南国の美容クリニック

　　　FDA-approved smooth-typed silicone gel implant is the brand of choice in our facility. It is filled with safe cohesive silicone gel that sticks together to prevent leaking when rupture or implant breakage occurs. Because of this feature, silicone implant is sometimes called 'gummy-bear implant'. Implant sizes vary from 100 to 800 cc, around 200 to 300 cc is the estimated size to see 1-cup bra size change in American bra sizes.

image of broken cohesive implant





　　Rough-surfaced silicone implant called textured-typed silicone gel implant was produced to reduce the incidence of contracture(hardening) of the capsule, the covering produced by the body when implant is inserted. But there has been a serious issue concern about the textured type. 10 or more years later after implanting, textured-type implants might cause a rare type of cancer called anaplastic large cell lymphoma(ALCL) in rare chance of 1 in a milionth of operated cases. Textured implants production may now be halted and this type might not be used anymore in medical settings.

　　Anatomical type is another popular implant type designed exclusively into anatomical breast shape, but this type also is not the type of choice in our clinic. The reason is that it might change its direction afterwards when it moves inside the body where the capsule space is very spacious enough to rotate the implant, which is not a problem in regular round type ones. Another concern is that most of these anatomical ones are produced with textured coverings, the reason we think that this might become extinct in the near future.

　　　Our clinic has been choosing smooth-typed inplants for over 10 years, since when the occurence of lymphoma was not an issue yet. The reason we do not select textured types is that they seem to produce more rippling(wrinkling) of breast skin, and sometimes their rough surfaces are more touchable from skin surface especially in individuals with originally smaller breast and thinner skin.

　　　Breast enlargement surgery is performed under general anesthesia, with actual operation of 30 minutes, or 1 hour for the over all anesthetic process. After 1 night of bandage compression, it will be changed to a band compression beginning the next day until a week or a few weeks later. Stitch removal of wounds is done 1 to 2 weeks later.

　　　Postoperative swelling is observed 1 to 2 weeks, and if bruises are noticeable, it might take until around 3 weeks. Inserting implants under the pectoral muscle causes more pain that lasts for 1 to 2 weeks. Unexpected side effects maybe noticed, such as bleeding and infection, so refraining from active movements and wetting of the wounds for 1 week postsurgically is a must advice.

　　　Approaches of implant insertion are made at armpits, areola, or submammary folds, but areola procedure might sometimes show noticeable scar redness or keloid, so usually we encourage patients to select submammary folds or armpit approaches.














　　Implants are placed in submuscular layer most of the time because it is assumed to be the most reliable level to insert implants.











　　　Subglandular(over muscle) placement is shallow enough to make implant contour or rims look so noticeable from breast skin years later, the main reason why it is not the first layer choice. But in cases with rich breast fat and skin tissues to cover the implants, to correct sagginess of loose breast skin, using 'dual plane technique' (submuscular insertion in upper breast area and subglandular in lower side) is also an option. But with thinner skin, this might not be able to hold implants after several years.


　　　Subfascial insertion is another method suggestion which imply placement in between muscle surface and its fascia(muscle membrane) but this is not realistic enough since pectoral muscle fascia is not that thick to differentiate this technique from subglandular placement.

　　　Keller Funnel is a remarkable creation of a plastic-made funnel to secure insertion of an implant through a smaller incision without unnecessary touching of the skin and instruments used in surgical setting, avoiding incidence of unwanted contamination of the implant and its space.






　　　The rough criteria of implant size and its outcome are the following:

180cc bef/aft
downtime: swelling&pain in 1to2 wks.,
　　if bruises, needs 2-3wks. to subside




300㏄ bef/aft
downtime: swelling&pain in 1to2 wks.,
　　if bruises, needs 2-3wks. to subside


400㏄　bef/aft
downtime: swelling&pain in 1to2 wks.,
　　if bruises, needs 2-3wks. to subside

　　　Pricing

		without tax	with tax
Fat Transfer	breasts	\200000＋full liposuction fee	\220000+full liposuction fee

　　Pricing is only for 1 treatment session.
　　2nd fat injection and beyond are 50% OFF.
　　Liposuction fee is required in every session. Refer to Liposuction page for pricing details.　　

　　　Mastopexy or breast lift is done for saggy breast, and breast tissue reduction is performed simultaneously if smaller size is desired or breast implant insertion if fuller breast is the goal. The skin on the lower part of the breast will be removed and tucked, and the areola will be transfered to a higher skin level around 20cm from sternal notch.


breast lift before/after
downtime: swelling&pain last for 1to2 wks.,
bruises take 2to3 wks. to subside




　　　Incision is made around areolar rim, down vertically to mammary fold inorder to remove excess skin, shaping a surgical wound that resembles a 'key hole', the reason why it is called the key-hole incision. Wound blends to skin color in time. If areolar sagging is not that severe, breast enlargement with implants only might work to see fuller lifted breast.





　　　　If breast reduction only is the goal, incision of areola's lower half rim is big enough already to remove breast tissues.




　　　This procedure is performed under general anesthesia, requires physical and lab tests preoperatively.

　　　It takes 3 hours or more to complete this surgery, a week of bandage compression and months of band pressing follows. Stitch removal is 2 weeks later.

　　　Breast wounds are lengthy , so they take time on checking up, taking measures to avoid infection and splitting.

　　　Breast lift has to resist the pulling force of gravity that tends to spread scar's width. Taping of the wound is recommended to avoid this.

　　　Pricing

		without tax	with tax
Breast Lift	both breasts	\500000	\550000
	＋silicone implants	＋\300000	+\330000
Breast Reduction	both breasts	\400000	\440000

　　　General Anesthesia Fee　\50000(with tax \55000)

　　　　　　 　　　　　　

　　　Enlarged male breast tissue(gynecomastia)is the main concern of men in breast care especially in younger generation. Male hormone testosterone usually acts to develop a masculine chest contour. But when it does not work well, minute amount of female hormone in male body becomes a dominant trigger to create a feminine breast shape.

gynecomastia gradeⅡa correction before/after
downtime: swelling&pain for 1to2 wks.,
bruises might be observed for 2to3 wks.


　　　Famous grading of gynecomastia' s severity goes as follows:


gradeⅠ　　　hypertrophic tissue just under areola









grade Ⅱa　　 hypertrophy extends all over breast








grade Ⅱb　　 severe hypertrophy with saggy skin but nipple stays higher than fold







grade Ⅲ　　　severe hypertrophy with saggy skin, nipple lower than fold







　　　Treatment with surgery is done accordingly to grading:
grade Ⅰ　　　incision along areolar lower half rim, only removal of breast tissue








grade Ⅱa　　 same incision as gradeⅠ, removal of breast tissue,
　　　　　　　 together with minilipo of breast from outer approach









grade Ⅱb　　same remedy as grade Ⅱa

grade Ⅲ　　　breast lift with 'key-hole' incision(refer to breast lift mentioned above)
　　　　　　　transfer of areola to higher skin level
　　　　　　　removal of breast tissue, excess skin, & mini lipo









　　　Grade Ⅰup to grade Ⅱb cab be performed under local anesthesia while grade Ⅲ needs general anesthesia. A week of bandage compression, then stitch removal 2 weeks later. Swelling and bruises last around 2 or maybe 3 weeks.

　　　To avoid bleeding and infection, caution of keeping wound dry for a week mst be observed.
　　　　　　　　　　　　　　　　　　　 　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　Pricing

		without tax	with tax
Gynecomastia Correction	grade Ⅰboth breasts	\180000	\198000
	grade Ⅱab both breasts	\300000	\330000
	grade Ⅲ both breasts	\500000	\550000

　　　　General Anesthesia　\50000 (with tax \55000)

　　　　Ideal areola size may vary in different breast sizes, but usually said to be around 3.5 cm in diameter. Reduction is designed to achieve this goal but areolas on bigger breasts tend to stretch out easily months later, resulting in a little more extended sizes than planned. So it is easier to create smaller areolas in smaller breasts than the bigger ones which are easily affected by the gravity.

　　　　Areola reduction is done by removing the outer excess area and tucking the skin together creating a circular wound around the rim. By making the scar at the boundary, it will not be easily recognized when the scar heals with lighter color than the skin afterwards.










　　　Treatment can be done usually under local anesthesia, needs an hour to complete. A day of compression with gauze and band is needed, then stitch removal a week later. Swelling and bruises might last around 2 weeks.

　　　To avoid bleeding and infection postsurgically, caution of keeping wounds dry for at least 5 days is advisable.
　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　　Pricing

		with tax	without tax
Areola Reduction	both sides	\150000	\165000

　
　　　In women, ideal nipple size is around 8mm in diameter, also 8mm in height, of course, these change accordingly to favorites or breast sizes.

　　　In men, about half of women's ideal diameter, which is 4mm is the best, and height , almost flat.



　　　Enlarged nipples usually resulted from breastfeeding and sometimes in men breast from natural cause.




　　　Nipple reduction is done by removing and tucking of skin of the lower base and partially at the lateral side of the upper part of the nipple







　　　30 minutes to an hour is the time needed to perform this procedure which is usually under local anesthesia. Since recovery of wounds at this area is slow, stitch removal is done after 2 weeks. Skin reduction is the main technique of this procedure, so mammary ducts will be preserved and remain intact, meaning breastfeeding is still possible afterwards.

　　　A day of bandage compression is necessary, swelling and bruises might last until 2 weeks.

　　　To avoid bleeding and infection, caution of keeping the area dry for at least 5 days is advisable.

　　　　　　Pricing

		without tax	with tax
Nipple Reduction	both sides	\150000	\165000

　　　　Inverted nipple is a cosmetic concern that can be seen from younger through older women. This issue is caused by underdeveloped mammary ducts which turn out shorter and tend to pull down the nipple.

　　　　Because mostly younger women are eager to repair this problem, it is necessary to obtain consent in possibility of injuring the mammary ducts, meaning the disturbance of the normal breastfeeding. The incision usually goes across the whole diameter of the nipple, but in our clinic, we try our best to preserve the top portion by just cutting the side portion.
　　　　
　　　Grading of severity:





gradeⅠ　　nipple flat
　　　　 　protrude easily with stimulating breast push








grade Ⅱ　　nipple denting or sinking
　　　　 protrude when pulled with tweezers


grade Ⅲ　　similar to gradeⅡ, nipple sinking
　　　　but not pointing with tweezer pull
　　　　requires sutured thread to be pulled




　　　Treatment according to grading:
grade Ⅰ　　no need of surgery(breast pump or breast feeding as natural remedy)






grade Ⅱ　　surgery needed. nipple lateral incisions on 2 sides, release duct adhesions,
　　　　　　Z plasty sutures on neck to hold pointed nipple,
　　　　　　1or2 weeks of traction device








grade Ⅲ　　surgery needed. nipple incised in half after pulling out with sutures,
　　　　　　release duct adhesion and cut short ones if needed
　　　　　　secure neck with Z plasty stitches, 1or2 weeks of traction device








　　　This procedure is usually performed under local anesthesia, swelling and bruises are not that obvious. Requires an hour or more to complete, 1or2 weeks later, stitch and device removal/

　　　Be aware that recurrence might be observed particularly in severe cases. Also cut ducts might not be able to work for breast feeding afterwards.

　　　To avoid unwanted side effects such as infection and have a satisfactory result of the surgery, keep area dry while held by a traction device, by refraining from washing it but just treat it with some aseptic wipes.

　　　　　Pricing

		without tax	with tax
Inverted Nipple Correction	both sides	\160000	\176000