K couture's format to Breast Augmentation in Seoul

K

K Couture

O.G.
Dec 3, 2013
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#1
So I am going to try to construct this thread in a methodological manner, because when I considered which surgeon to select this was how I layed it out during my decision making process. I wanted to make a decision that was as objective, as logical and as empirical as possible rather than go with my “feeling”. The point of this mini guide is to demonstrate that there is a methodology to selecting your surgeon which bypasses marketing and advertising, before and after pics and reviews (which are not always accurate nor applicable to the individual patient’s pre exisiting structure).

I consulted a total of 8 Breast Specialists but I will only be mentioning the 5 that stood out to me, because these 5 were the only ones who left an impression. I made 2 separate trips to korea to complete these consultations. So I am pretty optimistic about my surgery thats scheduled for in just over 2 weeks

A bit about my boobage or lack off….I’m pretty much a surfboard. My mum was a surfboard too until she got preggers and gave birth to 3 kids. I hate kids -_-. Anyways so lack of boobage runs in my family lol. My case is not simple too because not only do I not have much breast tissue, my breast muscles are also tighter and I have broad shoulders. Additionally, my nipples are a little higher up than the ideal location. So this is the pre exisiting structure which my surgeon has to work with.

Dr Song

He was very very talkative. The impression I got from him is that he is very passionate about his speciality. He seemed very excited to talk to me about his technique and the academics of breast augmentation. In fact his consultation turned into more of a discussion and teaching session than a consultation haha. Which I didn’t have a problem with.

He was going to perform the surgery via an endoscope, and actually showed me videos of his usage of the endoscope to separate the muscle layer. He also explained how he planned to position the implant in the submuscular plane whilst leaving an open side pocket to allow for natural movement of the breast.

He also suggested using fat graft to minimize the distance between my nipples because he felt that it was something I was very concerned with.

When I asked him about placing the implant closer he said that was only possible to a mild extent to avoid a mono boob aesthetic. Additionally I also asked about resection of the inner chest wall muscle. However he said because that region is thin, it can cause a creasing and wrinkling effect if too much is resected. Hence he did not recommend it.

When I asked him about risk of capsular contraction his response is: “I’ve done many breast augmentations, and through my experience I am always thinking about how to minimize any risk of complications for the patient. I cannot guarantee there will be no complications, but I have enough experience to actively minimize the risk. Also, don’t use too big an implant that will help too”.

When I asked him about motiva, he said it was not suitable for me because motiva would not allow for enough tissue expansion due to how soft it is. Additionally anatomical implants would be able to give me more natural cleavage due to this shape and structure.

Pros:
1. Very detailed DISCUSSION on how to select the right breast implants.
2. Provided me with so much information that while I learnt a lot I could not absorb all of what he taught me
3. Very academic type surgeon

Cons:
1. Did not mention how my nipple is higher than the ideal location.
2. Did not have a specialized breast facility
3. Did not do a breast fitting with me
4. Doesn’t have their own breast center

Neutral comment:
Drains compulsory. However unlike Dr Lee he explained why he prefers it. Reason being not just for if in case of bleeding, but also will allow him to suck out any air build up during the procedure which could delay swelling. Ok that makes sense.

Recommended size: 330cc
Recommended implant: Anatomical
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Dr Lee
I’ve had a friend who did her BA through him before and she told me how good the after care service is. He is also a very reputable breast surgeon even amongst the senior level and higher surgeons.

His opinion was that I would require the anatomical implants due to my breast being naturally positioned slightly above the ideal location. Hence the region underneath my nipple would require more expansion than the upper breast. This is in line with what all the surgeons I have mentioned in this post said, so there is no conflicting opinion here.

When I voiced my concern about having a gapped breast post op, he did some quick measurements of the distance between my nipples and said it won’t be an issue because my nipples are within a reasonable distance. Not too close not too far.

I asked him about what Dr Song recommended which was a combination of Fat Graft plus Anatomical implants. Dr Lee said he was not fond of using Fat Graft because of the low survivability and the risk of developing uneven lumps around the breast. When asked about motiva he said he prefers using Allegan because it has not been out on the market long enough for clearly empirical evidence of superiority over the current ones which have been available on the market for years.

Pros:
1. Reputation within this field, not through marketing but respected amongst his peers.
2. Academic publishings
3. Have their own breast center

Cons:
1. No English or Chinese translators. I’m not 100% sure about the Chinese translators but there weren’t any on site the day I had my consultation at least
2. It was a bit hard for me to communicate with Dr Lee. His English was understandable but his demeanor made me less inclined to feel comfortable enough to ask all the questions wanted to. To add his responses were rather abrupt and he did not explain much in detail.
3. Did not give me a good explanation on how to minimize the risk of capsular contraction. His response was pretty much “the risk goes down with the surgeon’s skill. It rarely happens to me patients”. This to me is not good enough. If you are cutting into me, I want to know exactly what will be done, how it will be done, what the risks and limitations are and what you will be doing to minimize that risk. I understand given his reputation he is confident of his skill, and I also understand that when patients ask dumb question repeatedly it can be frustrating af. However I am not one to ask dumb questions, and I have enough knowledge to engage in an objective conversation with the surgeon. I really had high hopes for this consultation but it wasn’t the case.

Neutral comment:

Compulsory drains required. However he did not explain why.
Recommended Size: 370cc
Recommended Implant: Anatomical
 
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#2
Dr Kim (male dr Kim.)

God I wanted to mention this because I absolutely hated everything about the entire experience. Note that I only went to this clinic because a friend of mine said they have their own breast center that is well facilitated so it was worth checking out.

From the moment I was in the lobby the in house translator was so phony. She had this big fake smile on her all the time and kept sucking up to me. Then the consultant pissed me off too when she had the nerve to say “our clinic is number 1 in korea and our surgeon is the best in korea and 3rd best in the world for breast surgery”. I already knew this was bs because there’s no such thing as “the best surgeon” Then I rang up some of my networks to do a check on the surgeon’s profile. While Dr Kim is a senior level surgeon, he was not the department head of the breast center. The surgeon with autonomy over the clinic’s breast center was another even more senior surgeon. Ok right……who on earth do they think they are talking to, feeding me bs like that.

Additionally when I was changing into my fitting bra the staff legit were standing there staring at me. And I had to ask them 3 bloody times to gtfo out of the room for some privacy. Dr Kim’s consultation was very quick too with barely any explanation. I just saw hideous breast pics which look like giant ant mounds sticking out from the chest. He also wanted me to use expanders in my breasts before placing in an implant size of 375cc. Yeah…..nope not happening. And the price quoted was like 15 million krw. Are you out of your mind? Bye Felicia. I pretty much rushed out of there asap.
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Dr Oh

This one is a professor level surgeon who again gave me detailed consultation with food for thought. His opinion is similar to Dr Song with regards to nipple distance and cleavage. However, he did not recommend fat grafting but rather suggested a step approach:

a) Resecting the inner chest muscle
b) Using anatomical 510 implant which can further close the gap and provide more cleavage. However this implant type is apparently not easy to come by and he will have to check the availability in Korea. If not available he will have to order it in from Europe. He also explained the difference between 310, 410 and 510 implant types, its pros and cons and its usage. I learnt a lot from his consultation.

When I asked about motiva he, like the other surgeons explained that it has not been used long enough to know the long term effects. The claim from motiva about decreased of capsular contraction is therefore not proven. Additionally, Capsular contraction is not a frequent occurance however varies from surgeon to surgeon. He suggests that his patients experience this at a less than 3% risk using Allegan or Mentor and thus the added decreased risk which is yet unproven, is thus irrelevant. The good thing he did mention about motiva is that it feels very soft and natural. Anatomical can be a bit hard even after full recovery if the patient doesn’t have enough tissue to conceal the hardness during touch. He did mention that perhaps a few years later after my tissues have been well expanded I could consider motiva. But with my current breast condition it is not suitable.

His method is similar to Dr Song, Submuscular with a partial opened corner pocket, via endoscope. While his English isn’t as good a Dr Song, he was very patient and took the time to answer all my questions as best he could with his level of English, which is consider to be still rather proficient J.

Pros:
1. Detailed consultation
2. Reputable surgeon in his field. Again note that when I say reputable I mean respected amongst his peers and within the industry, not due to marketing.
3. Offered an approach which caters to my needs whilst taking into account the limitations my body has. (I don’t have enough fat to do a combination of implant + fat graft) His approach being the muscle resection + 510 implant type
4. In house Breast Center
5. Vectra breast simulation machine (l freaking love this machine. It showed me what my breasts would look like from different angles)

Cons:

1. I am not that sure about the muscle resection. Honestly I am aware it can go well but also aware that there can be complications. I do not yet know the frequency of occurance with regards to the complications however. Hence why I listed it under cons

Neutral: No drains are needed except in the event he notices bleeding.
Implant recommended: Anatomical 510
Implant size: 375cc
 
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#3
Dr Kim (Female)

Ok I am going to talk a lot about her because this woman just blew me away. First of all when I walked into the room to meet her, I was expecting a male surgeon. I even felt the need to (yes I know its prejudice of rude of me) to ask “are you one of the directors here?” to which she answered yes. I have always steered away from female surgeons because well, I’m an unapologetic betch who can admit that under certain conditions I can be prejudice. However from the moment she opened her mouth she had me engaging in a very stimulation conversation which was both a conversation and a discussion on my surgery. I left her office thinking to myself, “damn, miss thang gots the whole single white female thing down pat(expect she’s Korean lol)”.

This has got to be the single most attentive and detailed consultation I have ever had with a surgeon. You see, Korean surgeons tend to have the mentality whereby the patient comes in for the consultation, you go by protocol, give your recommendation and move on to your next task. Rather systematic in a way, which isn’t bad. Now Dr Kim graduated from Harvard and did her surgical resisdency and attendingship in the USA before moving back to Korea. Her English is as fluent as mine is and her approach to consultations is that of a Western standard, not a Korean standard. Read on to see what I mean:

Dr Kim: So before I give my recommendation, I want to make sure we have very good communication. I can only perform my job to the best of my ability if I understand exactly you want
Me: (smiles at her :biggrin:. Already quite impressed)
Dr Kim: Breast Surgery is about 4 main aspects. We need to discuss SIZE, SHAPE, incision site and IMPLANT TYPE. But this is not enough. We also need to discuss the ratio of your shoulder width to nipple position, to waist, to hip. Only then can we choose an implant most suitable for you, which you like, which balances with your frame.
Me: (smiling even more. Even more impressed)

She then proceeded to show me pictures of breast type. Asked said “can you identify which breast is using the round implant and which is using the anatomical”. Now she asked me this question in order to make sure that my interpretation of breast aesthetic and therefore the way I communicate my desired aesthetic to her is objective.

Next she went on to take my measurements. She said that my breast muscle is little tight however the tissue has good elasticity. The distance between my nipples is within a normal range however my nipples are a little high. For this reason she suggested anatomical 410, because 410 can give me the expansion I need in the lower breast region, with ample front projection, whilst being softer than the 510. Procedure will be done via endoscope in the sub muscular plane with an opened corner pocket

After that we did a breast fitting and she showed me a breast simulation with the Vectra machine to demonstrate how the different implant placement techniques can create different aesthetics. It was quite enlightening to see a 3d simulation from a full body scan in this manner. Dr Kim suggested that because because I have broad shoulders, having some extra side boob would be beneficial to balance out my body ratio. This can be done via a placement technique. She suggested that the incision should be to the under boob because that area requires the most expansion. However I am the queen of keloids. Legit one scratch and my skin starts to turn black. One incision and it turns into a bump red thang. Its not pretty. So she agreed to do it via the armpit and manipulate/position the tissue towards the lower breast region.

This next part of our conversation I felt it was important to illustrate:

Dr Kim: You see in the states the Caucasian women tend to have bigger breasts than Asian women, so surgeons in the states are more experienced using the underboob approach as Caucasian women can easily hide the incision scars in the crease. But Asian women, many are very small and therefore sometimes the crease cannot be well hidden and it may bother some women. That’s why many opt for the armpit incision. But for recovery the underboob incision is relatively faster. However that’s not to say the arm is slow either. If you take care during your recovery it shoudn’t be a problem. And I usually recommend my patients to stay for 2 weeks so I can monitor their condition until I am satisfied they will be leaving without issue.

When I asked her about risk of the implant tearing or leaking this is her response:

Dr Kim: The implant tears because if it becomes creases whilst sitting within the breast pocket, over the years the creased position its in causes a tear to occur. Many surgeons like to make the pocket tight to prevent risk of implant rotation. I however like to make the pocket just right. This will not only mitigate risk of rotation it will also ensure that the creasing effect is greatly minimized.

Implant recommended: Anatomical 410
Implant size: 370cc

Neutral: Same with Dr Oh, no drains required UNLESS she notices bleeding.

I think you guys understand what I mean when I said there is a clear difference in consultation experience between western and Korean surgeons. Of course I am generalizing and this varies from surgeon to surgeon. However, from my consultations with surgeons in US, Canada, Spain, Australia compared to Korean surgeons, if we were to compare in terms of how detailed and patient orientated the consultation went, hands down the western style is much more preffered. In saying this, I do believe the Korean surgeons do pronounce better results as they perform more surgeries per capita plus the industry is very well developed in korea.

Anyways in conclusion this is my analysis. From comparing various opinions this is the unanimous conclusion:

1) Motiva is not suitable for me
2) I require anatomical implants
3) My nipple height is slight above the ideal base line
4) My breast muscles are on the tighter side and therefore require expansion with the anatomical type implants.
5) Anatomical looks more natural but is slightly harder than round implants. Its not an issue with you have enough pre existing breast tissue to conceal it
6) Anatomical has a risk of rotation but if the sealing method is done well, this risk can be minimized greatly
7) Drains are an extra precautionary which can be helpful but not needed if no bleeding occurs. Some surgeons prefer to err on the side of caution. If you request drains to be left in the surgeon will comply.
8) From the simulations, a little extra side boob will help balance out my amazon like frame9) Do not underestimate a female surgeon LOL. They can be just as impressive if not even more impressive than a male surgeon. I feel female surgeons have to work harder to prove themselves in their field.
10) While underboob incision is more ideal and easier on recovery for the patient, in my case armpit incision can be done too so long as my surgeon is skilled

11) Communication with a surgeon is so important. I spoke for 45 mins with the female Dr Kim because I felt so comfortable asking her my questions and she by far answer all of them with a brilliant and concise response, in layman terms. Making sure I understood everything. In constrast with Dr Lee and the male Dr Kim, I didn’t feel comfortable asking more questions than the main ones I had prepared because they didn’t make me feel comfortable to do so. Objectively speaking, the more questions I asked with satisfactory responses, the more confident I am in the surgeon’s proposed methodology.

12) I have to be realistic that my boobs are probably going to be a bit firmer than most women because I am going from an A to a Low D pretty much. But this choice is due to the fact that I have an amazon like frame. I’m taller and broad and a unblessed with a surf board chest lol. Surgery is plus and minus and I can’t have everything, big boobs and very soft breasts is not realistic. But whatever, least I can catfish a guy from the moment they see my cleavage right? Haha


Things I’m not sure/concerned about due to conflicting opinions amongst the surgeons:

1) Whether I will be satisfied about distance between my boobs (hope its not too far apart)

2) Whether I should opt for muscle resection of the inner breast wall due to the potential complication of creasing. I do not know the margin of error. Should probably speak to Female Dr Kim once more before my surgery during my pre op consult

3) Whether a breast fat graft can maximize my results (2 surgeons say yes 2 surgeons say not necessary) However, I don’t have enough fat at the moment so this is irrelevant. But still something I do think about after shoving down a couple more burgers down my throat.

Anyways my surgery is in less than 2 weeks. Wish me luck ppl xox
 
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#4
Best of luck @K Couture ! Thanks for sharing the method of your consults. It gave me great insights on what manners an actual consult should be done. I'm not going for breasts in the meantime but your post sure help if later i choose to do it, however i will follow your consult method for my facial surgery in the near future.
Thanks for being an inspiration.
 
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#5
Hi @K Couture just want to thank you. I've been silently reading through the forums and your posts are the most knowledgeable and informative. There are so many reviews which seem sussed even the ones with pics but yours were always talking about teaching us how to do our surgery journey better rather than saying which clinic is good or bad. I really appreciate it!

What @versible said is so true, this consult method I plan to use not only for my boobs and face too. It really is a formula to choose a doctor by the doctor's skill only and just what because this b & a pic looks good or this girl said this place is good and all that. I would like to take some of your time to ask for facial surgery what type of questions should I ask the doctor during consultation? This thread only explains what to ask during breast.
 
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#6
uhhhhhh u cant ask that lol. You gotta specify what type of facial surgery you wanna know get and what aesthetic you are going for because the questions which should be asked to the surgeon is based on that. You can't really generalize the questions.
 
#7
Sorry I wasn't thinking. I plan to do V line eyes and nose. I rather do it all at the same time to get it over and done with. My face is squarey eyes small and nose flat but not very wide. Hoping I can look like angela baby hehe maybe it is wishful thinking :P I guess I will be content if it is as close to that as possible.
 
#8
hrmm there are some surgeons who will refuse to do any non facial contouring combination together with V line due to the swelling. My zygoma surgeon for example, is one strict surgeon. He won't do eyes or nose together with V line as it can make breathing post op difficult due to swelling during the recovery phase. Many surgeons also abide by that rule. But i think there's surgeons who will agree to allow for eyes and vline together since eye swelling isnt that bad.

ummm questions to ask for eyes: if from your current structure to achieve angela baby eyes is it realistic, is epicanthoplasty, lateral canthoplasty or lateral cantepexy required. If the laterals are required ask the surgeons about scarring, recovery and whether your lower optical muscles can handle it.
 
#10
No i never consulted him. All the surgeons i consulted with are breast specialists only who only do perform BAs or Breast reconstructive surgery. Already decided on my surgeon but now I am struggling to quit smoking :sad: and i gotta find someone to carry my bags for me lol. I'm travelling really heavy cos im gonna spend quite a while in Europe after my boobage
 
#13
GAH sorry for the late replies guys. I just had my BA and Ill be updating this thread on my experience soon. But I gotta say when i woke up IT HURT SO MUCH. Like excruciating pain which lasted like 15 mins then they gave me painkillers which brought it down from a 8 to a 5. After an hour it went down to a 2/3.

I later realized why mine was so painful but my friend's had barely any pain. Long story short, like what another forumer told me, the more expansion your muscles require the more painful it is. My friends usually go 1 - 2 sizes up and they never complained of pain, just soreness like they went to the gym and did a heavy workout. But I went up by 4 sizes! And my muscles were already tighter than most girls. Thats why it was so darn unbearable. Luckily that only last a few moments when I woke up. im currently lying in a comfortable pain free position where I refuse to get up unless i gotta pee LOL
 
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#15
I was like about to strangle the taxi driver. He was driving like a maniac and my freshly post op boobs were bouncing up and down it was so painful!

PS: anyone who has done their boobs and is a side sleeper, after how long did you sleep on your side? My surgeon says 1 month but when i did my facial surgery, be it nose eyes facelift zygoma etc etc the surgeons all say a month but i always do it after 2.5 weeks and nothing happens Does it apply to the boobs too?
 
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