Melissa’s Surgery Design
May 19th, 2009
Melissa had her surgery yesterday at 7:30AM. She was asleep for the surgery. After much thought, she decided on a final volume of 300ml. Based on her breast diameter, I chose a Mentor Smooth Round Moderate Profile implant. The implant had a minimal fill volume of 275ml. Since Melissa chose a saline filled implant, we were able to fill this implant to 300ml based on the manufacturers recommendations.
The chosen incision was a 18mm(less than 3/4 inch) placed at the crease beneath the breast. This is the smallest incision which can be used because the implant will not fit through a smaller incision. The incision was closed with absorbable sutures beneath the skin and skin glue was applied as a final closure. The skin glue serves as a dressing as well. No other dressings were placed. No bra or breast strap was placed. There was no wrap either. No drains were used nor were there any pain pump tubes to contend with. I have found that this method works best for my patients and the after care cannot be simpler.
Surgery was completed on the left side followed by the right. It only took about an hour to complete. Her recovery was uneventful and she left the office about an hour after surgery was completed.
I anticipate that she will have an easy recovery. Immediately after surgery the result looked very natural. Of course, the complete healing process will take some 6 months to a year.
Look forward to Melissa’s video comments in the next couple days.
Anticipation
May 18th, 2009
As surgery draws closer, patients feel a sense of nervous anticipation. For many, the unknown of having cosmetic surgery, makes the days spent waiting quite nerve-racking. I believe it is the fear of pain and possible complications that often weighs heavily on a patient’s mind. Melissa’s anticipation of the positive change in her figure with breast augmentation surgery is a good example of keeping the proper focus. I appreciate her careful attention to the information she has received about her role in all of this.
Over my years of practicing medicine, I have adopted certain philosophies in my office, which include implementing surgical strategies to reduce pain after surgery and thoroughly discussing the procedure with the patient. This stems from my own experience as a child, when I had my tonsils and adenoids removed at 5 years old. To this day I remember the smell of ether (not found in hospitals today) as I was going to sleep. After the surgery I was sick to my stomach, which was typical for this drug at the time. Finally, the pain in my throat was very memorable. The ice cream and Popsicles were of little consolation, as I simply could not eat them. It was too painful! We have given careful consideration to pain control, both during and after surgery in an effort to reduce our patients’ experience with pain after surgery.
There are many things we do to reduce pain after surgery. It starts even before surgery. We pre-medicate the patient in our office just before surgery. This has reduced the need for strong narcotic pain medications by fifty percent. During surgery, care is taken to eliminate all bleeding. Blood collection can cause a significant elevation in pain. Other pain mitigation techniques include a large amount of local anesthetic that is injected to numb the nerves going to the breast, just before I insert the implant. Finally, I have eliminated the use of all dressings after surgery. In my opinion, dressing serve no real purpose and often contribute to increasing pain after surgery. Over half of the patients undergoing breast enlargement surgery in my office take only mild pain medication and acetaminophen after surgery. Women who have delivered a child say they experience a fullness or heaviness during recovery, similar to feeling as if their milk has come in.
So my advice before surgery is to try to relax the best you can. Focus on the preparation outline we have given you. If necessary, call my office to have any last minute questions answered. In most cases, patient concerns are easily addressed. Only on a rare occasion, do I prescribe a sedative or sleeping pill for overly anxious patients. Your personal strength and desire to improve your physical image will get you through this!
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