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Breast AugmentationAuthored by Dr. Susan Kolb According to the American Society of Plastic Surgery, there has been a tremendous growth in consumers who undergo the breast augmentation procedure. In 1992, over 32,000 received the breast augmentation procedure. In 2004, over 252,000 underwent the same procedure. The decision to undergo breast augmentation is a serious one. Alternatively, the benefits can be enlightening- with improved self image, appearance, or even better fitted clothes that require less alteration. But first, let’s explore some of the considerations... Pre-Surgery If you’ve thought about breast augmentation before and are now approaching the serious stage, you have probably seen many television shows, heard radio advertisements and even witnessed firsthand this cosmetic surgery change in one of your co-workers or friends. You may even go to the Internet to conduct your own research and learn more about the procedure. Yet, no information can replace the advice of a trained medical specialist. It’s important to be armed with a list of questions for the doctor and some knowledge about the expectations of the procedure- a thorough investigation. Initially, evaluations-including medical history, general health, breast examination-will be performed to determine the most effective surgical approach for the procedure. The surgeon will describe the procedure options, the types of implants that are available through their office, anesthesia, possible risks and complications as well as reasonable outcomes. This can be visualized by showing you before and after photos of the surgeon’s patients. Mammograms, x-rays and photographs may be required. Preoperative instructions often include the temporary abstinence of certain drugs such as those which contain aspirin, birth control and other estrogen containing hormones. Antibiotics may be prescribed for a few days prior to surgery to help prevent infection. The Procedure A breast augmentation can be completed in a hospital or outpatient surgical center under general or local anesthesia. The determination of anesthesia type may coincide with the physician’s choice of approach to the procedure as well as your personal preference. Pre-medication to relax the patient is administered before the procedure. The physician will also mark where the incision will be on the patient. The Approach Incisions can be made in the lower portion of the breast with the goal to be hidden in a “naturally” created crease at the bottom of the breast post surgery. Alternatively, incisions can be made in the lower portion of the areola (the nipple’s dark pink area). Or finally, incisions can be made in the armpit crease or belly button to lessen any evidence of the surgical procedure. The implants that are used typically contain a saline solution that is inserted into a pocket above or below the muscle, depending upon physician recommendation. There are numerous implant manufacturers that produce implants with varying texture surfaces. Different sizes of implants may be used to balance breast asymmetry. In some cases, an inflatable implant may be used so that the surgeon can adjust the inflation amount. Small sutures are used to close the incision. The length of the surgery is dependant upon the approach, taking up to two hours or more. It’s important to consider the most important considerations for you- for example, is decreased recovery time and healing due to local anesthesia and the armpit approach most important and realistic for you? Will the doctor be cutting through breast skin, milk ducts, fat, muscle, and breast tissue for insertion? In fact, ask your doctor about breast feeding and nipple sensitivity prior to surgery. Answers are best offered by a physician trained in the area of breast augmentation. The training of the physician can differ as well. So, ask the physician about their credentials. Post-Op Post operative instructions vary depending upon your particular situation and the surgeon you choose to perform your procedure. The following provides an overview of some of the common post operative instructions. Day One: Patients can most often be released the day of surgery or otherwise may require an overnight stay. The doctor will put a special garment on the patient or wrap the patient’s breast area in bandages. Pain associated with breast augmentation can vary dependant upon the approach and your body, but is typically minimal to moderate for two weeks or more. Instructions from the doctor will include, but not necessarily be limited to: 1) medication- antibiotic and pain relief 2) bed rest and limited activity. The physician will determine which activities are permissible thereafter. However, depending upon the approach and outcome, strenuous exercise and overhead lifting may be forbidden for several weeks. Day Three-Five: The garment and bandages will be removed soon after the procedure. The doctor will determine this day and recommend a surgical bra that often must be worn for several weeks thereafter. Swelling and discoloration should disappear in a few days after surgery. Day Five to Seven: Sutures are removed and your physician may recommend massage to keep the breast supple. Some numbness may occur. Inherent complications with any surgery do potentially exist and should be discussed with your doctor. Infection and slow healing can occur. Some patients have reported that the breasts become too firm due to the formation of scar tissue or that there is increased nipple sensitivity. Depending upon the approach and recovery outcome, scars from the incisions fade or are hidden in your skin’s crease over time. Talk with your physician about recovery expectations to determine the length of your post-op recovery. And of course, list all the advantages that can occur post-op with an improved overall appearance, self-esteem and new image. It is important to note that in some cases a breast lift may be used in combination with a breast augmentation to achieve a fully satisfactory outcome. |
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