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All patients undergoing breast augmentation surgery should understand
the potential risk for complications. The following inherent risks
must be understood and assumed by the patient as part of this procedure.
Although most patients have very satisfactory results, the unlikely
complications include those already mentioned in association with
the implant (ruptures and capsular contractions) and the following:
infection, hemorrhage into the breast pocket, chronic pain, increased
breast asymmetry, breast flattening or indention upon tightening
of the muscles, unsightly scars at the site of the incision, lung
collapse or untoward reactions to anesthetic administration. Additionally,
any surgery involving the breast can result in diminished or lost
sensation of the nipple or skin although typically temporary complications
can make this loss of sensation permanent. A significant amount
of discomfort is normal with every breast enlargement procedure.
Should unusual bleeding occur after the procedure, your breast will
immediately become noticeably asymmetrical (the one with the bleeding
will be much larger), painful and swollen. This will necessitate
a return to the surgery center to stop the bleeding and to remove
the blood clot. Infection is also a possibility although very unusual.
If antibiotics fail to treat the infection, the implant may need
to be removed until the infection is treated and then replaced.
Other problems which occur but are usually of transient nature
include hypersensitivity of the nipples, tightness in the chest
wall and shooting or burning pains at the sides of the breasts.
In 1992, the FDA adopted a voluntary moratorium on the use of silicone
gel breast implants. Subsequently, these implants have become available
again for cases of breast reconstruction and for some patients undergoing
breast augmentation. Since the moratorium in 1992, many scientific
studies have carefully evaluated silicone breast implants and many
disease states including autoimmune disease. The majority of these
studies have indicated no increased percentage of patients suffering
diseases with implants as compared to a general population group
without implants. Although this information is reassuring, additional
studies are currently in progress to more carefully evaluate this
issue.
There are other very rare potential complications from this operation
in addition to the ones that have been mentioned, but it is not
possible to advise you of every conceivable complication. Complications
after any type of cosmetic surgery are relatively rare and most
patients are very pleased with the results and their new appearance.
Instructions for Postoperative Augmentation Mammoplasty:
On your day of surgery you can expect to feel sleepy; this may
continue the following day. There is also a feeling of tightness
and discomfort throughout the chest area and perhaps radiation into
your arms or back for which pain medication will be prescribed.
Each day thereafter you will notice an improvement.
Please remember that no two sides ever heal the same after an operation
and that this is normal. Major discrepancies, however, should be
reported to your surgeon. Please follow the instructions below to
minimize possible complications.
- Keep ice bags applied to your chest on the day of your surgery.
- If the underarm incision is used, you may remove the Ace bandage
on the second day after surgery and begin to shower, and massage
the breasts as instructed. The wrap should be applied to the top
half of the breasts in an effort to keep the implants as low as
possible during the initial healing phase.
- If the underarm incision is used, it will be covered with a
clear plastic dressing. Please remove this plastic sheet while
showering on the day of your first post operative visit -- usually
six to seven days after your operation.
- If your incisions are placed around the nipple or under the
breast fold, you will probably be placed in a brassiere at the
end of your operation. Stay in your brassiere. Do not take it
off to wash until after your first postoperative visit, usually
five to seven days after your operation.
- A small percentage of patients experience significant nausea
after any operation. This may be due to your pain medication or
antibiotics. Please let us know if this persists and we will change
your prescription.
- During your final preoperative visit, you will be given prescriptions
for pain medication and antibiotics. The antibiotic tablets are
to be taken on a daily basis, beginning on the day of your surgery.
To minimize the possibility of nausea, always take these antibiotics
or pain pills on a full stomach.
- Do not do anything which causes discomfort prior to your first
office visit after the operation. To avoid unnecessary swelling
or bleeding, do not bend over, strain, exercise or do any other
activities that could increase pressure in your chest during the
first week. It is very unusual for bleeding problems to develop
after the first week. You will be encouraged to resume your normal
activities after the first office visit. You will also be encouraged
to continue your massages.
- Sexual intercourse and all other physical activity may resume
one week after surgery or anytime thereafter as long as you are
physically comfortable.
- You may drive a car with caution, wearing a seat belt, beginning
48 hours after your last pain pill or sedative. Do not drive after
taking a pain pill or other sedative!
- It is preferable that you sleep on your back or sides during
the first two weeks after surgery. Patients with under arm incisions
will be required to wrap an Ace bandage snugly over the top half
of their breasts, pushing them downward during this period. Patients
with under breast or "nipple" incisions will wear their
brassiere day and night, until the first postoperative visit.
After the first week, all patients may use their own discretion
regarding a brassiere. Do not wear a push-up bra or any with pressure
wires during the initial healing phase unless directed to do so,
as the wires could help displace your implants upward. You may
occasionally wear such a bra for a special dress or evening, but
do not routinely wear this type of bra, especially in the first
six months following your surgery.
- Recovery rates vary from person to person, depending to a large
degree on patient motivation. Most patients feel well enough to
drive a car and perform desk work between three and five days
after surgery. Aerobics instructors may resume teaching ten to
fourteen days after surgery, but everyone feels some discomfort
related to the surgery for weeks or months to come. The best rule
is to avoid activities that cause significant discomfort and to
enjoy those that do not.
- Resume examining your own breasts within a month of your procedure
and having your physician do a routine breast examination every
six or twelve months. Also return to see your surgeon at least
annually for a breast examination as a plastic surgeon can best
examine an augmented breast. Mammograms must be obtained as indicated
by your gynecologist or personal physician. We request that copies
of your mammography report be forwarded to our office as well
as your gynecologist or personal physician's office. Generally,
a baseline mammogram is suggested at age 35, an annual mammogram
for women after the age 40, but earlier or more frequent mammograms
may be recommended by your physician.
Please feel free to contact our office regarding any other questions
or problems you may encounter.
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