Plastic surgery restores form and function through reconstructive procedures, cosmetic enhancements, and body contouring.
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Breast augmentation is typically performed under general anesthesia. This ensures the patient is completely unconscious, feels no pain, and has a protected airway throughout the procedure. A board-certified anesthesiologist or a nurse anesthetist continuously monitors vital signs.
The surgical facility adheres to strict safety protocols. The skin is sterilized, and the patient is draped to create a sterile field. Sequential compression devices are placed on the legs to promote blood circulation and prevent deep vein thrombosis (blood clots) during the operation.
Some surgeons use a “multimodal” anesthesia approach. This involves injecting local anesthetic (numbing medication) into the breast pocket during surgery. This preemptive pain control blocks nerve signals before the patient wakes up, significantly reducing immediate postoperative pain.
The surgeon makes the pre-determined incision (inframammary, periareolar, or axillary). Through this opening, a pocket is created either behind the breast tissue or under the pectoral muscle. This dissection is done with precision to minimize bleeding and trauma.
For silicone implants, the Keller Funnel is often used to insert the device. This allows for a “no touch” technique where the implant slides smoothly into the pocket without contacting the skin. This reduces the risk of infection and allows for a smaller incision.
Once the implant is in place, the surgeon sits the patient upright (if possible) to check for symmetry. Adjustments are made to the pocket if necessary to ensure the implants sit at the same level and have the desired projection. The implants are inspected to ensure they are lying flat and are not kinked.
The incisions are closed in layers. Deep sutures dissolve over time and hold the tissue together. The skin is typically closed with absorbable sutures and reinforced with surgical glue or sterile tape strips. No external stitches usually need to be removed.
A surgical bra or a compression wrap is immediately placed on the patient. This dressing helps to minimize swelling, supports the implants in their new position, and provides comfort. Drains are rarely used in standard breast augmentation but may be utilized in complex revision cases.
After surgery, the patient is moved to the recovery room (PACU). Nursing staff monitor the patient as they wake up from anesthesia. Pain and nausea are managed immediately with intravenous medication.
Patients typically spend about an hour in recovery. Once they are alert, stable, and able to drink fluids, they are discharged. A responsible adult must drive the patient home and stay with them for the first 24 hours.
The first day of recovery is focused on rest. Patients may feel tight, sore, and groggy. The chest will feel heavy due to the skin stretching and muscle adaptation. Patients should rest with their upper body elevated on pillows to reduce swelling.
Movement is encouraged to promote circulation. Patients should get up and walk around the house gently every few hours. Arm movement should be restricted; patients should not lift their arms above their shoulders or lift anything heavy.
Pain is usually manageable with oral medication. Most surgeons prescribe a few days of narcotic pain relievers for breakthrough pain, combined with muscle relaxants to prevent spasms if the implants are under the muscle.
Patients are encouraged to transition to non-narcotic pain relievers (like Acetaminophen) as soon as possible. Anti-inflammatory drugs (NSAIDs) like Ibuprofen are often avoided for the first few days to prevent bleeding risks, but may be added later to help with swelling.
During the first week, swelling and bruising may peak and then begin to subside. The implants will sit high on the chest, which is normal. The muscle needs time to relax, and the skin needs time to stretch.
Most patients can return to non-strenuous work (desk jobs) within 5 to 7 days. Driving is permitted once the patient is no longer taking narcotic pain medication and can move their arms comfortably enough to turn the steering wheel safely.
As recovery progresses, the implants begin to settle into their natural position. This process is often called “dropping and fluffing.” The muscle relaxes, allowing the implant to drop lower, and the lower pole of the breast rounds out.
Patients can gradually increase their activity level. Lower body exercise (walking, stationary bike) can often resume at 2 weeks. Upper-body exercise and heavy lifting are typically restricted for 6 weeks to ensure the internal pocket heals securely.
Patients are instructed to keep their incisions clean and dry. Showers are usually permitted 24 to 48 hours after surgery. Patients should not soak in a bath, pool, or hot tub until the incisions are fully healed (usually 4 to 6 weeks).
Once the incisions have sealed, scar therapy can begin. This may involve silicone gel sheets or scar creams to help the scars fade and flatten. Sun protection is vital to prevent the scars from darkening.
Patients are educated on the signs of potential complications. These include increasing redness, fever, severe pain on one side (hematoma), or significant asymmetry. Any of these signs warrants immediate contact with the surgeon.
Routine follow-up appointments are scheduled to monitor healing. The surgeon checks the position of the implants, the quality of the scars, and the overall health of the breast tissue.
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Acute pain usually lasts 2 to 3 days. After that, it feels more like soreness from a heavy workout. Most women switch to Tylenol within 4 to 5 days. Muscle spasms can occur for a week or two but are managed with muscle relaxants.
Most surgeons allow you to shower 24 to 48 hours after surgery. You can let the water run over your breasts, but avoid scrubbing the incision area. Pat dry gently. Do not submerge in a bath for at least 4 weeks.
This is normal. The pectoral muscle is tight, holding the implant up. Over the next few weeks to months, the muscle will relax, and the implants will “drop” into the pocket, filling out the bottom of the breast and looking natural.
It depends on the implant type. Smooth implants often require displacement exercises (massage) to keep the pocket open and soft. Textured implants should not be massaged as they need to adhere to the tissue. Follow your surgeon’s specific instructions.
You will wear a surgical bra for the first few weeks. You can usually switch to a sports bra without underwire at 2 to 4 weeks. Underwire bras should be avoided for at least 6 weeks to prevent irritation on the incisions while they heal.
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