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BREAST AUGMENTATION

BEFORE AND AFTER PHOTOS

GENERAL DISCUSSION

Topics to be considered and discussed

  • Patients expectations

  • Cosmetic issues

  • What is normal?

  • Size

  • Asymmetry

  • Type of Implants

SURGICAL PROCEDURE

Details of the surgical procedure and follow up

  • General Anaesthetic (detailed explanation by Anaesthetist)

  • Per-operative antibiotics

  • 1.5 hours of operating

  • Local anaesthetic infiltration

  • Approach/incision

  • Plain of pocket sub glandular/ sub muscular/ dual plane

  • Dressing

  • Bra and upper pole strap 6-8 weeks

  • Pain relief

  • Home when ready - Day case or 1 night stay

  • Change of dressing at 4-7 days

  • No upper body or high impact exercises 6-8 weeks

  • Out patient follow up

GENERAL ADVICE

Advice for before and after the procedure

  • Two-three weeks prior to surgery take 1gm of vitamin C twice daily. If you are taking vitamin E stop taking this as it can cause bruising.

  • Do not take Aspirin for 3 weeks before surgery. Please check first with the Doctor who prescribed this for you that this course of action is medically safe for you. If you do have a headache or tummy ache take Paracetamol or Panadol.

  • No alcohol of any kind prior to surgery; 10 days for major facial surgery and 5 days for most other procedures. It is also advisable to avoid alcohol following surgery for up to 5 days.

  • Smoking should be stopped 2 weeks prior to surgery. It has been conclusively shown that smoking does increase the complication rate in cosmetic procedures considerably.

  • Arnica 30 tablets should be taken 3 days prior to surgery and a week following surgery. If it is difficult to obtain Arnica 30 then Arnica 6 will be fine. This is a very old homeopathic remedy and is excellent for the prevention of bruising and swelling. Bromelain tablets (has an enzyme in it derived from pineapple) will also help with the bruising and swelling; this should be taken for the same period of time as Arnica. Both of these products are available from a large chemist, homeopathic chemist or health shop.

  • Do notify us of any underlying medical conditions that you may have. Medical histories are taken at your first consultation but this may be quite some time from your surgery, so let us know any recent problems that my have arisen in that time.

  • Do not take valuables to the hospital with you, they do have a patient’s safe deposit box, but unless it is important for you to have it with you it is best to leave valuables at home.

  • Please bring the correctly sized support bra, selected preoperatively, which we will use in the immediate postoperative period to help keep you more comfortable.

  • It is normal to feel a little nervous the night before surgery. Try and rest in the knowledge that we will be looking after you.

  • You will arrive at the hospital where you will be admitted by the administrative and nursing staff and you will then see your Consultant Anaesthetist and me.

  • You will then be taken to the operating theatres for your surgery.

  • The support bra will put on by the nursing staff and an upper pole strap for people who have undergone sub muscular breast augmentation. These should be worn for up to six to eight weeks following surgery.

  • It is important that you sleep in a reclined position, using a number of pillows, for the first nights after surgery as this reduces swelling.

  • It is important not to bend over, pick up heavy objects or stain (ie constipation etc) as this increases the pressure in the head and can lead to the rare complication of causing a bleed in the tissues. Please keep your intake of roughage, fruit and vegetables high.

  • Following surgery do call the office immediately if you develop a temperature, notice excessive swelling, bruising, persistent vomiting or excessive pain.

  • It is normal to feel tired for a few days following surgery, get as much sleep and rest as possible.

  • Almost all patients develop a case of ‘Post Op’ blues several days after surgery and question why they have gone through with the surgery. This is perfectly normal and temporary and your spirits will improve as you see the postoperative bruising and swelling subside and disappear. Try reading, watching TV or listening to music to occupy yourself.

  • Bruising will improve on a daily basis but often takes two to three weeks to completely go. Do not be surprised when bruises move as gravity pulls them down the tissues.

  • Swelling is often at its worse on the second day after surgery and then will start to reduce on a daily basis. The majority of the swelling should have subsided after the first month after surgery.

  • After surgery patients study the operated area in fine detail and their awareness of the changes made and natural differences from one side to the other will be greatly heightened.

  • I use minimal dressings which are splash proof to allow people to shower and keep clean.

  • The sutures used are dissolvable and do not need removal.

  • Vitamin E oil gently massaged into your scars is beneficial approximately three weeks after surgery. Initially scars feel lumpy when touched. The majority of this will settle down and soften over the first six weeks and will continue to fade over the next 12 to 18 months.

  • Avoid sun on your scars for 6 weeks following surgery. Wear a good sun block if in a sunny climate and also a hat if you have had facial surgery.

  • You should refrain from strenuous physical activity including impact exercises for 6 to 8 weeks following surgery.

  • Do not expect miracles overnight! A good idea about the final result from your surgery will be obtained at approximately 6 weeks but the optimal results can be 6 months of more.

  • It is importamt to get back into the routine of regular breast self examination when the breasts have settled down after surgery and to act on any changes detected.

  • We are here to look after you and answer any questions and reassure you if you have any concerns.

POTENTIAL RISK

Whilst the chance of risk is very low, it must be discussed and understood

  • Pain, improves with time

  • Haematoma

  • Return to theatre

  • Scar hypertrophic, keloid

  • Bleeding

  • Bruising

  • Swelling

  • Infection

  • Rippling Wrinkle

  • Upper Pole fullness

  • Cleavage

  • Over/Under augmentation

  • Continued Asymmetry

  • Irregularity

  • Capsule

  • Silicone controversy

  • Breast cancer/Anaplastic Large Cell Lymphoma(extremely rare, none reported in the UK)/Mammogram

  • Breast feeding

  • Leak and rupture/replacement of implants

  • Further surgery

BAAPS ADVICE

Additional advice provided by the British Association of Aesthetic Plastic Surgeons

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