Why are different medications prescribed in South Korea versus the west?

I just had my breast augmentation. I bought a 3 month pack of "lukio tab montelukast sodium" for anti capsular, basic pain killer and 3 other tablets I take three times a day. I find it interesting that PS in the west usually don't prescribe as complex medications.

Doctor Answers 3

Medicines for breast surgery - why are they different in the USA and South Korea

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Thank you for asking about  your breast augmentation.

  • Since we don't have evidence that montelukast prevents capsular contractures, I don't prescribe it unless a contracture forms.
  • I do not prescribe antibiotics after surgery - research shows that they are most effective given in one dose, right before surgery.
  • The prescriptions I provide my patients are a narcotic pain killer, a muscle relaxant, an anti-nausea patch and anti-nausea pills. 
  • I also have my patients have acetominophen and ibuprofen at home for mild pain.
  • Your surgeon will need to tell you what your other pills are for and why you are taking them.
  • Surgical practices vary from one region to another - even here in the USA - because the climate and the people are different - and different situations call for different medications.

Always consult a Board Certified Plastic Surgeon. Best wishes, Elizabeth Morgan MD PHD

More medications doesn't always mean better treatment

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There are a couple of comments I would like to make in response to your question.  First, although it's difficult to comment specifically as we don't know exactly what your Korean doctors prescribed, I think it's fair to say in general that "more isn't always better."  I think each and every medication that a physician prescribes should have a defined purpose.  In fact, I would even go so far as to say that we should always try and keep our patients' medication regimen as simple as possible, while still providing optimal care.  At least in the West we would not simply devise or adopt a medication regimen just because it was more complex.

Having said that I can tell you that not all physicians in the West have the same prescribing practices.  Some my keep their prescribing relatively simple, and that is good if it works for them and their patients.  In my own practice, I prescribe montelukast, often called by its trade name "Singulair" here in the US, prophylactically for a month after breast augmentation, as I believe it helps lower the risk of capsule contracture even beginning, instead of waiting for it to start before prescribing medication.  While no formal scientific studies have been done on its use prophylactically to prevent capsule contracture, there are studies which have shown that it is effective when used to actually treat an established case of capsule contracture.  The way that I am describing it in this situation is considered "off label" use of the drug here in the US, just as it is for any capsule contracture issues, studies or no studies, and I think it is justified.  In addition, I prescribe a short course of steroids after surgery too, for the same reason, and a couple of medications which help control pain without relying strictly on narcotics.  Lastly, most of my patients receive a short course of antibiotics after surgery as well.  I know a number of other surgeons who agree and do the same, or a similar, thing. So, I'm not sure whether you are implying that a more "complex" regimen is better or not, but it's would not be accurate to make the generalization that plastic surgeons in the West don't aggressively prescribe an appropriate amount of medication designed to prevent some of the known risks and complications of breast augmentation and improve the overall recovery and postoperative experience after surgery.  Again, while I have not formally compiled or published any data on this, I can tell you that we just reviewed my experience over the past 2 years since I have been doing this, and the rate of capsule contracture in our practice is now slightly below 1% per year.  I have also found similar experiences from colleagues using similar methods with whom I have spoken. I hope this answers your question.  Best of luck with your recovery!

Joseph L. Grzeskiewicz, MD
San Diego Plastic Surgeon

Different medications in South Korea?

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Not sure..but I would say that in the US we follow what we call "standard of care". Even though, each practitioner has specific things they do, we still follow what is standard of care.  This means we do things that are proven by research to be effective to maximize outcome for each patient. Otherwise I would ask your surgeon in South Korea this question as well.  Hope this helps. 

Bhupesh Vasisht, MD
Voorhees Plastic Surgeon
5.0 out of 5 stars 94 reviews

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