WEBVTT

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Today, while watching the ultrasound

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since I can't demonstrate on a person

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(Today's implant is a pork)
I brought in some pork belly

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With pork belly

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I'll show you how it looks when the implant folds

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and show the difference between texture implants

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and smooth implants

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I will show you how they differ

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directly through the ultrasound

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(Shinyu Clinic)

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Human muscles have fibers

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(You can't see the lines well with this pork)
but with pork belly, it's hard to see them

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However, you can still see that there are layers

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(Skin)
This is the skin layer

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(Layer 1)
You can see the layer in the middle

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(Layer 2)
and this layer

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(Layer3)
and this layer are all different

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In surgery

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if you enter between Layer 2 and Layer 3

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there’s no bleeding

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But if bleeding occurs suddenly

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(Off track)
it means you’ve cut into the wrong layer

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You need to recognize that and stop immediately

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(Doctor should realize the situation immediately)
You must think that there's something wrong

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Especially during breast reduction or augmentation

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if bleeding starts unexpectedly,

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it means the layers were not correctly identified

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At that point, you should stop and check again

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if you're going the right way

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(Subscribe)

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If I'm using

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(A scissor?)

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a tool like a Mommotome

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you can manipulate it while watching the ultrasound

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This is very important because

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(You can identify the scissor through the ultrasound)
it shows the tools, that I put right here

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You can see these things

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and you can track them accurately

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If there’s something to be removed

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you can follow it

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precisely on the ultrasound

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and remove just that

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(Seroma removal, Mommotome have the same surgery method)
This is how the Mommotome works

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and when there's seroma around the implant

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 it’s also removed in the same way

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However

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if there’s an implant

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it is risky

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Implants can rupture easily

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which is why hospitals are reluctant to perform this procedure

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Many people come to get serous fluid out

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After surgery at another hospital

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the serous fluid is pooled, so many people come to get the serous fluid out

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Because plastic surgeons

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touch it with their hands

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It's dangerous to extract serous fluid around the implant

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They come to me then

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I look at the serous fluid with ultrasonic waves

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And extract it with a syringe

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So what does it look like when there's an implant?

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I'm going to put the implant under the pork belly

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(Something like a white line on the surface of the implant)
This is the implant

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You can see this skin

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If the implant is folded

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(The pork belly is too thick...)
Oh, this is actually thick

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It's hard to show how it's folded

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(So we changed it to a pig skin hehe)

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(Pig skin)
If you look at this part

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This white part, this reddish part

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It's pig skin

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White here

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There are smooth lines

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(You all see three lines here, right?)
One, two, three go by

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This is a smooth skin

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Usually, the implant skin is

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not just a single layer

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It's three or four layers

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Usually, it's four layers

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But if you look at the texture implant

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(It feels rough compared to smooth)
It definitely feels rough

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If you look at this

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You can tell if it's texture or smooth

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(What does the implant look like when it's folded?)

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The middle part is white, right?

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That's how the air could be full or the serous fluid could be full

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The air is actually full right now

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As if the white line breaks in the middle

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It shows a different pattern?

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(Can presume that the implant is folded)
The serous fluid is usually pooled

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Then, I'll think that this part is folded

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(You can see that the prosthesis is implant from this)

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When we first practice or study ultrasound

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I put pork or something like that

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When we practice mammotome

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We put some olives in the middle

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When we do things like Mommotome

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We practice removing olives

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If there's a tumor during the Mommotome surgery

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How does it look?

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It looks like there's something on the ultrasound

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It looks different

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Actually, the breast is ambiguous

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There's something

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(This... What is this?)
There's a lot of uncertainty about whether there's one or not

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(If an exact assessment isn't possible, monitoring over time is essential)
That's why follow-up observation is the most important

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We need to see how it changes

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Even if it's unclear at first

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it becomes clear over time

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(Subscribe)

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How do I get rid of lumps?

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Let's say there's an implant underneath,

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If you poke the implant

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(Big accident)
that would be bad

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Since the implant would explode

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So you have to look at it carefully

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Move carefully

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Put the anesthetic in here

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(Injecting anesthetics)
Then, it floats like this

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It's floating

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So when there's an implant down here

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This is how you make space

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If you make a space like this

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The distance from the implant has widened

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(Get rid of the lump and it's over)
so it‘s over

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You can remove the lump like this

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That's why it's funny

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If you want to be good at Mammotome

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You need to be good at anesthesia

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If you want to be anesthesia, you need to be able to look at an ultrasound

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(A person who is good at everything)
do it like this

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(Suddenly releasing know-how...?)

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Oh...I'm sure you all know

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It's hard to copy

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It's just like how they say

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after drawing, "it's easy, right?"

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(Easy, right?)

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(What will it look like when the air goes in?)
What happens if there's air in there

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Actually, no air should go in

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If you get air in, you can't see it on the ultrasound

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I'll do one more layer

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On this layer

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If you put in air

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(I can't see anything..it‘s white..)

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I can't see the back

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That's why there's no air in there

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I'm not putting the implant in a vacuum

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There's a lot of air around the implant

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Then you can't see it on ultrasound

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If you try to extract the intestinal fluid while you can't see it

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(It's really important to watch ultrasound)
The prosthesis could explode

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After surgery, with breast reduction or putting in implants

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A lot of people say that there is a sloshing sound

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This could be because of trapped air

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Or trapped fluid

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If it is extreme to the point of discomfort, we take it out

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(Stressing)
Looking at the ultrasound

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doing after-care post-surgery is necessary

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(Recommend getting treatment at a clinic with ultrasound equipment)
Relying on touch

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the plastic surgeons just feel around with their hands

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Saying it’s all good

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It shouldn’t be like this

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Because we always looks at this

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we have no choice but to do it more

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Then the patients become more comfortable with it as well

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And it’s also fun for me too

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(The feeling of discomfort disappears!!)
They say it feels much better

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The areas that were filled become reduced so they say it feels much better

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They all say this

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Everyone feels that way

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(Feeling of satisfaction after providing treatment)
Then it becomes fun for me as well