• Archives of Plastic Surgery
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• v.32 no.6
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• pp.767-769
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• 2005

Late capsular hematoma is one of the rare complication of augmentation mammoplasty. Although the cause has not unfolded yet, the possible damage of capsular vessels chafed against the textured prostheses is questioned. Reviewing the literatures, we present a 23-year-old female subjects to incidental swelling of the right breast a year later after augmentation mammaplasty with saline-filled textured prostheses. An MRI study confirmed intracapsular fluid collection sparing the prostheses. The exploration was followed and serosanguinous fluids was drained out of the intracapsular space, and then the existing prostheses were replaced with the smooth surface ones. In the 9 months since the last surgery the patient remained well without any further problem. Intensive massage of the breasts might be accounted to the probable cause of late hematoma in this case.

• Archives of Plastic Surgery
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• v.41 no.5
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• pp.458-465
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• 2014

The axillary technique is the most popular approach to breast augmentation among Korean women. Transaxillary breast augmentation is now conducted with sharp electrocautery dissection under direct endoscopic vision throughout the entire process. The aims of this method are clear: both a bloodless pocket and a sharp non-traumatic dissection. Round textured or anatomical cohesive gel implants have been used to make predictable welldefined inframammary creases because textured surface implants demonstrated a better stability attributable to tissue adherence compared with smooth surface implants. The axillary endoscopic technique has greatly evolved, and now the surgical results are comparable to those with the inframammary approach. The author feels that this technique is an excellent choice for young patients with an indistinct or absent inframammary fold, who do not want a scar in the aesthetic unit of their chest.

• Archives of Plastic Surgery
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• v.38 no.3
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• pp.323-325
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• 2011

Purpose: Breast implant ruptures and displacement are problematic complications after augmentation mammoplasty. The authors report a patient whose cohesive silicone gel implant ruptured and migrated into the pleural cavity after augmentation mammoplasty. Methods: A 23-year-old female had received augmentation mammoplasty at a local clinic a week before visiting our hospital. When the patient's doctor performed a breast massage on the sixth postoperative day, the left breast became flattened. The doctor suspected a breast implant rupture and performed revision surgery. The implant, however, was not found in the submuscular pocket and no definite chest wall defect was found in the operative field. The doctor suspected implant migration into the pleural cavity, and after inserting a new breast implant, the doctor referred the patient to our hospital for further evaluation. The patient's vital signs were stable and she showed no specific symptoms except mild, intermittent pain in the left chest. A CT scan revealed the ruptured implant in the left pleural cavity and passive atelectasis. Results: The intrapleurally migrated ruptured implant was removed by video-assisted thoracic surgery (VATS). There were no adhesions but there was mild inflammation of the pleura. No definite laceration of the pleura was found. The patient was discharged on the first day after the operation without any complications. Conclusion: Surgeons should be aware that breast implants can rupture anytime and the injury to the chest wall, which may displace the breast implant into the pleural cavity, can happen during submuscular pocket dissection and implant insertion.

• Journal of the Korean Society of Clothing and Textiles
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• v.42 no.5
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• pp.737-752
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• 2018

The frequency of breast augmentation surgery continues to increase annually; however, the method of follow-up care varies from hospital to hospital. In particular, many different types of post-operative bras are available in the market. This study evaluated the wearing comfort of various commercial bras that were worn immediately after breast enlargement surgery prior to the manufacture of the bra. According to interviews of medical professionals and market research, five types of brassiere were selected and evaluated by wearing satisfaction, functional performance, and an external appearance test for 6 subjects with breast augmentation surgery. The evaluation questionnaires were based on a 5 point Likert scale with data analyzed using SPSS 20.0. The study results revealed that the bra with the highest degree of satisfaction was CNB (without bra cup) type. However, the use of CNB type showed dissatisfaction in functional evaluation questions regarding breast shaking and material & tactile sensation. In the future, it is necessary to develop a new post-operative brassiere based on a CNB type bra that showed the best evaluation. However, it is also necessary to identify the merits of the other four experimental bras and reflect these advantages.

• Archives of Plastic Surgery
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• v.42 no.3
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• pp.302-308
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• 2015

Background In the literature on nipple-sparing mastectomy (NSM) with one-stage immediate implant reconstruction, contralateral symmetrisation has drawn little attention, with many surgeons still performing standard cosmetic mammaplasty procedures. However, standard implant-based mammaplasty usually does not result in proper symmetry with the mastectomy side, especially regarding breast projection, overall shape, and volume distribution. Methods We retrospectively reviewed 19 consecutive patients undergoing unilateral NSM with immediate prosthetic reconstruction and contralateral simultaneous symmetrisation by using the tailored reduction/augmentation mammaplasty technique between June 2012 and August 2013. Results The average follow-up time was 13 months (range, 10-24 months). No major complications, such as infection, haematoma, and nipple-areola complex necrosis, were experienced. Conclusions Our experience suggests that simultaneous contralateral symmetrisation with tailored reduction/augmentation mammaplasty after unilateral immediate implant reconstruction after NSM facilitates durable and pleasant symmetric outcomes.

• The Journal of Korean Obstetrics and Gynecology
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• v.30 no.2
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• pp.133-143
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• 2017

Objectives: The purpose of this study was to evaluate the effect of combined treatment of needle-embedding therapy and acupuncture for breast augmentation. Methods: 136 patients had needle-embedding therapy and acupuncture combined treatments for breast augmentation. The treatments was performed once a week for 10 weeks. We measured bust circumference, underbust circumference, bust circumference and underbust circumference difference, treatments either before or after. Results: The mean of bust circumference was $77.75{\pm}4.93cm$ before the procedure and $80.25{\pm}5.01cm$ after the procedure, $2.50{\pm}1.95cm$ significantly increased. The mean of underbust circumference was $70.01{\pm}3.99cm$ before the procedure and $70.49{\pm}4.08cm$ after the procedure, $0.48{\pm}1.48cm$ significantly increased. the mean of bust circumference and underbust circumference difference was $7.74{\pm}2.24cm$ before the procedure and $9.76{\pm}2.55cm$ after the procedure, $2.01{\pm}1.72cm$ significantly increased. Conclusions: The combined treatment comprising needle-embedding therapy and acupuncture had a significant effect with regard to breast augmentation.

• Archives of Plastic Surgery
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• v.34 no.1
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• pp.93-98
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• 2007

Purpose: Many options are available for the incision and pocket selection in breast augmentation. Each method has its advantages and disadvantages. To leave an invisible operation scar and to achieve easier pocket dissection by the central location of the incision on the breast, we made a transareolar-perinipple incision. To overcome the disadvantages of the transareolar incision, originally advocated by Pitanguy in 1973, we modified the direction of incision line and dissection plane. Methods: To avoid the injury of 4th intercostal nerve responsible for nipple sensation, we made perinipple incision on the medial side of the nipple instead of trans-nipple incision and made the transareolar incision as 11-5 o'clock on the left side and 1-7 o'clock on the right side instead of 3-9 o'clock on both sides. To avoid the possible infection and breast feeding problem caused by the injury to the lactiferous duct, and the possible implant hernia caused by the incisions lying on a same plane of pocket dissection, we made a subcutaneous dissection just above the breast tissue medially down to the bottom of breast tissue and made a subglandular or subfascial pocket, which may avoid the injury of lactiferous duct and create different planes for skin incision and pocket dissection. Other advantages of the transareolar-perinipple incision include easier pocket dissection, less chance of hematoma, and as a result less postoperative pain because of the central location of the approach which allow finger dissection and meticulous bleeding control with direct vision, without any specialized instrument such as an endoscope or long mammary dissectors. As for pocket selection, we made dual pockets. We prefer subglandular or subfascial pocket. Also, we made a subpectoral pocket in the upper 1/4 of the pocket to add more volume on the upper part of the augmented breast, which can make aesthetically more desirable breasts in thin Asian women with small breasts. Possible disadvantages of our method are subclinical infection and scar widening, which could be overcome by meticulous operation techniques, antibiotic therapy, and intradermal tattooing. Results: From September, 2003 to August, 2005, 12 patients underwent breast augmentation using round smooth surface saline implants by our method. During the mean follow-up period of 13 months, there were no complications such as infection, hematoma, capsular contracture, and sensory change of nipple, and results were satisfactory. Conclusion: We suggest breast augmentation via transareolar-perinipple incision and dual pockets(subpectoral-subglandular or subfascial) as a valuable method in thin oriental women with small breasts.

• Archives of Plastic Surgery
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• v.46 no.1
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• pp.7-15
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• 2019

Breast animation deformity (BAD) has been reported to occur after submuscular implant placement following breast augmentation and immediate breast reconstruction. Despite its apparent impact on patients' quality of life, BAD has only recently become a topic of general concern. Its incidence and etiology have yet to be established. The aim of this systematic review was to identify papers that clearly defined and classified BAD and described how the degree of animation was assessed. We performed a search in PubMed and Embase. Studies meeting the inclusion criteria that described BAD after implant-based breast augmentation or immediate breast reconstruction were included. After screening 866 publications, four studies were included: three describing BAD after breast augmentation and one describing BAD after immediate breast reconstruction. The median percentage of patients with some degree of BAD was 58%. The highest percentages were found in patients operated on using the Regnault technique or the dual-plane technique (73%-78%). The lowest percentages were found following the dual-plane muscle-splitting technique (30%) and the triple-plane technique (33%). We found no studies meeting the inclusion criteria that analyzed BAD after prepectoral implant placement. This review of the current literature suggests that the degree of BAD is proportional to the degree of muscle involvement. Evidence is scarce, and the phenomenon seems to be underreported. Future comparative studies are warranted.

• Archives of Plastic Surgery
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• v.45 no.2
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• pp.196-203
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• 2018

• Archives of Plastic Surgery
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• v.42 no.1
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• pp.4-10
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• 2015

Mammary implants marketed by Poly Implant Proth$\grave{e}$se (PIP) were found to contain industrial grade silicone and this caused heightened anxiety and extensive publicity regarding their safety in humans. These implants were used in a large number of patients worldwide for augmentation or breast reconstruction. We reviewed articles identified by searches of Medline, PubMed, Embase, and Google Scholar databases up to May 2014 using the terms: "PIP", "Poly Implant Proth$\grave{e}$se", "breast implants" and "augmentation mammoplasty" "siloxanes" or "silicone". In addition the websites of regulating bodies in Europe, USA, and Australia were searched for reports related to PIP mammary implants. PIP mammary implants are more likely to rupture than other implants and can cause adverse effects in the short to the medium term related to the symptoms of rupture such as pain, lumps in the breast and axilla and anxiety. Based on peer-reviewed published studies we have calculated an overall rupture rate of 14.5% (383/2,635) for PIP implants. However, there is no evidence that PIP implant rupture causes long-term adverse health effects in humans so far. Silicone lymphadenopathy represents a foreign body reaction and should be treated conservatively. The long-term adverse effects usually arise from inappropriate extensive surgery, such as axillary lymph node dissection or extensive resection of breast tissue due to silicone leakage.