Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The consultation is the foundational step of the surgical journey. It begins with a detailed physical examination, during which the surgeon assesses the quality of the breast tissue, the degree of ptosis (sagging), and the position of the nipples. The surgeon also evaluates the patient’s overall frame, shoulder width, and chest wall shape.
Measurements are taken from the sternal notch to the nipple to quantify the degree of sagging. The surgeon palpates the tissue to determine the ratio of fat to glandular tissue, which influences the surgical technique. This is also the time to identify any asymmetry or masses that may require investigation.
An open dialogue about the patient’s desires is crucial. Patients are encouraged to describe their ideal outcome, not just in terms of cup size but in terms of lifestyle. Do they want to run without pain? Do they want to wear backless dresses?
The surgeon manages expectations by explaining the trade-offs, such as scarring versus shape. Visual aids, such as before-and-after photos of patients with similar body types, help align the patient’s vision with surgical reality.
Breast safety is paramount. The American Society of Plastic Surgeons recommends that women over 40, or younger women with a family history of breast cancer, obtain a baseline mammogram before surgery.
This ensures there are no suspicious lesions or calcifications in the tissue to be rearranged. If abnormalities are found, clearance from a radiologist or breast surgeon is required before the cosmetic procedure can proceed.
A thorough review of the patient’s medical history identifies potential risks. Conditions such as diabetes, autoimmune disorders, or connective tissue diseases can impair wound healing. Smoking history is specifically scrutinized.
The surgeon reviews all medications and supplements. Blood thinners, anti-inflammatories, and certain herbal supplements must be paused to prevent excessive bleeding. History of keloid scarring or poor wound healing is also discussed.
Nicotine is a potent vasoconstrictor that compromises blood flow to the skin and nipple. In breast reduction, where tissue flaps are rearranged, smoking can lead to disastrous complications like nipple necrosis (death of the nipple tissue) and wound dehiscence (separation).
Surgeons enforce a strict no-smoking policy, typically requiring cessation for at least 4 to 6 weeks before and after surgery. This includes vapes and nicotine patches. Urine tests may be conducted to verify compliance.
Patients are advised to be at a stable, maintainable weight before surgery. Significant weight loss after surgery can cause the breasts to deflate and sag again. Significant weight gain can cause them to enlarge.
Surgeons typically prefer patients to be within a healthy BMI range. Obesity increases the risk of complications such as infection, delayed healing, and deep vein thrombosis. Some surgeons have strict BMI cutoffs for safety.
Proper nutrition is essential for healing. Patients are advised to consume a high-protein diet in the weeks leading up to surgery to build the building blocks for tissue repair. Vitamins such as C and Zinc may be recommended.
Hydration is also critical. Avoiding alcohol for at least a week before surgery helps prevent dehydration and reduces bleeding risk. A healthy body heals faster and with fewer complications.
Recovery requires planning. Patients must arrange for a responsible adult to drive them home and stay with them for the first 24 to 48 hours. They will not be able to lift anything heavy or drive while on pain medication.
Preparation includes setting up a recovery area at home with pillows for elevation, easy-to-eat foods, and necessary supplies like gauze and dressings. Planning for childcare and time off work is essential to reduce stress during recovery.
Standard pre-operative testing includes a Complete Blood Count (CBC) to check for anemia and infection, and a coagulation profile to ensure normal clotting. For older patients or those with medical conditions, an EKG may be required.
These tests ensure the patient is physiologically fit for general anesthesia and the surgical stress. Any abnormalities are addressed before the surgery date is confirmed.
On the day of surgery, or sometimes the day before, the surgeon performs detailed markings on the patient’s skin while the patient is standing upright. Gravity affects breast position, so markings made lying down would be inaccurate.
The surgeon draws the new nipple position, the incision lines, and the areas of tissue to be removed. This “blueprint” guides the surgery and ensures symmetry. The patient verifies the planned incisions and nipple placement.
The surgeon assesses the patient’s emotional readiness. Breast reduction is a significant change in body image. Patients should have realistic expectations and a stable mental state.
For adolescents with juvenile hypertrophy, the surgeon ensures the patient is mature enough to understand the procedure and the permanent nature of the scars. The motivation must come from the patient, not external pressure.
Patients are typically measured for a surgical bra before the procedure. This bra provides compression to reduce swelling and support the new breast shape. It usually zips or hooks in the front for easy access.
Wearing the correct size is crucial. A bra that is too tight can cause necrosis, while one that is too loose will not control swelling. The surgeon or nurse ensures the patient has the appropriate garment ready.
Send us all your questions or requests, and our expert team will assist you.
Ideally, yes. Being close to your ideal weight reduces surgical risks and ensures the best aesthetic result. If you lose weight after surgery, your breasts might sag. If you gain weight, they might get bigger again. Stability is key.
Generally, no. The tissue removed is sent to pathology for examination for any abnormal cells or signs of cancer. This is a safety protocol to ensure no hidden disease is present in the breast tissue.
You should stop taking Vitamin E, fish oil, garlic, ginger, ginkgo biloba, and ginseng at least two weeks before surgery. These supplements can act as blood thinners and increase the risk of bleeding and hematoma.
You should generally wait at least 2 to 3 weeks before flying. Flying increases the risk of blood clots (DVT) in the legs, which can be dangerous after surgery. If you must fly, discuss specific precautions with your surgeon.
It is extremely rare to need a blood transfusion for a standard breast reduction. While there is some blood loss, surgeons use techniques to minimize it. Transfusion is only considered in substantial decreases or if the patient was anemic beforehand.
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