Doctor Article · Korean Breast Augmentation · MARBLE Plastic Surgery · Dr. Seo Il-Beom
Doctor Article Overview
Quick breast augmentation does not always mean better breast augmentation.
Dr. Seo Il-Beom of MARBLE Plastic Surgery explains Korean breast augmentation, implant placement, dual plane technique, transaxillary incision, peri-areolar incision, and why long-term stability matters more than quick surgery.
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1. Why quick breast augmentation sounds attractive
2. What can go wrong after breast augmentation?
3. Implant placement and capsular contracture
4. Why Dr. Seo prefers dual plane breast augmentation
5. Transaxillary and peri-areolar incision
6. Doctor’s Note from Dr. Seo Il-Beom
Quick and easy breast surgery sounds appealing because patients naturally want less downtime, less pain, and a simpler recovery.
When first considering breast augmentation surgery, you may have thought that it is simply making an incision and inserting an implant into the body.
But the process can feel overwhelming and intimidating as you get deeper into it, especially when you start thinking about general anesthesia and the recovery process.
The more you browse online, the more you discover that there are different surgical methods, incision sites, implant placement options, and many other factors to consider.
Then, something catches your attention: “quick and easy procedure,” “lunchbreak procedure,” “short recovery.” These phrases sound very appealing, especially when shorter downtime is promised.
Dr. Seo’s question: In breast augmentation surgery, a quick and easy method may promise a minimally invasive, tissue-preserving procedure and faster recovery. But does it provide a better outcome?
How are good outcomes achieved, and what is considered a good outcome?
A bad breast augmentation outcome can include capsular contracture, rippling, severe asymmetry, implant displacement, bottoming out, or other long-term problems.
Let’s start off with what a bad outcome is.
Animation deformity, capsular contracture, rippling, severe asymmetry, inflammation, implant displacement, bottoming out — you name it.
| Possible issue | What it means |
|---|---|
| Animation deformity | The breast shape moves unnaturally when the chest muscle contracts. |
| Capsular contracture | Scar tissue around the implant becomes too thick or tight. |
| Rippling | Implant edges or folds become visible through thin tissue. |
| Severe asymmetry | The two breasts look noticeably different after surgery. |
| Inflammation | The tissue around the implant becomes irritated or infected. |
| Implant displacement | The implant moves away from the intended position. |
| Bottoming out | The implant drops too low over time. |
The cause of a bad outcome could be poor surgical planning, an inexperienced surgeon, or even a product defect.
Nobody wants any of that. Anyone looking into breast augmentation surgery is looking for the best result for themselves.
You can more easily understand what makes a good outcome by learning the basics of breast augmentation surgery.
Implant placement is one of the most important decisions in breast augmentation because it affects tissue coverage, recovery, implant visibility, and capsular contracture risk.
First, implant placement options are probably one of the most important factors to take into account when coming up with a surgical plan.
When breast augmentation with implants is performed, the implant can be placed in one of three anatomical planes: sub-glandular, sub-fascial, or sub-muscular.
Fig A. Different placements of breast implants.
| Implant placement | Key point |
|---|---|
| Sub-glandular | Placed below the mammary gland. Easier dissection and faster recovery, but the implant sits closer to the glandular area. |
| Sub-fascial | Placed below the pectoral fascia. Gives more implant coverage than sub-glandular, but fascia dissection is delicate. |
| Sub-muscular | Placed below the pectoral muscle. Gives the most coverage, but early pain and downtime can be greater. |
In sub-glandular placement, the implant is placed below the mammary glands. This gives easier access for dissection and has minimal bleeding, which can lead to faster recovery.
However, because the implant is placed near the mammary glands, where a microbial ecosystem is present, the risk of capsular contracture can be higher.
In sub-fascial placement, the implant is placed below the pectoral fascia, the thin layer that wraps the muscle. This placement provides better coverage over the implant and reduces capsular contracture risk compared to sub-glandular placement.
However, dissecting the thin layer of fascia is time-consuming and more prone to bleeding.
Lastly, in sub-muscular placement, the implant is placed below the pectoral muscle, providing the most coverage over the implant. This allows the implant contour to look less prominent compared to other placements.
The contractions from the pectoral muscle also reduce the formation of an overly thick capsule. However, with pectoral muscle dissection, more post-operative pain and slower downtime can be experienced.
Capsular contracture is a long-term complication where scar tissue forms around the implant.
This occurs when the body recognizes the implant as a foreign body. The body protects itself by creating a barrier around the implant and isolating the foreign body.
In simple terms: A thin capsule around the implant can help hold the implant in place. The problem begins when the capsule becomes too thick or tight, causing pain, tightness, breast shape change, or implant position change.
To a certain extent, having a thin capsule is beneficial for the surgical outcome because it holds the implant in place without it slipping and sliding.
However, if the fibrous tissue forms excessively, the patient can start experiencing discomfort such as pain, tightness, changes in the shape of the breast, and changes in implant position.
Based on human anatomy, capsular contracture risk can be reduced significantly by adjusting the placement of the implant and performing meticulous surgery.
Dual plane breast augmentation places the upper part of the implant under the pectoral muscle and the lower part under the breast tissue.
Now that we have learned the important things about breast augmentation surgery, let’s find out which implant placement Dr. Seo Il-Beom of MARBLE Plastic Surgery prefers.
Before any surgery is performed, a surgical plan is necessary. Dr. Seo personalizes it by first assessing the patient’s chest anatomy, aesthetic preferences, and lifestyle.
But in most cases, particularly in Asian females with less breast tissue, Dr. Seo prefers the dual plane placement.
| Dual plane point | Why it matters |
|---|---|
| Upper implant under muscle | Helps cover the implant edge in thin tissue. |
| Lower implant under breast tissue | Helps create natural lower breast fullness. |
| Controlled muscle release | Allows the pocket to be shaped by the patient’s anatomy. |
| Pocket modification | Helps reduce bottoming out and visible implant edges. |
| Longer surgical time | Precision matters more than speed. |
The dual plane placement is a modified version of the sub-muscular placement. The upper pole of the breast implant is placed under the pectoral muscle, while the lower half of the breast implant is placed under the breast tissue.
This allows the breasts to look natural even when the patient has little breast tissue for implant coverage.
If the top half is a sub-muscular method and it is more painful with longer downtime, why do surgeons still perform the sub-muscular method?
That is because it can reduce the probability of capsular contracture while providing a more natural appearance. The difference is in how the pocket is made and how the breast implant sits in the body.
The benefit of the dual plane method comes from precise muscle control and release, and the modification of pockets.
“The goal is to make the body look beautiful, not just to augment the breast.”
For example, with aging comes breast ptosis. Dual plane is favored because it can reduce breast ptosis by avoiding a situation where the implant is held only by skin that sags over time with age.
It can also benefit patients with already mild to moderate breast ptosis, helping them achieve natural and beautiful breasts without the need for mastopexy in selected cases.
And once the 10-day post-op mark is over, regardless of the implant placement, the pain level is generally similar.
The drawback is that the surgery takes longer, approximately 2 hours. The reason is the precision needed for dissection.
Adjusting exactly how much of the pectoral muscle should be dissected is crucial because not everybody has the same anatomy. Breast augmentation is not one-size-fits-all and cannot be copy-pasted.
This is how bottoming out is prevented, and how implant edges can be disguised even through thin tissues while still providing a soft upper slope and enhanced lower breast fullness.
Different planes of implants have their pros and cons, but with dual plane, the surgeon can get the best of both worlds. The best thing about it is that the surgeon can manipulate the implant placement and shape the breast according to the patient’s anatomy.
Breast augmentation planning starts with anatomy, tissue thickness, chest shape, asymmetry, and the patient’s aesthetic goal.
Incision choice should be decided by scar location, anatomy, implant control, and the surgeon’s ability to make a precise pocket.
Moving onto incision sites, there are mainly three incision sites that are commonly used: inframammary fold, transaxillary, and peri-areolar incisions.
The approach of the incision site varies depending on the patient’s preference, lifestyle, and anatomy.
Something everyone has in common is wanting the scar to be hidden or wanting “minimal scarring.” This is why thorough and proper consultation is needed to minimize the scar as much as possible.
Fig B. Different incision sites for breast augmentation surgery.
| Incision site | Key point |
|---|---|
| Inframammary fold | Direct access and easier implant control. The scar can be more visible when lying down. |
| Transaxillary | Scar hides in the armpit fold. HD endoscopic skill is important for precise pocket creation. |
| Peri-areolar | Scar can blend with areola pigmentation and gives direct pocket control. It is technically difficult and not suitable for small areolas. |
Many surgeons prefer the inframammary fold method because it is an easier way to prevent complications. The proximity to the breast allows better control in placing the implant, helps reduce the probability of post-operative bleeding, does not require muscle dissection, and allows use of a Keller Funnel for easier implant insertion.
The con of this incision site is that the scar can be noticeable, especially when lying down.
However, Dr. Seo mainly prefers the peri-areolar and transaxillary incision sites.
With the transaxillary incision, the scar is placed in an area where it is almost unnoticeable because it hides in the folds of the armpit. It is also one of patients’ favorite incision sites because the incision does not go anywhere near the breasts.
Before endoscope was incorporated, blunt dissection technique was used. This gave less control and precision when placing the implant under the muscle.
In turn, only saline or small silicone implants could be used for transaxillary incision due to the small incision length.
However, that is not the case anymore.
Although transaxillary incision is a more difficult approach because it is further away from the breast, it has become much easier to create both a bloodless pocket and sharp electrocautery dissection using HD endoscope.
This reduces the use of drainage and creates a well-fitted pocket. The technique also allows the pectoralis major’s costal origin to be completely divided to create the dual plane.
This also means that the pocket can fit larger implants and reduce asymmetry without making an incision near the breast.
Of course, those advantages do not come for free. It requires a learning curve to use the endoscope while being skilled at creating a dual plane.
What about the peri-areolar incision?
The great thing about this method is that the scar can be disguised through the natural pigmentation of the areola as it fades with time.
But the method is definitely on the trickier side. There are risks of severing the lactiferous ducts and nerves, and it requires meticulous suturing to provide good scar quality.
So why does Dr. Seo prefer this method despite all of that trouble?
Technical point: Peri-areolar incision is not just a scar-hiding method. For Dr. Seo, the bigger advantage is direct surgical control: pocket development, muscle release, hemostasis, and complex correction through a controlled approach.
The biggest advantage of this method for a surgeon is the controlled development of the pocket under direct vision. This gives the ability to release the muscle fibers of the pectoralis major as necessary.
Just like the transaxillary method, creating a bloodless pocket is crucial. With the peri-areolar incision, hemostasis can be maintained with ease.
It is the most advantageous for malformation corrections, such as tuberous breasts and breast asymmetry, and for revision procedures such as capsulectomy, implant exchange, and glandular plication.
However, patients with small areolas are not candidates for this procedure because the size of the areola dictates the incision width.
Although it takes many years of experience and high skill to perfectly execute this method, the benefits outweigh the struggle.
The result that comes with breast augmentation surgery is not something we should envision only in the present time. Long-term stability is the bigger picture that must be seen and considered.
One might think surgical efficiency is about faster recovery and faster results. However, it is about getting it done the first time with safety and precision to avoid unnecessary complications and revision surgeries while getting what the patient wants.
“Surgical efficiency is not just faster recovery. It is getting it done the first time with safety and precision.”
With Dr. Seo’s over 20 years of experience as a board-certified plastic surgeon, and his hands-on experience with many different types of cases ranging from easy to difficult cases, his goal is to achieve satisfactory results with long-term stability.
This is why, although it may take a little more surgical time, he prefers selected cases with transaxillary and peri-areolar incision with dual plane.
Perfection takes time and patience. In return, the result that one has always wanted can be achieved.
Are you willing to sacrifice more time on surgery for a better outcome in the long run, or would you rather enjoy the moment and have a quick in-and-out surgery with faster recovery?
Doctor’s Note
Dr. Seo Il-Beom
What should patients remember before choosing Korean breast augmentation?
Breast augmentation should not be planned only around speed, incision size, or short recovery. The important question is whether the implant can sit in a stable pocket that matches the patient’s anatomy.
For patients with thinner breast tissue, Dr. Seo often considers dual plane placement because it can help cover the upper implant edge while creating natural lower breast fullness.
Transaxillary incision with HD endoscope and peri-areolar incision require technical experience, but they can give the surgeon more control in selected patients.
Peri-areolar incision is especially important for complex corrections such as tuberous breast, breast asymmetry, capsular contracture revision, implant exchange, and glandular plication.
The goal is not simply to make surgery faster. The goal is to create a natural breast shape with long-term stability.
*This note is for general education and does not replace personal medical advice. Final treatment decisions require personal consultation with a qualified medical provider.
After reading Dr. Seo’s article, compare the surgical explanation with MARBLE’s breast augmentation process, implant information, current breast augmentation promotions, recovery posts, and real patient stories.
No. Quick Korean breast augmentation can sound attractive because of shorter downtime, but Dr. Seo explains that breast augmentation results depend more on implant placement, incision choice, pocket control, tissue coverage, and long-term stability than speed alone.
Dual plane breast augmentation places the upper part of the implant under the pectoral muscle and the lower part under the breast tissue. Dr. Seo often uses this method for patients with thinner breast tissue because it can help cover the upper implant edge while creating natural lower breast fullness.
Dr. Seo may prefer transaxillary incision because the scar can hide in the armpit fold and the breast itself does not need a visible incision. With HD endoscope, he can create a more precise pocket and perform dual plane breast augmentation through the armpit approach.
Peri-areolar incision is technically difficult, but it allows direct pocket control, careful muscle release, hemostasis, and easier access for complex corrections such as tuberous breast, breast asymmetry, capsular contracture revision, implant exchange, and glandular plication. This makes it one of Dr. Seo’s key strengths.
Patients with small areolas may not be suitable for peri-areolar incision because the areola size limits the possible incision width. The final incision choice should be decided after checking anatomy, scar preference, implant size, and surgical goal.
Breast augmentation may take about 2 hours when precise dissection, dual plane pocket creation, and careful incision planning are needed. The goal is not simply to finish quickly, but to create a stable implant position and natural breast shape.
Final thought
Quick breast augmentation can be attractive, but Dr. Seo’s point is that speed should not replace planning, anatomy, incision control, and long-term stability.
A better breast augmentation result starts with the right pocket, the right incision, and the right plan for the patient’s body.
Written by Dr. Seo Il-Beom, MARBLE Plastic Surgery
This article is for general education and does not replace personal medical advice. Final treatment decisions should be made after consultation with a qualified medical provider.
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