision but large implants for breast augmentation.


But logically, you would need a large incision spot to insert large implant. We need to have an incision spot of 4cm to insert most widely used implant size of 280~290cc.

If you are to use low to mid 300cc implant, the incision spot needs to be about 4.5~5.5cm long.



There was a patient who really could not stand any scar on her body. As her request, I made an incision about 3.5cm long to insert 300cc implant on the axillary fold.

I completed the operation but the scar was large enough to be noticed so I doubted if small incision was really beneficial or not.



If the incision is small, it gets in the way of the equipment used during the operation. Therefore, the equipment will keep on touching the skin leading to more traumas on the skin.

When we design the axillary fold incision, we tend to start at the deepest spot in the armpit. When we look at that area again after the recovery, the skin in that particular area is different from the other parts and therefore, more visible to the eyes.

The better solution would be to make the incision larger so that the equipments used such as endoscope, retractor, gauze can move about without hurting the incision spot. Also this large incision line would look more naturally like the original axillary fold therefore it would be less visible to the eyes.



This is what operation is all about. You do not need to make it big with necessary changes, but also you do not need to put much effort in minimizing the incision to make the patient feel more comfortable which could lead to worse outcome that you did not prepare for....


Let’s say that you built a building. You might think that the construction building is not too big so you don’t need to use a large safety shade and minimize the number of danger signs used. The construction could take a shorter time than average projects. But this is a dangerous thought. There are safety issues also with small construction projects.



No matter how minor the operation is, we need to carefully check on all the safety measures and equip all the safety related equipments before conducting the surgery. We should not try to minimize anything, including the incision length.

There is a pre-axillary line on your body. We start from behind the pre-axillary line and move to a deep spot found when you lift up your arm. You can find a spot where there are wrinkles and straight line. This is the incision spot.

Today, we shared on the spot and length of the incision area.
Thank you for reading.

Q&A on breast augmentation

I went to an event a couple of days ago and did a Q&A session. One question stood out to me the most.

Actually, there are a few patients who question this.

The question was this. My husband really opposes the idea of me getting a breast augmentation. Can I say that my breasts became larger because I got them treated in eastern medicine clinic, or got filler or gained weight? Can I avoid any troubles with my husband by telling him this?



The answer from me is that “it is difficult” to do so.

If your husband does not notice that you got a breast augmentation, then it means that there is no wanted outcome. There is no patient who will be satisfied with breast augmentation if one cannot notice it.

Breast augmentation requires inserting implants according to different cup sizes to make a change in the body therefore if the husband cannot notice it, it means that there isn’t any change in the body of the patient.



There are some who want to make the breasts larger but so that someone touching it feels natural.

You can make the breasts feel natural but it is difficult to make your husband not notice it. (Unless you don’t have a relationship with your husband)

Most of the patients share that they want a breast augmentation before the operation but do not share what they feel (worried about the complications) after the operation. They just say that they are highly satisfied.

There are some who want to keep it a secret from their parents.

This applies when the parents object the breast augmentation, but usually, it is not the mother that objects. The mothers understand their daughter’s complex with the breast size and can sympathize with the daughter.



But, the fathers do not. Do you want to work in a liquor store with big breasts? Why do you want to change the body that your parents gave to you? Such are the reactions from the fathers.

Fathers do not understand the complexes that the daughters have (because they have not experienced it)

Someone asked me if I would be OK with my daughter getting a breast augmentation. In truth, I know the danger with the operation procedure, anesthesia, etc so it is not easy for me to say “yes” right away.

But if I was not a doctor, I would be more careful in answering the question (Also, I do not have a daughter)

Then, how about my wife? I would think much more on this. But I think I would say yes if she really wants to get a breast augmentation.
I would conduct the breast augmentation on my wife, but I don’t think I can do it on my daughter.



There are patients who worry that their family members could notice during the recovery due to the inconvenience and pain that the patients would suffer from.

The time for recovery and pain differs a lot from one person to another. I have stated this in the past but I would like to share it again. You need to select small sized implants to have less tension and pressure that will lead to no pain and quick recovery. In such case, your family members would not notice easily. Also, your skin cannot be too tight.. Theses are the important factors.

Today, I answered a question on “will my family not notice my breast augmentation?”

Thank you for reading. Have a great day.

Things to consider before breast augmentation 

When I look at both online and offline information on a surgery, there are numerous amount of explanations on surgeries.



xx method,  @@ technique, OO breast augmentation; such labels are put on the information to look differentiated and advanced so that all these can lead to good outcome. This makes the patients think that only one particular method is the correct one. I am concerned about this thought.

A human body is very complicated. A thousand or even 10 thousand people are each individually different. Some people have different bone structure, some have different amount of tissue cells, some have a lot more fat, and some have a lot more muscle...... Such differences are really diverse and at the same time, what each person requires in an operation is different as well.

Therefore, it is wrong to think that one particular technique or method can provide the best result possible at all time.

Surgical technique, methods and equipment used are something that one should not explain that these are better than others and promote. There are better methods that are appropriate to the patient’s body and her wants.

This applies to implants as well. Can you say that OO implant is better than @@ implant? No, absolutely not. Implant is a product but the surgery is not. Implant is manufactured in some plant to shape a human body.

We need to choose the right product for the patient and also contemplate whether it was the best one for the patient after the surgery. All products today have their advantages and disadvantages.

Which product with what label is the best one? This type of question is same as asking which of the two, iphone or Galaxy is better. There is no meaning to asking such a question.

Then, what is really important? Let’s share a few.

- What is the expected improvement resulting in the surgery by the patient? i.e. Clarifying the target of the operation
- How is the status of the patient’s body and original breasts before the operation? i.e. Accurate assessment of preoperative condition
- Selecting the most appropriate method according to the patient’s status, i.e Optimal choice of the technic of the operation
- Communicate so that the patient understands the whole situation, i.e. Appropriate communication between the surgeon and patients

These factors are important for the success of the operation.

Clarifying the goal of the operation, analyzing the patient body and status, planning the overall procedure properly and having enough conversation with the patient should be the priority.
OO method. @@ technique.  XX implant. These are not the core important factors, they are sub ones.

In order to derive successful surgery results, it is important to spend your time mostly on analyzing patient status and the target of the operation. There are things that you gain from the operation but there are also some that you lose out. If you want to achieve satisfaction in volume, there is a problem with the implant being exposed and looking unnatural. Such should be the considering point when selecting the size of the implant.

Also, the patient must be educated on the problems that may arise from a particular surgery so that she is emotionally secured after the procedure. There is no one method that is completely advantageous. If there was, all the surgeons would be applying that technique. (In reality, there are lots of techniques applied...)

Therefore, the surgeon needs to be comfortable with various methods that can be applied to different patient status and objectives. A good doctor would be the one who applies the most appropriate method for the patient. The doctor should not recommend and apply self developed method that could or could not be appropriate for the patient. This is not a good doctor.

Today, we shared about the important factors such as communication and planning in breast augmentation.

Thank you for reading and have a good day.

Solution to problems, accidents, complications, and aftereffect caused after plastic surgery | Knowledge on plastic surgery

There are times when the patients are not happy with what results in after the plastic surgery.



There are several reasons to this. The patient might not have had enough information on the surgery, too much advertising / promotion has blind-sided the patient, maybe the clinic or the surgeon was not skilled enough. Also, I think that there was not enough communication between the patient and the surgeon that could have led to the outcome.

In the neighboring country of China, there are cases where the patients physically abuse the doctors because of the negative outcome. Is there no solution to the dissatisfaction caused on the patients? I would like to share about this today.

First, I would like to look into a situation that is normal.

1. At first, the patient notices a problem in her body and wants it to be taken of. She starts to search for hospitals/clinics that can provide a treatment for her problem.

2. The patient visits the appropriate institute, meets the doctor and talks about related topics. She also gets information on the problem that she has and aftereffects of the plastic surgery. Then we would contemplate with all these information and decide on the surgery.

3. The patient shares everything that she feels such as physical problem, inconvenience caused after the surgery to the doctor. If these problems are minor, the doctor will monitor the situation. If the problems are severe, recorrection could be considered.

4. Long term monitoring is necessary after the surgery. The monitoring on the patient status, examination of x-rays, photos are conducted for minimum of 1 year. The patient and the doctor communicate on the changes that took places and other problems that arose after the surgery.

There is a reasons why I mentioned the term “normal case” above

In reality, the activities mentioned above are not followed. There are many, many cases where something abnormal happens. Let’s talk about these.

1. Cosmetic surgery could be perceived in both medical and business aspect. There is much capital involved with it. What I mean to say it that...

Medical actions are undertaken in order to protect the health of our people and this is why the government has great interest in it. There is a National Health Insurance, where all the Korean people are registered into. Also, this National Health Insurance is applicable to all the hospitals / clinics at our country. But cosmetic surgery cannot be covered by this insurance. It is not related with the health of our people.

Then, is cosmetic surgery absolutely not related to medical treatment? (Is it same as going to a parlor and getting your hair dyed?) We cannot say that it is because we use a knife for cosmetic surgery.

The government needs to intervene so that the cosmetic surgery is not done only for business purposes. It needs to check if unqualified doctor is putting a knife onto the body, if inexperienced doctors spending much money are advertising heavily, if there are many incidences of complications or not. Someone needs to monitor and overlook these activities.

Surprisingly, there is no entity that does this in Korea. The patients are exposed to these much invested advertising by the hospitals and leads to encountering the medical entities without any subjective reasonings. This first encounter is important because the patients could make a decision with false or wrong information. She would not be able to understand and accept what happens after the surgery and could lead to much conflict with the medical institute.

2. Although this might happen, there can be a way out of it. The patient needs to meet the doctor no matter if she got false or wrong information from both on and off line. Therefore, she has a chance to talk with the doctor appropriately.

This is why I think that the conversation between the patient and the doctor is the last bastion. This is the final chance that a doctor can meet and explain to the patient, the circumstances of putting a knife onto the body and correcting the false information that the patient has.

But, there are times that such an opportunity goes to waste.

The patients register into large hospitals that do heavy advertising, get counselling from 2-~30 hospitals to gather information. They also compared the specs of these hospitals.

Medical treatment is a connection of one person to another, to find out what problems can be treated and if there are any aftereffects in the process but this concept has been long been changed to a product that patients shop for.
How much do you think that such a patient, who tours around different hospitals and makes a choice, can trust the surgeon?
If you are going shopping to a Walmart, you can pick up an item and throw it away or not buy it the next time if you do not like it. But you cannot throw away your body and buy a new one. This is the biggest difference and the biggest problem.

3. Now, the patient pays her bills and completes the surgery in the hospital
This is the point where the problems begin.
As the swelling goes away, the patient should be confident about her looks, show off her looks, have no problems with the surgery and have her body as perfect as she saw in the advertising.

This does not happen in reality.

No matter how interested or caring the doctor is, if the patient does not listen to the doctor or even remember what the doctor said due to the much and mixed information that she got from the different hospitals, the doctor and the patient would not be able to communicate with one another on the expected problems that arise after the surgery.

4. Whether it is minor or not, there is always a problem with plastic surgery. As long as a person has a greed to look better, the dissatisfaction rate cannot be 0%.

Generally the complications should not be looked at with the patient’s subjective eyes but with objective sense and see how dissatisfied the patient is.
There are many cases where the patient is not satisfied with the size of the breasts after the breast augmentation although the size of the implant had been decided together prior to the augmentation.
Then, now the priority is for the patient to spend much time with the doctor and share all the dissatisfying points that she has. The information related with this surgery and dissatisfaction can only be collected from the doctor.

The more complain the patient has, such conversation between the doctor and the patient would be difficult. The patient has much expectation before the surgery and if this expectation is not fulfilled, she would be very resistant to the hospital personnel and the doctor would defend his/herself by saying that “this problem could not be avoided”.
If there is no proper conversation, then there would be many conflicts. There are organizations for solving such conflicts, but these does not help that much.
The legal confrontation or conflicts between the hospital and the patient takes much tiring time. This also shows that our medical system does not have developed policy.

5. The biggest problem with the cosmetic surgery is that this is no warranty, ie. No insurance coverage for it if there are any problems.

A problem would lead to legal confrontations, and whether this is solved or not, there would be much money involved with it. In most cases, the patients already have spent much money on the surgery therefore they do not have money to spend elsewhere.
Such reasons make the patients react physically on the hospital and the doctor.

This could be an unnecessary comment, but I think that the government needs to step up in such situations.
Whatever the percentage is, whether it is 1% or 0.5% or 2%, the patient should be able to collect some amount of the related cost from the patient or the hospital. This collected money should be spent on the problems that may arise after the surgery. (This is just my own wish....)

All policies or laws are unnecessary if the doctor and the patient cannot come to an agreement. If things do not work out, then we should complain about the law.

But if you talk to the surgeon properly before a surgery and expressed all your feelings, then do you think it would be difficult to talk about the problems that arise after the surgery?

You should have realistic wants
You should open up and have a structural talk with the doctor
You need to have an objective understanding of the surgery
You need to continue to talk with the doctor after the surgery

I think these are more important than any other policies or regulations.

This thought came up to my mind when I read thousands of words on medical conflicts stated on Consumer Protection Board homepage.

This is all for today. Thank you.