Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Breast aesthetic surgeries are typically performed in accredited surgical facilities or hospitals. These environments adhere to the highest standards of safety, sterility, and patient care. The operating rooms are equipped with advanced monitoring technology and emergency equipment.
The surgical team consists of the board-certified plastic surgeon, an anesthesiologist or nurse anesthetist, surgical technicians, and nurses. This multidisciplinary team works in unison to ensure the procedure is efficient, safe, and successful.
Most breast surgeries are performed under general anesthesia, meaning the patient is completely asleep and feels no pain. In some less invasive cases, such as minor revisions or nipple corrections, local anesthesia with sedation (twilight sleep) may be used.
The anesthesiologist continuously monitors the patient’s vital signs heart rate, blood pressure, and oxygen levels throughout the procedure. Modern anesthesia is very safe and allows for a quick wake-up with minimal nausea, thanks to advanced medication protocols.
The surgeon makes precise incisions based on the preoperative markings. For augmentation, the incision may be inframammary (under the breast), periareolar (around the nipple), or transaxillary (in the armpit). For lifts and reductions, the incisions are more extensive to allow for skin removal.
Through these incisions, the surgeon creates a pocket for the implant or dissects the tissue to be reshaped. This is done with extreme care to preserve blood vessels and nerves. Electrocautery is used to minimize bleeding and seal small vessels as the surgeon works.
In augmentation, the implant is inserted into the prepared pocket, either under the pectoral muscle (submuscular) or over it (subglandular). The surgeon employs techniques like the “no touch” Keller Funnel to insert silicone implants, reducing the risk of infection and capsular contracture.
For lifts and reductions, the breast tissue is reshaped and secured with internal sutures. The nipple areola complex is moved to its new position. The surgeon checks for symmetry and optimal shape while the patient is in a semi-upright position on the operating table.
Once the desired shape and size are achieved, the incisions are closed in layers. Deep sutures dissolve over several months, holding the tissue together. The skin is closed with fine sutures, surgical glue, or tape to minimize scarring.
A surgical bra or compression dressing is applied immediately. This helps to reduce swelling, support the breasts in their new position, and protect the incisions. In some cases, surgical drains may be placed to remove excess fluid, though this is becoming less common in standard augmentations.
After surgery, the patient is moved to the recovery room (PACU). Nurses monitor the patient as they wake up from anesthesia. Pain management begins immediately with intravenous or oral medications.
Patients typically spend 1 to 2 hours in recovery before being discharged. They must meet specific criteria, such as stable vitals and the ability to drink fluids, before they are allowed to go home with their responsible caretaker.
Pain levels vary by procedure. Augmentation, especially under the muscle, can cause tightness and pressure. Lifts and reductions often involve less acute pain but more skin sensitivity.
Surgeons use a multimodal pain management approach. This includes a combination of narcotics for the first few days, muscle relaxants to prevent spasms, and non-narcotic pain relievers like acetaminophen. Anti-inflammatory drugs are often avoided initially to stop bleeding.
The first few days require rest. Patients should sleep on their backs with their upper body elevated to reduce swelling. Movement is encouraged to prevent blood clots, but arm usage is restricted.
By the end of the first week, many patients can stop prescription pain medication. They may be able to return to light, sedentary work. Showering is usually permitted after 48 hours, but soaking in baths is prohibited.
Swelling and bruising gradually subside. Patients can slowly increase their activity levels but must avoid heavy lifting and high-impact exercise. The breasts will begin to settle into a more natural position as the muscles relax and the skin stretches.
Scar care begins once the incisions are fully healed. Patients continue to wear their surgical bra or a sports bra 24/7 to support the healing tissue. Follow-up appointments allow the surgeon to monitor progress and clear the patient for increased activity.
Complete healing can take up to a year. Nerves regenerate, restoring sensation that may have been temporarily lost. Scars fade from red to pink to white. The implants (if used) drop into their final pocket position (“drop and fluff”).
Patients can eventually return to all normal activities, including upper body workouts. Regular self-exams and annual check-ups become part of the long-term maintenance routine.
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A standard breast augmentation usually takes about 1 to 1.5 hours. A breast lift or reduction is more complex and typically takes 2 to 3 hours. Combined procedures like an augmentation mastopexy can take 3 to 4 hours.
Drains are small tubes used to remove excess fluid. They are rarely used for standard breast augmentations today. However, they are commonly used in breast reductions and tummy tucks to prevent seromas (fluid collection). Your surgeon will tell you if drains are likely for your specific procedure.
You can drive when you are no longer taking narcotic pain medication and can move your arms comfortably enough to turn the steering wheel safely. This is typically about 5 to 7 days after surgery.
You must sleep on your back, propped up with pillows, for the first few weeks to minimize swelling and protect the incisions. Most surgeons advise against sleeping on your stomach for at least 6 weeks or until the breasts are fully healed and comfortable.
Once the incisions are fully closed and any scabs have fallen off, you can start scar therapy. This typically involves silicone gel sheets or scar creams. Keeping the scars out of the sun (or using high SPF) is critical for the first year to prevent them from darkening permanently.
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