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Breast Augmentation Tips |
Tips for Achieving the Best Results
There are a number of things that can be done before, during, and after breast
augmentation surgery to ensure the lowest complication rate, the speediest
recovery, and the best results. Explained below are a number of the steps Dr.
Loftus takes. Ask your doctor if he or she takes these extra steps. If the
answer is no, ask why.
Getting the Most out of Your Consultation
Evaluating your breasts carefully: During your initial hour-long consultation,
Dr. Loftus will examine your breasts and make careful measurements which will
guide her in advising you about your options. She will make special note of
nipple position, breast volume, breast width, distance between your breasts,
breast shape and projection, and height of the fold beneath each breast. She
will point out asymmetries (no two breasts are symmetric), and she will explain
which of your features she can improve and how. If your doctor does not evaluate
your breasts carefully and make careful measurements, you should question him or
her.
Using sizers to get the results you want: Dr. Loftus recommends bringing a
sports bra to your consultation so that you can use implant sizers to determine
the volume of implants that will give you your desired result. This is extremely
useful in determining your final size and helps eliminate uncertainty and
anxiety for you. Dr. Loftus will offer guidance on implant size, but you will
make the final decision.
Customizing Your Surgical Plan: Each woman differs in their physical features
and goals. Therefore each woman deserves a surgical plan tailored to her needs.
Dr. Loftus will explain all the options and will design a plan that is best
suited to your needs.
Reducing Your Risk of Complications
Reducing Infection: To reduce the risk of infection, Dr. Loftus will give you
two different antibiotics (Levaquin and Kefzol) at the time of your surgery
(most doctors prescribe only one antibiotic). Together, they cover virtually
every possible bacteria. Additionally, they EACH provide combined coverage for
the most common cause of infection, which is Staph. Next, Dr. Loftus recommends
that you have your operation in her state-of-the-art surgery suite (which is
known for exceptional privacy, comfort, and safety), where the risk of infection
is substantially lower than in the hospital, as hospitals are laden with
antibiotic-resistant bacteria. Next, Dr. Loftus' staff will sterilize the
instruments she will use during your surgery upon your arrival, rather than days
or weeks ahead of time. This ensures the highest degree of sterility, as the
instruments will be brought directly from the autoclave onto the operating room
table, as opposed to being stored between the time they are sterilized and used
(which is done in other operating rooms). Dr. Loftus will then personally
oversee the "prep," which is where the operating room nurse scrubs your skin
prior to surgery with bacteria-killing solution. Finally, during your operation,
Dr. Loftus will be the only person who handles your implants (and before she
handles them, she changes gloves), thereby reducing the possibility of
contamination. All of these steps have enabled Dr. Loftus to have a zero rate of
infection (so far). Given that she performs hundreds of breast augmentations
each year, this is a very impressive record.
Reducing Capsular Contracture: No one knows exactly why capsular contractures
form around saline implants, but most plastic surgeons think that they are
related to bacterial contamination that occurred at the time of surgery.
Therefore, every step taken to reduce the risk of infection (see above) should
translate into reduced risk of capsular contracture. Dr. Loftus has found that,
indeed, all of the efforts she has made to reduce infection have resulted in a
reduced risk of capsular contractures. In fact, although the national risk for
capsular contracture is 10-50% (depending on which study you read), Dr. Loftus'
own rate of capsular contracture is less than 1%. Dr. Loftus also thinks that
breast implant displacement exercises are important for keeping your breasts
soft and natural. She will instruct you on these after surgery and will work
with you until you are comfortable performing them. (For an explanation of CC's,
visit Breast Augmentation risks and Complications.)
Reducing Deflation: Dr. Loftus will reduce your risk of deflation by overfilling
your implants, according to the manufacturer's recommendations. (This usually
means 25-30 cc's, which is equivalent to an ounce of fluid.) To accomplish this,
Dr. Loftus will select an implant that is smaller than the size you chose and
then she will overfill it to the amount that you chose. By doing this, Dr.
Loftus has had zero deflations.
Reducing Rippling (Wrinkling): Dr. Loftus will reduce your risk of rippling by
overfilling your implants (see "deflation", above) and by recommending smooth
implants (textured implants have the distinct disadvantage of increased
rippling). These two simple measures markedly reduce the risk of rippling.
Additionally, if you have a modest amount of breast tissue, Dr. Loftus will
recommend that you consider placing the implant under the muscle to avoid
rippling in the upper half of the breast.
Reducing Sloshing: Sloshing, quite simply, is reduced by overfilling your
implants. There is no disadvantage to overfilling our implants. You should
clarify this issue with your surgeon to ensure that your implants will be
overfilled.
Reducing Nipple Numbness: Permanent nipple numbness occurs in 15% (national
average) of all women who have breast augmentation, due to damage to the nerve
which provides sensation to the nipple (the 4th intercostal nerve). As this
nerve is small, it is often not visible during the operation, hence making
damage more likely. To minimize the possibility of damage to the nerve, Dr.
Loftus avoids "cutting" or "cauterizing" anything in the area of the nerve,
which is on the side of the breast nearest the armpit. Instead, she gently
stretches tissues apart to make room for the implant. By stretching rather than
cutting, Dr. Loftus is more likely to stretch rather than cut the nerve. Because
stretched nerves are unlikely to develop permanent numbness, whereas cut nerves
are likely to develop permanent numbness, Dr. Loftus has a less than 1% rate of
permanent nipple numbness in her practice. Be certain to ask your doctor about
this issue.
Reducing Asymmetry: Dr. Loftus says that even though she looks at breasts all
day long, she has never seen a pair of symmetric breasts. She will point out to
you where your asymmetries exist so that she can help you understand which
asymmetries she can fix and which ones she cannot. Regardless of the degree of
your asymmetries, Dr. Loftus will strive to attain the best result for you and
the highest degree of symmetry possible. Toward this end, she will actually sit
you up during surgery to see how your breasts look while you are in an upright
position (we all know that breasts appear quite different when one is lying down
versus standing or sitting up). This enables her to make final adjustments to
ensure the closest degree of symmetry possible and the best result for you.
Speeding Your Recovery Following Breast Augmentation
Reducing Pain: Breast implant placement under the muscle can be very painful
with an unpleasant recovery period....OR it can be minimally painful with a much
faster recovery. Dr. Loftus takes some very important steps to ensure the latter
in her patients. First, she will give you a muscle relaxant before (and after)
surgery. As muscle spasm is an important component of breast augmentation pain,
this is very effective. Next, after you are asleep, Dr. Loftus injects
long-lasting numbing medicine (similar to Novocain, but much longer lasting) on
all sides of each breast. This "blocks" the nerves from sending pain signals to
your brain after surgery. Before Dr. Loftus closes your skin, she puts a large
dose of the same numbing medicine directly into the area where the implant is
sitting. This essentially "marinates" the tissue surrounding the implant with
numbing medicine. For a variety of reasons, the body is very slow in absorbing
the numbing medicine around the implant, and it therefore can last for several
days. Don't worry, though, because once it wears off, you do not suddenly feel
pain. In fact, most do not even notice when it wears off. It has been shown in
multiple medical studies that blocking the initial pain a patient feels after
surgery markedly reduces their overall pain and speeds their recovery. Some
plastic surgeons advocate placing a pump in the surgical site to infuse numbing
medicine for a few days following surgery. Although this is effective in
controlling pain, it is no more effective than placing a large single dose into
the pocket at the time of surgery. Further, it introduces a much higher risk of
infection, as the pump tubing communicates the outside world with your implants
for as long as the pump is in place. Finally, Dr. Loftus will see to it that you
are given prescriptions for Demerol (meperidine), which is a powerful pain
medication, as well as Celebrex (or Vioxx), which is a powerful non-narcotic
pain medication. Working together, they are very effective in combating pain and
discomfort.
Reducing Nausea: One of the most common causes of nausea is pain. Dr. Loftus has
found that taking the above steps to reduce pain has markedly reduced the
incidence of postoperative nausea and vomiting, even in those who are prone to
it. Further, Dr. Loftus advocates a number of simple medications which are very
effective in reducing nausea. All of her patients receive decadron (a steroid
which reduces nausea), Zofran (an anti-nausea medication that is so effective
that it is routinely prescribed for cancer patients), Reglan (a medication which
prevents your digestive system from slowing down, as a slowdown can trigger
nausea), and Pepcid AC (this over-the-counter medication is a fabulous drug
which further inhibits nausea in surgical patients). By taking all of these
steps, Dr. Loftus has effectively reduced the rate of nausea and vomiting in her
surgery center. In fact, although the national average for postoperative nausea
and vomiting is 33% and 22%, respectively, the incidence of nausea and vomiting
at the Loftus Plastic Surgery Center is 12% and 8%. |
Source:
http://www.cancerbacup.org.uk/Cancertype/Breast/Typesofbreastcancer/Pagetsdisease
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