For women considering a breast aesthetic procedure, the consultation process with a board-certified aesthetic plastic surgeon, or breast specialist, is the critical first step in achieving their ultimate result. During the consultation, the patient should educate herself about the procedure she is seeking, choose the right surgeon for her goals, and be as informed as possible about the procedure before she agrees to scheduling her surgery.
At most practices, you will begin by scheduling an initial consultation, where you will discuss your aesthetic concerns with the surgeon of your choice. In most cases, the consultation will be quite thorough, including a precise history of general health, focusing on previous breast surgeries or illnesses involving the breast. Careful examination and measurements of the breast, and a discussion of the patient’s desires are critically important. An important issue will be determining both the concerns about the breast appearance that the patient has, and to what degree is the patient prepared for the sacrifices and limitations that this surgery requires. As important as is the issue of implant selection, equally important is the location of the scar. The main concern of many of our patients, therefore, is to hide or camouflage the scar in a place that would not attract attention. Given the patient’s desires and anatomic limitations, the pros and cons of each incision must be carefully and thoroughly informed. It should be emphasized that while the final incision is one of the most important patient requests, post-operative issues will play a role in the incision selected. Prior scars, especially hypertrophic or keloidal scars, body type (obesity), and prior history of blood clots will be important factors. Also, the appearance of scars, which is closely associated with the thickness and pigmentation of the skin, are factors. It is also essential to discuss the trade-off between scar length and visibility.
Breast augmentation (enlargement) is one of the oldest and most popular surgical procedures. One of the many questions you need to answer is: What breast cup size do I hope to achieve? The answer? There is no simple answer! Who is a candidate for breast augmentation? Women of any age, those whose breasts are no longer growing, content with their breast development, in good health, both physically and emotionally, and of realistic expectations. Most of us realize that a psychological maturity should be achieved before considering such an elective surgical procedure. What can you expect from your consultation? First, you will need to provide a complete personal and family medical history. A physical examination follows in which your breasts are measured and photographs taken. You will have the opportunity to discuss your expectations and wishes. Naturally, the procedure and its inherent risks and benefits, alternative procedures, the possible use of breast implants, and the limitations are explained. “Before and after” photographs of other women who have undergone breast augmentation surgery will be made available. Informational brochures describing implants in detail are yours for the reading. Sizes, shapes, and materials of implants are all important choices. Recommendations for surgical procedures and types of anesthesia follow. Finally, the costs of surgery will be discussed. All responsible plastic surgeons are anxious to provide excellent service as well as the highest level of personal attention!
Breast augmentation in Turkey, a country known for both its state-of-the-art medical facilities and affordable breast augmentation price, costs a slight fraction of what it does in more affluent countries. Long-lasting results and a natural look, especially when working with one of Turkey’s top plastic surgeons, are often the end result. Despite the potential risks of traveling, apart from a list of important Turkish breast augmentation information, you should be prepared if you are considering traveling to Turkey for breast augmentation.
Breast augmentation in Turkey is thriving by leaps and bounds. Thousands of women annually flock to this country that is both on the cutting edge of medical technology and knowledgeable in the latest methods of increasing breast size. Indeed, Turkey is one of the top 10 countries in the world for cosmetic surgeons who specialize in creating beautiful, firm, and natural-looking breast tissue, while a breast augmentation in Turkey specialist performs thousands of successful surgeries. If it is being performed for medical reasons or by a specialist, Turkish breast augmentation does provide one with the most affordable breast augmentation price in the world.
Patients seek breast augmentation for different reasons, and each has its unique set of advantages and considerations. The following are reasons why some patients consider breast augmentation:
Being a cosmetic procedure, however, breast augmentation surgery may not be suitable for everyone. Plastic surgery comes with its full set of advantages and disadvantages. Breast augmentation may not be suitable for someone who is pregnant or breastfeeding, has breast cancer, or breast abscess; had radiation therapy or infection to the breast region; has a poor medical history; has had a negative skin reaction; active infection; or undergone an underdeveloped breast surgery.
In addition to the expertise and experience of the surgeon, several other factors also influence the cost of breast augmentation. Nonsurgical silicone gel implants are more expensive than saline implants, which can increase the total breast augmentation price by around $1,000. Other factors that may also affect cost include the type of anesthesia used, the type of liposuction, any sort of pathology that may exist within the breast, and the type of pre- and post-operative testing.
A good way to anticipate these costs is to ensure that your breast aesthetic consultation is thorough and comprehensive. You should first call a few surgeons to find out the breast augmentation price range of breast augmentation in your area in order to compare breast augmentation price. Your primary care doctor, a friend, or a family member could provide you with the names of a few different surgeons. But the best way to choose a surgeon is by word-of-mouth. If you know someone who has already had breast augmentation, have a chat with them. During your first consultation, a lot of this information will be discussed. If asked, your doctor will provide his experience, any treatment that may be needed, and costs, after a physical examination and conversation with the doctor.
Millions of women in the United States and around the world undergo breast augmentation, reduction, and reconstructive surgery each year. If you have made the decision to proceed with breast aesthetics, the most important step is to arm yourself with knowledge and know, from the start, what to expect from your consultation with your plastic surgeon. Know thy body and also know what your wishes truly are regarding breast aesthetics. Build a repertoire of honest expectations about your outcome and remember, aesthetics is the key word.
The initial step in breast aesthetics is locating a qualified plastic surgeon. While it is first by definition, it is wise to proceed with caution in this department. First, realize that plastic surgery should be confined to qualified plastic specialists only. Many other types of physicians, such as dermatologists, perform cosmetic or non-reconstructive breast aesthetics surgery. Always check with the American Board of Plastic Surgery and inquire whether or not your surgeon of choice is not only board certified, but also is certified as a plastic surgeon. Ask those patients who have had breast aesthetics at the hospital level for referrals. Many hospital-based doctors cannot make you look worse; their track records are good and the physicians with whom they work are usually highly experienced. Avoid the glossy ads and the latest chief. Be cautious of quickie formulas to improve results. Always ask, “Where are your patients now?” and examine the results of those patients at their first operation, as well as their second and third operations.
The physical preparation for breast aesthetics consult involves several actions you should prepare yourself to do. Book your consultation at a time when you are not menstruating, have had a menstrual period, or have weaned your child. If you will be going through with the surgery, three to four months will be needed to complete all of the details and plans associated with your planned breast aesthetics surgery. If you will be needing a series of surgical procedures, plan at least two weeks between each of your consultations. This will allow you to have all your questions answered and will provide you with knowledge that will allow you to make the most up-to-date decisions. It is also a good time to arrange for childcare for your family, as needed, once you are home following your procedures.
Emotional preparation for breast aesthetics consult involves several questions that you should ask yourself before the consultation date has been set. You will have a happier consultation and will be relieved of unnecessary prolonged decision making or decision dilemmas if you can answer these questions before or at this time. What do I want? How big do I want to be? What do I dislike? How visible is the scarring acceptable to me? How different will this outcome look from other new strategies? What are my husband’s feelings and needs? What are my present and future medical needs? When do I want the breast aesthetics surgery?
When considering breast aesthetics surgery to change the appearance of your breasts, you should list questions that you have about the surgery so you do not forget to discuss these issues. We have provided a checklist to assist you with this, but it is important that you also ask about anything important to your needs. It is likely that you will be anxious and could forget to ask about basic issues.
You have many options when it comes to cosmetic surgery for your breasts. There are three primary techniques for breast enlargement – subglandular (on top of your pectoral muscles), partial submuscular (a.k.a. dual plane; under your pectoral muscle and over your rib cage), and full submuscular (under your pectoral muscle and your rib cage). The most common incisions for breast enlargement are the inframammary (fold under your breast), areola, transaxillary (beside the breast), and transumbilical (belly button). A Brazilian breast lift is a technique with which implants are used to adjust the size, shape, and position of your breasts. There are also several techniques for breast lift and breast reduction, as well as implants for breast reconstruction.
Women who are unhappy with the size or shape of their breasts, or who may have physical discomforts – back/neck pain, rashes or skin irritation, shoulder dents, or tension headaches – may want to consider breast aesthetics surgery. In addition to improving your figure, breast surgery could improve your quality of life and self-image. After breast surgery, they may feel more comfortable, more attractive, and more youthful. Women who give birth and breastfeeding may want to remove the pregnancy and nursing “provenance” from their silhouette. Women who have lost significant amounts of weight may also turn to breast aesthetics surgery to correct sagging, loose skin areas or to restore the volume of their breasts. So if you are unhappy with your breasts, you could talk to board-certified physicians about enhancing your appearance. The physicians could help you decide which of the many breast-improvement options – breast lift, breast reduction, breast enlargement, breast reconstruction – could improve your figure, health, and energy levels.
Breast reduction patients may experience more postoperative pain due to the extent of the surgery. Swelling, bruising, and temporary numbness of the skin may also follow the breast aesthetics surgery. The worst discomfort is typically over two days right after surgery and is usually manageable with pain medication. Laser-assisted or endoscopic techniques may speed up recovery. Discomfort can be minimized by keeping the arms raised and supporting the back. A recuperation period of just a few weeks is necessary before returning to work, but patients will be encouraged to limit physical exertion for up to a month.
Implant surgery should result in only minimal soreness, with bruising disappearing around four to six weeks after breast aesthetics surgery. Biomaterials such as acellular dermal matrix and Synthetix can also be used to help speed up recovery. Factors that help quicken recuperation times include not performing submuscular placement, avoiding manipulating periareolar capsulotomy, and choosing smaller implants. A few months are required for the implants to settle into their final location. The patient wears a surgical bra or sports bra for several days after breast aesthetics surgery and can only shower after this soft support has been taken off. Light activities such as walking can be resumed at that time. Regular physical activities can be resumed about a month after breast aesthetics surgery.
Pain after breast aesthetics surgery can sometimes become an underlying challenge to patients. Having adequate pain relief can make a significant difference pre- and postoperatively, as well as improve both the success rate and the patient’s satisfaction with the procedure. Women’s perception of pain is highly individualistic, and therefore it requires medical personnel to pay a great deal of attention when caring for patients’ pain. It is vital for the consultation and the perioperative period to provide patients with sufficient information about pain, its nature, and its possible alleviation to dispel fears that may exist.
Non-pharmacological pain relief, or alternative pain management, involves an experimental approach targeting the senses. Interventions including muscle relaxation exercises (such as splinting), pain and sleep education, meditation, and music listening have shown to provide effectiveness in reducing pain. The combination of several modalities seems to offer the best outcome. Such interventions are effective with analgesics and can be offered together with pharmacological pain relief techniques to enhance the effect.
Pain control is designed to counteract the anaesthetic block and obtain satisfactory pain relief in general. Paracetamol is well studied and an effective analgesic after day-case breast operations and is reported to provide equal analgesic effect to Non-Steroid Anti-Inflammatory Drugs (NSAIDs) and opioids in other literature. It does not, however, combine additive analgesia with the NSAIDs or the opioids. It is recommended to start with 1g four times daily. NSAIDs are a good alternative. The drugs are started preoperatively or in the wake-up period after the operation and before surgically induced visceral pain is expected, and they are continued for three to four days believing that verbalgia/hyperalgesia is a problem after breast operations.
Opioids should be prescribed according to expected pain intensity and expected side-effects. These drugs are, therefore, dosed individually based on pain history and taking into account possible nausea, somnolence, and dizziness. This being said, subjective pain variations and relevancy towards psychological and emotional troubles should not be underestimated but embraced in the analgesic organization. However, opioid analgesics can be seen as addictive and missing part of the overall pain treatment. The decision-making process should take into account both agents, responsible for the prescription and possible monitoring and later follow-up.
When using regional anesthesia, it is optimal to provide the effect postoperatively. A single dose of epidural morphine or bupivacaine is efficient, yet has limitations due to increased risk of a compromised surgical wound. Thoracic paravertebral blocks have been used with good effect, and research support shows that it is given in combination with intake of NSAIDs.
In the diagnostic stage for breast cancer, sentinel lymph node biopsy procedures could be performed to not infrequently suffer from pain problems in both axilla and the breast. The meeting review audit of the intermediate hiatus of the pectoralis major muscle could likely be a helpful technique to use perioperatively.
Recovery following breast aesthetics surgery can be more involved and sometimes more complicated than many women may expect. Following any type of breast aesthetics surgery, it is absolutely essential to follow your surgeon’s postoperative instructions.
Ice packs are often used to ease discomfort and reduce swelling during the first couple of days. Pain and discomfort can also be managed with prescribed or over-the-counter pain medications.
To ensure your recovery is as smooth and trouble-free as possible, it is best to avoid certain normal activities for a period following your procedure. While the guidelines will vary from patient to patient, there are some general recommendations that most women can follow: do not lift, push or pull anything that weighs more than 10 pounds (a gallon of milk) for up to 4 weeks following surgery, avoid reaching overhead as much as possible for up to a week, avoid vigorous physical activity, particularly vigorous arm movements such as mopping and vacuuming, avoid driving a car for at least a week, avoid sex for at least a week, get plenty of rest.
Initial Appearance and Healing Process
To be truly satisfied with the outcome of your breast aesthetics surgery, it is important to understand the process of healing, which is unique to each patient. The patient and the surgeon must hold realistic expectations and understanding as to what is possible, before and after surgery.
A small amount of bleeding is normal under the surgical incision, causing some swelling and bruising. As a result, the breast may appear slightly larger. The difference is usually because of the drainage tubes under each arm. The chest is typically very swollen, sore, and tape over the incisions, incision lines, and stabilizing elastic band or bra. Initially, you may feel anxious about the early postoperative process, but keep in mind that the immediate postoperative healing period is short-lived in the scope of recovery. The discomfort and postoperative anxiety should improve rapidly. Although you feel that the results should be quick, remember that it will take some time for the overall result to be seen and appreciated.
There are many different postoperative techniques, such as swelling reduction exercises, to reduce discomfort and aid in the early healing process. The majority of draining tubes are removed early in the postoperative period. Aerobic exercises usually can be initiated about 3-4 weeks post-op, and limited or modified weight lifting within 6-8 weeks. Complications can occur. It is important to telephone timely all unusual changes or concerns, especially if in reference to one breast only relating to swelling, bruising, congested drainage sites, or locally increased temperature, or for concerns of possible fever.
Immediate Post-Surgery Breast Appearance
Immediately after breast aesthetics surgery, the breasts may feel and appear somewhat higher, and the overlying skin of the breasts expanded to make room for the inserted breast implant or tissue pre-expanded with tissue expanders. Over the next few months, the implants or expanders will settle as the newly expanded tissues relax and stretch. As the tissues adjust to the implant or expander, the breasts will slowly reposition themselves closer to the desired location. During the immediate post-operative period, both the breasts are frequently displaced higher than their ultimate location. The extent and duration of this elevation and displacement vary considerably among individuals, with factors such as age, skin elasticity, implant size, and surgical technique all influencing the post-surgery shape of the breasts. While some individuals have mostly favorable breast appearance immediately after surgery, this is less common. In the initial weeks following breast aesthetics surgery, asymmetry of the left and right breasts is frequent. This disparity will continue to decrease over the course of several months as the breasts and surrounding tissues stretch and relax.
Immediately after the breast aesthetics surgery during which round silicone-gel-filled breast implants were placed into the breasts, the size, appearance, and feel of both breasts might resemble those shown in Figures. During the initial days and weeks following the breast aesthetics surgery, the goal is for the implant to descend step by step via gravity and the pressure of active, methodical implant displacement in order to achieve the optimal location for the implant at the end of breast surgery. Throughout the entire recovery process, the patient participates in a series of postoperative breast displacement exercises.
Wound Healing and Swelling Resolution
Wound healing and swelling resolution are key components in the process of recovery after breast aesthetics surgery. After breast aesthetics surgery, the area of the wound repair is protected from outside environmental factors by using sterile techniques, placing dressings on top or underneath the skin repair, using closed/incisional negative pressure devices, and applying post-surgical garments. After drainage, reawakening the tissues to inductive therapeutic devices, ointments, and gels reattribute the skin a role in wound healing. In the case of chronic breast wounds, additional techniques using biophilic-active/index materials elastofrost, Vello, or Xcell to reverse tissue glycation and desiccation are performed to enhance wound healing. Wound management plays an important role in managing swelling resolution after surgery.
The application of negative pressure dressing after breast aesthetics surgery is helpful in managing lymphedema after breast surgery, breast-reconstruction flaps, vascular composite allotransplantation of the abdominal wall, and chronic breast wounds. After the tissue’s hydration reconstitution to the initial conditions, the supportive materials are removed and the available lymphexite breast phantom model is applied. The lymphexite breast phantom model is used to qualitatively determine the effect of the histoplastic ratio on skin lymphatic drainage. The data obtained are used to assist in pain and localized immunogenic reaction loci after bioluminescent hyperspectral imaging of the intact epigenetic phenotype of the skin lymphatic drainage using the neckline predictor. The lymphexite breast phantom with intact epigenetic phenotype is used for imaging the behavior of lymphatic skin nerve bundles in contaminated diseases of the breast skin.
Dressings contribute at different stages of wound healing by providing a microenvironment of moisture to facilitate cellular migration, optimize cell activities in a wet environment, and prevent plasma leakage from the vessel without increasing lactate dehydrogenase activity. An ideal dressing should be nonadherent, permit gas exchange, expel excess exudates, protect the wound from trauma and infection, and improve aesthetic outcomes on the face, neck, vulva, areola, and nipple. Especially, the integration of aesthetic and functional outcomes is essential to help patients restore their daily routines. The scar’s functionality and reduction in thickness are improved, thus maximizing the aesthetic outcome and reducing surgery-related anxiety. Therefore, dressing application after using negative pressure can contribute to the supportive material selection used to increase the circulatory lymphatic rate in the wound bed.
Bruising is a normal inflammatory process following breast aesthetics surgery. It occurs 24-48 hours postoperative and, if allowed to run its course, gradually resolves on its own over many weeks. Bruising is seldom fully absorbed by the body and converted to skin color more quickly with ice, heat, Arnica, and Bromelain, as well as herbal supplements such as Ginkgo Biloba. You may safely apply concealer after 24 hours and may use light makeup to conceal the bruising after 3 days. You may notice a light yellow or pink coloration around the shaped sizer or silicone implant. The pink color is a normal, temporary effect of stretching the breast tissue and skin over the shaped sizer. Darker color changes to the skin or pigmentation represent scar healing, and these skin color changes usually resolve in 12-14 months.
In darker and tanned skin individuals, the risk of pigmentation changes is greater, with a greater tendency to develop a “hyper or hypo” pigmentation response. Tai rubbing or friction of the adjacent skin is to be strictly avoided starting at day five. Lightly pressure areas of the skin and perchlorate discharges by the skin can lead to scar desaturation and widening. This is an entity attributed to excessive tension along the vertical limb of the old inverted T skin incision. The skin incision is free of tension at the time of closure and the skin easily approximates together using fine absorbable sutures. These will absorb in 4-6 weeks.
Likelihood of Bruising
Introduction: Breast aesthetics surgery is a common plastic surgical procedure. Patients who undergo breast surgery postoperatively often experience bruising, which can be distressing for patients. Our study aimed to determine the likelihood and severity of bruising in these patients, enabling them to better prepare for expectations postoperatively. It highlights the variables that lead to bruising and addresses how it can be approached.
2 Materials and Methods: A multicenter, prospective observer-analyzed cohort study was undertaken. A cohort of patients who had undergone reconstructive, aesthetic, or benign breast procedures were analyzed. Data were collected on patient characteristics, surgical details, bruising in four specific areas, surgical complications, and admission treatment. Postoperative bruising at Day 1, 4, 7, and 14 were analyzed.
Results: One hundred and two patients were enrolled with a mean age of 54.7. 96% of the participants were women. 67% of the procedures were breast reconstruction. 83% of patients had bruising at Day 1 versus 47% at Day 14. Opioid use was statistically significant in leading to more noticeable bruising on Day 1 and Day 4. There was no evidence to suggest that clexane and/or aspirin use postoperatively, BMI, smoking status, breast group, theater length, and combined procedures affected postoperative bruising. The results showed that breast reconstruction was the group that developed new and more noticeable bruising on Day 7.
Duration of Bruises and Skin Color Variations
The duration and the visible appearance of bruises and skin color variation may vary from individual to individual. Cosmetic surgery candidates should be aware that disciplinary changes in the skin macrostructure may cause additional changes in the skin color transition layers, which have an impact on the appearance of the skin. To reduce the duration of the visible bruises, early lymphatic drainage massage is recommended as a possible solution.
At the early stage of postoperative recovery after surgical skin incision, it is possible to observe at the site of the attack an initial pain, swelling, redness, and blood clots forming in the surrounding area of the incision. After the incision has been successfully informed, which is approximately by the third day, pain, swelling, and skin redness significantly decrease. Up to the postoperative sixth or seventh day, a patient may experience subcutaneous blood flowing into the upper parts of the dermis and forming visible bruises on the skin and adjacent tissues. The process of resorption of blood from the tissues can take up to two weeks or longer. The duration and visibility of bruises depend on skin properties, anatomical area, skin thickness, blood vessel characteristics, patient’s skin reaction to the injury, surgical procedure, and manipulation during breast aesthetics surgery, incision length, depth, rapid lymphatic return or lymphatic stasis after operation, postoperative care, and lymphatic drainage disorder. Information analyzed in this research, conclusions, and recommendations are significantly important and provide reliable data that will ensure faster postoperative recovery with reduced visible signs.
Scarring and how scars heal and present is an important focus of the entire healing process postoperatively. With regards to postoperative scarring, when manipulating tissue for rejuvenation, flap, graft, or wound repair, it comes with some similarities in care. Factors that contribute to the final outcome vary according to patient characteristics and procedure specifics. Factors that relate to the patient’s internal health and age have genetic components that contribute to their quality of scar formation. By recognizing the variables, along with understanding the growth factors that assist in incisional healing, one can enhance their potential for a more satisfying final scar outcome. Many times, simple and safe interventions such as tension management, biologic therapy to enhance scar suppression such as cryotherapy, or scar massage help with this process.
Key Points:
– Scarring and how scars heal and present is an important focus of the entire postoperative healing process.
– By recognizing the variables that can enhance the potential for a more satisfying final scar outcome, surgeons can educate and prepare their patients pre- and postoperatively on the initial and final scar appearance.
– It’s important to remember that the overall goal of improving the quality of scarring is to use predictive strategies and minimize the hypertrophic phase during the entire process of wound healing and determine the final low amount of visible scars.
Types of Scars and Locations
Scars can be placed in different locations depending on the technique used and area of the breast receiving surgery. They will give the best results when given time to mature, with approximately 80% improvement occurring within a year, and continuing to blossom with time.
Inframammary Fold (IMF) incisions follow the natural curve of the breast and are recommended for patients with significant breast ptosis and can be used for any surgery of the lower pole of the breast. They are more noticeable when the arm is raised, so consideration for clothing choices may have to be made depending on the patient’s comfort level with the resulting scar’s visibility.
Periareolar scars are camouflaged by the border between the pigmented skin of the areola and the nonpigmented natural skin. Drains and lumpectomies can be performed from this incision during a mastopexy-augmentation or mastopexy lifts done for grade I or II breast ptosis. Vertical scars (lollipop scars) are used during vertical breast lifts to combat more serious grade II or early-grade III breast ptosis. The incision begins at the inferior border of the areola and extends vertically toward the inframammary fold. The scar is mainly noticeable on the inside of the breast but can be hidden, or decreased by transfer of more breast tissue superiorly. A true artist’s eye can judge what and how much can be added to the upper pole of the breast.
Scar Permanence and Appearance Expectations
The scars from breast reduction are permanent. At first, the scars will be pink. Over the next several years and in some cases, decades, they will mature to white. As a general rule, while young scars are very conspicuous, they progressively become less and less so due to sun exposure and improved skin laxity. Older scars are usually much less obvious. The level of scar maturation depends on each individual and cannot be predicted for every person with accuracy; however, ethnicity, skin type, genetics, and age appear to play significant roles in the process.
Some other factors can influence wound healing and the appearance of scars. These include feeding, smoking, menopause, diabetes, obesity, poor nutrition/hydration, being overly or underweight, systemic diseases, and systemic steroids. Such things must be kept in mind when considering the goals and scheduling of a breast reduction. After several months of healing, your scar will be re-evaluated. The vast majority of women are so enthusiastic about their improved breast shape, size, and perkiness that they are not at all concerned about any residual, albeit acceptable, scarring. A few women may have some disappointment in the scar appearance, but most of these women will not seek any further treatment to improve their appearance, as the new breast aesthetics usually successfully compensates for their scar concerns. In a very small minority of cases, scar revision procedures are required, but keep in mind that more surgery leads to more scars. Talk to your plastic surgeon about scar revisions. Since the results of any scar revision are never exactly predictable, women must weigh the benefits of an improved scar with the possibility of trading it against an increased scar burden, which may or may not improve the current appearance.
Women seeking breast procedures are generally well aware of the changes they are seeking for their anatomical appearance. Patients may expect a variety of physical and emotional improvements from cosmetic and reconstructive procedures. Among patients seeking breast augmentation, the emotional benefits of feeling more womanly, more feminine, and sexier after the procedure have been described. Improved self-confidence and self-image have also been cited by these patients. Among women who have undergone breast reduction, numerous emotional benefits have been noted. These include a reduction in self-consciousness, improved self-esteem, and an increase in body image satisfaction. Emotional well-being may also be enhanced after breast aesthetics surgery, as a result of reducing or eliminating symptoms of neck, shoulder, back, and breast pain that patients were experiencing preoperatively. Finally, psychological benefits have been noted in patients who had undergone breast reconstruction. Other domains of patient satisfaction after breast aesthetics surgery, measured through standardized assessments, show high scores of satisfaction after breast enhancement, breast reduction, and breast reconstruction.
Other nuances to patient satisfaction and emotional well-being from these procedures may also be related to cultural factors or to the country where the procedures are performed. Although cultural practices often regulate body image and perception, and procedures utilized to create a sense of inner beauty are quite similar, variations in the meaning and importance of these procedures should be taken into consideration. In comparison, women from some geographic regions and cultures might view these procedures as a significant step in initiating a change of identity in the direction of more independence and increased freedom. These sociocultural differences may attenuate the projected emotional well-being improvement. Nonetheless, body image and patient satisfaction vary across age group and reasons for surgery, and a high rate of patient satisfaction is evidenced overall, varying by clinical diagnosis. Whether patients seek improvement for cosmetic or reconstructive reasons, significant improvement should be expected in patient satisfaction scores after breast aesthetics surgery.
Satisfaction with Surgery Outcome
Because so many patients experience long-term satisfaction after having undergone breast aesthetics surgery, it is no surprise that many studies have now confirmed what any experienced breast imaging or surgical team already knows: that is, by and large, patients are satisfied after breast aesthetics surgery. Most studies tend to focus on the cosmetic outcome of the surgery and on the patient’s degree of satisfaction. Relatively few of these studies have used validated measurement instruments (such as the BREAST-Q patient satisfaction instrument) to identify key predictors for satisfaction. Because satisfaction with breast surgery is likely to be the result not only of good cosmesis but also of the successful intraoperative techniques used to achieve this outcome, it is worth discussing how the use of validated measurement tools may, in future, aid our understanding of where we should be focusing our attention to help maximize patient satisfaction.
It is clear that the experience of other patients who have undergone breast surgery can also influence a patient’s decision-making, especially when trying to confirm realistic expectations. Recent studies on patient satisfaction are reviewed in this chapter, divided according to different domains linked to the breast: implants, oncoplastic and reconstructive breast surgery. General conclusions are drawn on patient satisfaction with breast surgery, identified areas that are likely to enhance or impair satisfaction with surgery, and provided a brief discussion of the impact of complication management on breast aesthetics surgery satisfaction.
It is completely normal to feel a complex mix of emotions when contemplating or experiencing breast surgery. Many patients come to breast surgery to remove painful and visible reminders of illness or injury, but the emotional impact may feel underrepresented in their care. They may experience a range of feelings, from satisfaction to disappointment. It is essential to talk to your doctor about what affects you. Addressing them can give peace of mind.
Consider the following steps to prepare and provide extra care for yourself and your loved ones. Be open with them about your emotional experience and ask for their support and understanding as you contemplate or go through the changes that are part of your surgical journey. Extensive communication between patients, friends and families, and the medical team can help create an open and caring environment for an emotionally complex journey. It is completely normal to have questions or concerns. With the breast aesthetics surgery procedures currently being developed, your breast surgery team is prepared to develop a personalized care strategy that will bring you satisfaction, hope, and physical and emotional results.
Details of incisions and surgical approaches used during breast aesthetics surgery are very important and variable. They affect breast shape, scarring, nipple sensation, nursing ability, and strength of chest and upper back muscles. It is important to know that even with the most careful surgery, sensation, fertility (ability to nurse a baby), and future surgery (augmentation, reduction, mastectomy, breast reconstruction) can be disturbed.
Every effort will be made to preserve sensation to the nipples. This is not possible in some, but almost all retain sensation. After implants, the most common sensation change is thinner skin over the breasts. Surgeons would be happy to discuss the implications of any of these procedures in your individual case. Implants may be inserted through infinitesimally small incisions. Fat and soft plastics have similar incision preferences. Traditional incisions are under the breasts (where it meets the chest – the inframammary fold), around the upper edge of the nipple (the periareolar approach), hidden in skin creases on the chest (axillary approach) and, in some cases, within the belly button. Small, currently available saline breast implants can be rolled and pushed through very small breasts for an almost scarless approach. In this case, it is impossible to change the position of the implant within the breast. Silicone gel implants require slightly larger incisions. Various techniques to release tight capsular muscle and breast tissue shelter around the implant after breast aesthetics surgery are in use.
Anesthesia Options
Breast surgery can be performed under general anesthesia or IV sedation with local anesthesia. If performed under general anesthesia, a board-certified anesthesiologist should administer the anesthesia. Approximately 15-20% of the adult female population appears to have at least some anxiety associated with breast surgery, either because of concern about anesthesia or about the operation itself. In women undergoing elective breast aesthetics surgery, researchers think approximately 40% would consider local anesthesia to avoid general anesthesia.
General anesthesia is associated with risks. Some women express concern about receiving general anesthesia. Some patients may not want to have an endotracheal tube inserted, or may not want to undergo more invasive general anesthetic techniques. Keeping the patient awake also enables the surgeon to evaluate breast size, shape, and symmetry intraoperatively, reduces the problem of intraoperative breast massaging, preventing fat necrosis in the immediate postoperative period, and decreases risks associated with combining anesthetic techniques.
For those patients concerned about general anesthesia and requesting conscious sedation, note that this procedure might not be appropriate for all. A larger operation, such as a combined augmentation-mastopexy, may not be suitable for local anesthesia alone. Furthermore, 40% will likely not find examination of the fat pad prior to reinsertion of the implant to be uncomfortable to some degree. It must be made clear that if the patient feels more than minimal discomfort, conversion of anesthesia to general requirements for a satisfactory surgical result.
Individual techniques vary in duration.
The type of breast aesthetics surgery influences factors like duration, anesthesia, and preliminary studies your surgeon must anticipate, but the length of the typical surgery plays a major role in the procedure. Augmentation of the breasts with prosthetic implants generally takes around a couple of hours. It involves making a three-to-four-centimeter opening in the submammary fold where the implant will be placed. Mastopexy with or without implants would last about another hour. Delays are expected in specific, more complicated surgeries, and not all patients perform the same. Pregnant mothers, overweight and heavy smokers who require these medications are at a high risk for complications. Always give a real answer to your physician to help you receive the best guidance, and know that surgery times and procedures listed can change.
How multiple procedures can change surgical length:
If you’re arranging more than one surgery in a single session, such as breast surgery combined with liposuction, tummy tuck, or a Brazilian butt lift, be prepared for longer surgical times. The typical liposuction process uses vacuum pressure to break and extract fat and is used in situations of fat build-up in specific places of the body. Some women choose to receive breast augmentation or want to undergo breast lifting with liposuction to improve the form of the body and breasts. It is also challenging for the breeder to run on two regions of the body, and it is a physically hyperactive task because it requires a secure, experienced doctor. It’s smart for a doctor to think about the inclusion of surgical operations when planning on various activities.
Results will continue to improve as time goes by. Knowing what your results will be like at the end of the 3 months or 6 months. Usually by the sixth month, you are able to wear any kind of shirt or blouse except the tight/low cut shirts (normally this is a personal preference; no clothes are prohibited). Usually by the first year, the breast evolves to a more mature look, staying soft and perfectly shaped. It is not uncommon for women to heal with some congestion in the neckline, fading with time. To have an idea, some patients need to use the simulators of the physical therapy to treat the pain, and this phase of congestion is variable in each type of breast aesthetics surgery. All of our patients have a discount card for lascivious lingerie and can only use normal lingerie after the sixth month.
Results differ from patient to patient. Age, bone structure, size and shape of the breast, skin, and any different scarring conditions will affect the results. Two patients may undergo similar techniques with the same implant, and they can end up with different scars and shapes. After 8 months post-operative, the result of the scar is completely predictable. At this time, you will probably feel motivated and more satisfied with your re-healing. Your confidence will increase, and you will be ready to wear that new outfit you were always dreaming of wearing. The time to assess the final results always depends on the type of surgery you have: When it is Breast Augmentation surgery or Breast Augmentation Mastopexy Surgery, it is clear to the patient that the volume and projection of the breast vary according to the time of breast aesthetics surgery when compared with the result after the sixth month.
Benefits of Breast Surgery
It comes as no surprise that 92,000 breast augmentations, 87,000 breast lifts, and 37,500 breast reductions were performed in 2014 alone. Unfortunately, deciding to undergo breast surgery is a personal and emotional one, often fraught with confusion, misinformation, and uncertainty. When a woman decides to pursue breast aesthetics surgery, whether for augmentation, lift, or reduction, she is making a decision that will impact her self-image, confidence, and body image. These surgeries provide not only physical benefits but significant emotional benefits as well.
1) Women who seek to be more proportional in size have noticeable improvements in self-confidence and a better self-image. If they are happier with their breast size and shape, they will more readily pursue personal and professional opportunities. Good communication and educating the woman about her options for surgery, how they work, what to expect, and what they might not accomplish will make the journey less anxious and less overwhelming.
Although recovery times are highly variable from patient to patient, returning to normal routines and activities, including light exercise, can usually begin after a few days or a week. However, patients should wait for the go-ahead from their surgeon before committing to anything strenuous. Specific instructions often require patients to avoid excess exhaustion, avoid extended exposure to the sun or heat, and avoid pain from feeling bored. If patients return to work but have a strenuous job, a medical leave of absence may be necessary, as well as permission from a surgeon. Furthermore, patients should not sleep on their stomach for several weeks after undergoing breast augmentation or breast reduction.
The presence of scarring can be an emotional moment for many patients. It takes anywhere from several weeks to several months for healing to continue. However, it’s important to keep in mind that it is happening, no matter how challenging the process might seem. Patients may return to the gym after about three to four weeks, depending on the healing process. Light and low impact workouts are the only type patients should do, and cardio may be slowly incorporated over time. At about six weeks, breast reduction patients typically return to work, and BA patients typically miss less time. It can take genuinely up to three to six months for the healing period to finish.
Expectations are important both for the patient and the surgeon. Unrealistic expectations must be carefully managed. For example, patients must be informed that implants do not last forever and there will usually be more breast aesthetics surgery in the future. Patients who want a significant reduction in their breast size may not believe the surgeon and then be unhappy with the breast, or the degree of scarring, as a result. If a patient is unhappy with their body shape or cannot make a decision, then it may not be the right time to perform breast aesthetics surgery. This is particularly pertinent for patients from different cultures who present with a “combined package” as part of a gift to themselves in celebration of a big birthday or after significant weight loss or after a difficult time, e.g., after a divorce. Time is a healer and people often get over the initial desire for surgery.
Patients who attend for breast surgery because they believe they will look more like someone else and as a result “solve” other deep-seated psychological issues are often seeking a transfer of personality, or even body. Be great at honest communication and managing patient expectations. Many potential issues are fully discussed at the initial consultation so that appointments for surgery can be viewed as the first part of a healing journey rather than the switch at the end of the tunnel, which allows them to completely hide from the sun. Preoperative assessment includes addressing mental and physical health and fitness. Dietary and smoking advice is given. Additional treatments are prescribed.
Post-Surgery Expectation Management
A comprehensive modular staged breast reconstruction can sometimes take up to a year to complete. These operations require good rehabilitation effort and time to make a reconstructed breast become soft and look natural. The patient’s participation in the entire staged reconstruction process can make the end result more pleasing to her. She should plan with the surgeon for the necessary surgery and rehabilitation to achieve the desired result. However, too many operations on the opposite unreconstructed breast can lead to excessive scarring, puckering, and irregularity of breast skin causing difficulty for secondary adjustment.
Planned appropriate twice-daily massage from the moment of transfer surgery can soften the reconstruction. Use a mirror to see your vertical and horizontal breast scar junctions. Try to locate the areas of clear firm hardness under the skin. Massage them to the level that you can bear pressure. A little pain involved does not damage your breast. These exercises may also shape your breast in a better or more natural shape.
