what to expect cont.
Typically, breast augmentation patients in Chicago undergo general anesthesia for surgery. When surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings and a surgical bra.
Dr. Casas’s Chicago clinic will provide you with a schedule of follow-up visits and appointments with a lymphatic massage therapist prior to your procedure. The massage is helpful for healing and reducing fluid and swelling around the implants. Bandages will be removed within a few days, and you may be instructed to wear a supportive bra and given exercises and self-massage to perform at home. Stitches will be removed in two to four weeks.
It is often possible to return to work within a week. Vigorous exercise, especially arm movement, may be restricted for three to four weeks. Dr. Casas will detail your schedule for return to normal activities based on the breast augmentation procedure performed.
Manual Lymphatic Drainage, administered by massage, is used after each procedure to reduce swelling. The number of sessions is individualized. It is important that patients follow a healthy lifestyle leading up to and following procedures, including not smoking, a healthy diet, and taking daily vitamins. In a letter to the Plastic and Reconstructive Surgery Journal, Dr. Casas writes:1
Preoperative Sizing for Breast Augmentation
By Dr. Laurie Casas, M.D.
Drs. Hidalgo and Spector demonstrate a valuable adjunct technique for preoperative sizing in breast augmentation in the February 2011 issue of Plastic and Reconstructive Surgery. Their approach is a patient-centric process that allows the patient to be the key decision-maker at a critical step in implant selection. Unfortunately, the study design has significant flaws, including the use of an unvalidated questionnaire and small cohorts that yield insufficient numbers for statistical analysis. These shortcomings of this “scientific article” should not deter the reader from understanding that this important patient-centric process is extremely valuable; however, “preoperative sizing” must be coupled with objective data from measurements and assessments of the patient’s chest wall; breast skin; tissue quality, quantity, and adherence; and nipple-areola position, size, and shape.
The finesse in the preoperative implant-selection process evolves as the plastic surgeon allows the patient to actively participate in the process while only offering patients implants to use for sizing that are tissue and dimensionally appropriate in width, height, projection, and volume so that the implant ultimately selected will fulfill the patient’s preexisting soft-tissue and chest wall requirements. Many patients will only reveal their unrealistic expectations through this type of patient-centric preoperative sizing process. Three-dimensional imaging may also help to evaluate patient expectations; however, the software is costly.
To achieve high rates of patient satisfaction and low reoperation rates for size dissatisfaction, the plastic surgeon must actively involve the patient. This method does provide the patient with that important decision-making power, but it must be masterminded by the plastic surgeon who has measured and evaluated the objective data from the clinical examination so that the patient is guided to choose the appropriate implant that will safely fill her unique breast dimensions yet provide her with an aesthetic result with which she is satisfied. As always, as plastic surgeons, we must not only merge scientific data with the artistry of plastic surgery but also practice the art of medicine in our approach to patient care. Bravo to Drs. Hidalgo and Spector for reminding us that the patient’s desires are a critical part of this implant-selection process.
References:
- Casas, L. (2011, February). Letters to the Editor: Preoperative Sizing for Breast Augmentation. American Society of Plastic Surgeons.
