Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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The consultation is a comprehensive medical and aesthetic evaluation. It begins with a candid discussion about the patient’s goals. The surgeon will ask the patient what bothers them most: the nipple position, the lack of upper pole fullness, or the excess skin.
A thorough physical examination is conducted. The surgeon assesses the degree of ptosis, the quality of the skin, the volume of the breast tissue, and the symmetry between the two breasts. Measurements are taken from the sternal notch to the nipple to quantify the drop.
The surgeon also evaluates the shape of the chest wall. Some patients have a concave (pectus excavatum) or convex (pectus carinatum) chest, which affects the position of the breasts. Spinal curvature (scoliosis) can also contribute to asymmetry.
This anatomical analysis allows the surgeon to formulate a customized surgical plan. They will determine which incision pattern is necessary and whether an implant or auto augmentation is recommended to achieve the desired look.
A complete medical history is essential for safety. The surgeon reviews any chronic conditions, such as diabetes, hypertension, or autoimmune disorders. These can affect wound healing and anesthesia risk.
A history of breast cancer in the family is discussed. Patients over a certain age or with specific risk factors will be required to have a mammogram before surgery. This establishes a baseline and ensures there are no suspicious lesions.
Previous breast surgeries, including biopsies or augmentations, are noted. Scar tissue from prior procedures can alter the blood supply to the nipple, influencing the choice of surgical technique.
The surgeon also reviews all current medications. Blood thinners, anti-inflammatory drugs, and certain herbal supplements must be identified and managed to prevent excessive bleeding during the operation.
Smoking is the single most significant risk factor for complications in breast lift surgery. Nicotine constricts the small blood vessels that supply oxygen to the skin and nipple. This can lead to necrosis (tissue death) of the nipple or the skin flaps.
Surgeons typically enforce a strict cessation period. Patients are required to stop using all nicotine products, including cigarettes, vapes, patches, and gum, for at least 4 to 6 weeks before and after surgery.
Urine tests for cotinine (a metabolite of nicotine) may be administered before surgery to verify compliance. Surgery may be cancelled if the test is positive, prioritizing patient safety over convenience.
This strict protocol ensures optimal microcirculation for healing. It significantly reduces the risk of wound breakdown, infection, and ugly scarring.
Patients receive a list of medications to avoid in the weeks leading up to surgery. Aspirin, ibuprofen (Advil, Motrin), and naproxen (Aleve) interfere with platelet function and increase the risk of bleeding. These are typically stopped 2 weeks prior.
Herbal supplements such as fish oil, Vitamin E, ginkgo biloba, garlic, and ginseng also have blood-thinning properties and must be discontinued. Multivitamins containing high doses of Vitamin E should also be paused.
Patients are advised to continue medications for blood pressure, thyroid, or other stable chronic conditions. The surgeon may provide specific instructions on which medications to take on the morning of surgery with a sip of water.
Some surgeons prescribe a regimen of Arnica Montana or Bromelain to be started a few days before surgery to help reduce bruising and swelling postoperatively.
The consultation is the time to align expectations with reality. The surgeon explains that a breast lift involves scarring. While scars fade, they are permanent. The trade-off is a better breast shape for a visible scar.
Patients are shown before-and-after photos of previous patients with similar body types and ptosis grades. This visual aid helps patients understand what is achievable and what the scars typically look like.
The surgeon discusses potential asymmetry. No two breasts are identical, and perfect symmetry is rarely possible. The goal is to improve symmetry and create a harmonious look, not perfection.
The concept of “bottoming out” or recurrent sagging over time is also discussed. Gravity and aging continue after surgery, and maintenance or revision may be needed in the future.
Proper nutrition is vital for recovery. Patients are encouraged to eat a balanced diet high in protein in the weeks leading up to surgery. Protein provides the building blocks for tissue repair and collagen formation.
Hydration is also critical. Patients should drink plenty of water and avoid excessive alcohol consumption, which can dehydrate the body and suppress the immune system.
Vitamin C and Zinc are often recommended to support the immune system and wound healing. However, patients should clear all supplements with their surgeon to ensure they do not interact with anesthesia or clotting.
Being at a stable, healthy weight is ideal. Crash dieting before surgery is discouraged as it can deplete the body’s nutrient reserves needed for healing.
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Recovery requires logistical foresight. Patients must arrange for a responsible adult to drive them to and from the surgery center and stay with them for the first 24 hours.
Help with childcare, pet care, and household chores should be organized for the first week. Patients will be restricted from lifting heavy objects and reaching overhead.
The home environment should be prepared. A recliner or extra pillows should be set up to allow sleeping on the back with the upper body elevated. Easy-to-prepare meals and snacks should be stocked.
Prescriptions for pain medication and antibiotics should be filled before the surgery date to avoid a trip to the pharmacy immediately after discharge.
Depending on the patient’s age and health, preoperative testing may be required. This usually includes a Complete Blood Count (CBC) to check for anemia and infection. A Basic Metabolic Panel (BMP) checks kidney and liver function.
For women over 40 or with a history of heart issues, an EKG (electrocardiogram) may be ordered to ensure heart health. A pregnancy test is mandatory for all women of childbearing age.
The surgeon assesses the patient’s emotional readiness. Surgery is a significant event that changes body image. Patients should be pursuing surgery for themselves, not to please a partner or meet external standards.
Patients with a history of body dysmorphia or unrealistic expectations may be counseled against surgery or referred for further psychological evaluation. A healthy mindset is crucial for a positive postoperative experience.
Yes, if you are over 40 or have a family history of breast cancer, a mammogram is typically required. It ensures there are no abnormalities in the breast tissue before the surgeon rearranges it. It also serves as a baseline for future screenings.
If you develop a cold, fever, or infection in the days leading up to surgery, you must notify your surgeon. Surgery may need to be rescheduled to ensure your body is strong enough to handle anesthesia and healing without complications.
You will need to remove all jewelry, including nipple piercings, before surgery to prevent burns from surgical instruments and infection. You may be able to replace them after the breast is fully healed, but the nipple position and sensation may change.
You will receive pain medication during surgery, so you should not wake up in severe pain. You will likely feel pressure or tightness in your chest. The anesthesia team will manage your comfort as soon as you wake.
You will typically be instructed not to eat or drink anything (including water) after midnight the night before surgery. This is a critical safety measure to prevent aspiration during anesthesia. Follow your specific instructions precisely.
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