Anesthesia – The are two kinds, local with twilight sleep so you won’t remember and general, which puts you completely under, in which case some doctors place a tube down your throat. You will be handled by an Anesthesiologist or Nurse anesthetist and an RN. The facility is undergoing JCAHO credentialing (the same rigorous standards as a hospital)
Anti-Nausea Medicine – Is available, including Zofran , Phenergan, Compazine and Scopolamine, a patch you wear the night before. Ask your doctor. Here is a tip on the meds if you are getting sick: take the pain pill and cut it in half so if you are taking one pill every 4 to 6 hours take 1/2 pill every 2 to 3 hours. Food will help if you are nauseated. Taking meds on a full stomach may decrease your risk of nausea, that is : Eat something with your pills.
Back Pain – Sometimes can be a problem with implants Some experience some back pain during recovery. This is because you hunch over and do not stretch your back. Please stretch after surgery and contract your muscle between your shoulder blades. This will help you. Stretch by “walking your hands up the wall ” and making an ” “angel in the snow” routine against the wall. Also grab the door edges and lightly try and walk/stretch through the door. This will stretch your Pectoralis Muscles.
Bras – I suggest wearing only a sports bra after surgery. I suggest not wearing an underwire for 4 weeks after surgery. Wear the Bra 24/7 except to shower and wash the bra. If the pain around the port or ribs is unbearable then remove the bra for the night. Wear an Ace bandage or loose jog bra, or nothing at all (its OK). You may find certain bras uncomfortable for a long time, T-shirt bras and other “plain” type bras tend to be the most comfortable as less and other fancy materials tend to itch newly augmented breasts.
Breast Feeding – According to La Leche League one can breast feed after with silicone or saline breast implants. Their is less than a 5% chance of not being able to breast feed.
Breast Lift Surgery – May be necessary if your nipple is below the crease of your breast. Dr J. will recommend this at the time of your consult. Sometimes an implant can give enough of a lift if large enough. Sometimes I wait a year before the lift to see the final position of the breast. I also use an adjustable implant so i can do a lift at the same time with a smaller implant to avoid a wide scar. Then I will fill the implant at three months with hopefully a thinner scar.
Cancer Detection – Will be much easier if you have your breast implants under the muscle. “There have been several studies regarding breast implants and cancer. One study in Canada examined 11,000 women with implants and 11,000 without implants. The study concluded that there was no increased incidence of breast cancer among implant patients. In other words, implants do NOT cause cancer. Another study performed at the Mayo Clinic examined roughly 6,000 women with implants and 6,000 without implants to try and determine if implants impeded the ability to see cancers on mammograms. In other words, were cancers more developed before they were spotted in breast implant patients. The conclusion of this study was that they were not. In fact, there have been a couple of studies that have suggested that implants might actually have a protective effect against cancer. The idea here was that implants are foreign to your body and your body is always trying to reject the implants by sending immune cells to fight the implants. If those immune cells happen to come across a cancer cell, they will destroy the cancer cell. It is an interesting proposition but still needs more work. My father came into practice in 1961 and implants came on the market in 1962. I have seen patients from the beginning of implants to the present and we have not had anyone have a problem related to cancer, cancer screening, or implants. In fact, early on in my practice, I had one of my breast implant patients call me and thank me for doing her implants. Because she had implants, she was doing more self exams and had actually found a small mass that turned out to be an early stage cancer. She said that if she hadn’t had the implants, she would not have been doing such self-screening and would probably have missed the mass until it was much larger and further developed.”
After breast augmentation with breast implants, excessive scar tissue may form around the breast implant which causes the breast implants to harden (similar to what a contracted muscle feels like) as the naturally forming scar tissue around the breast implant tightens and squeezes it. Every patient will have some scar tissue form around the breast implant, however if it forms a lot the implant will feel firmer or even harder depending on the “grade” of capsular contraction the patient has. Capsular contracture grades from 1-4 with for being the worst. While capsular contracture is an unpredictable complication of breast surgery, it is also the most common complication of breast augmentation. This forms more in active patients required to work, take care of children who are young (up to 3 years). Constant motion will affect capsules and make them worse. Even carrying a heavy purse can induce a thick capsule. Suggest switching “purse arms” and trying to use opposite hands for daily activities.
Deflation – When a breast implant loses the liquid inside. Deflation can happen to 1/15 implants and is NO ONE’s fault!. You must remember to to buy your Mentor insurance within 1 month of surgery to get an extended warranty against deflation. It is Not Dr Jeneby’s responsibility!. The warranty “pays you back ” 8-10 weeks after a deflation and you must pay for your surgery up front until Mentor receives the implant from us. “Not fair” but Mentor needs to examine the implant first before giving a decision on reimbursement.
Dog Walking – Please consult your doctor as to when it is safe to walk your dog after surgery..Usually around 2 weeks.
Exercising: In general: for the first 4 weeks it should be reduced
Week 1: Treadmill, Light walking, No lifting weights that activate BREAST MUSCLES(PECS)
(stretching ok -no massaging yet)
Week 2: Treadmill, Light walking, No lifting weights that activate BREAST MUSCLES(PECS)
(stretching ok -massaging at 2 week)
Weeks 3: Light Jogging(under 2 miles). Light weights (10 pounds), Stretching, massaging.
Week 4 : Full workout in Jog Bra. Stretching, Massaging.
Feel of Implants – Implants feel a bit firmer than natural breast tissue. Depending on how much tissue you have naturally will also make a difference. Most men do NOT care, most probably wouldn’t notice the difference anyway(especially under the muscle where the implant is hidden well). This people will always feel the implant regardless of saline or silicone.
Hematoma – Is a blood clot that must be addressed by your doctor. To avoid, don’t push yourself into doing things you shouldn’t be. That’s why you are not supposed to play tennis, golf, lift, etc. for 3-6 weeks after. Using common sense, you will be able to determine what you can and can’t do. Also avoid certain drugs 2-4 weeks before and after surgery.
Keloids – Are a very specific type of pathological scar that occurs mainly on individuals with genetic origins in Africa, the Mediterranean, and Southern Asia, but even then, they are not common.
Look of Implants – After surgery, implants will ride high on the chest. It will normally take 4-12 weeks for them to “drop” into place. The more natural breast tissue you have and the smaller the implant, the more natural the look. Keep in mind, most women wish they had gone larger! Placing them under the muscle also allows for a more natural appearance.
Mammograms – Will be much easier to read if you go under the muscle. Mammograms are sometimes suggested before BA for patients with a history of breast cancer or to use as a base. Dr jeneby will take a mammogram under 1 year old.
Other Surgeries – May be planned for the same day. Recovery may be longer, but you will only have to go under anesthesia once.
Recovery Time – Most women say BA really does you in for the first 24-48 hours. You must have someone with you for the first 24 hours, if not longer. If possible, allow yourself a week or two off from work, more if your work requires physical activity. If you have young children, have someone help you for a week or more. Dr Jeneby uses an OnQ pain Ball for your recovery. You can find out more on the website or by going to www.iflo.com.
Ridges – Depending on the implant size and the amount of natural tissue, you may notice the top ridge of the implant.
Ripples – Rippling comes from not having enough natural tissue to cover the implant or having a large implant. Having the implant filled all the way (overfill) may help deter the problem. Ripples are usually only seen when the body is in a certain position, which varies in each person.
Saline – Is salt water that is safely absorbed by the body. The shell of the implant is still silicone. These type of implants by Mentor & Inamed (formerly McGhan) have been FDA approved.
Scars – Your incision scar will be permanent, but most are light to nearly invisible. At first it may be thick & red, but should become thin and light. Use silicone strips available from the office starting at two weeks after surgery. Keep them on 12 hrs a day and wash them. You may use steri strips or bandaids to hold them on. If you experience a rash from them , STOP using them. and call Dr Jeneby.
Sex – if you get your blood pressure up then swelling can occur, causing bleeding which can cause more scarring. Generally two weeks with a bra on and VERY LIGHTLY should be OK. Use common sense and discretion.
Shooting Pains – You may feel short, shooting pains in your chest after surgery. This is ok, but can continue up until about a year after. This is the nerves in your breasts regenerating. Especially around the ports near the incisions radiating toward you r back or shoulders.
Sleeping – Will be a major problem the first few nights after surgery. Do not sleep on your stomach it will continue to be a problem, Help alleviate by lifting yourself higher onto two pillows. I found that two feather pillows inside of a sham works well o sleeping on a recliner.
Smoking – Smoking causes blood vessels to constrict, decreasing the flow of blood and oxygen your body needs to heal properly causing recovery to take longer. Nicotine and carbon monoxide is known to inhibit recover time, increases the risk of pulmonary complications and can impede wound healing, which may decrease the quality of surgical results. Most plastic surgeons urge patients not to smoke for at least 4-6 weeks before and after surgery. We offer Chantix prescription or zyban.. I also take a nicotine test the day of surgery.
Stairs – Are not a problem, but, due to fatigue after surgery, don’t go up and down too much.
Stretch Marks – Are not common because breast implants do not increase the the projection of the breast as much as the base diameter where there is more skin. Stretch marks are common with pregnancy because this causes the breast tissue to enlarge quickly. Stretch marks may be more likely with larger breast implants as there will be more stretching of the skin. Dr J uses adjustable implants to decrease this risk as the implants are enlarged slowly.
Surgery Time – Takes about 1-1:15 hrs hours, but you’ll need at least 24 hrs if not a few days to recovery from surgery. Recovery in the recovery area is 2-4 hours before you can go home.
Sweat – Between the breasts may form from your new cleavage. May want to leave powder and/or a cotton ball between the breasts.
Swelling – Most women will experience swelling after surgery, especially with larger breast implants. Ask your breast surgeon about taking Bromelain (available by Dr Jeneby) to reduce swelling after surgery. Approximately 500 mg is taken daily for seven days prior to surgery and for 7-10 days following surgery. One breast surgeon recommends taking the 500 mg in divided doses following each meal as in some people it may cause minimal gastric symptoms when taken on an empty stomach.
Tanning – Is OK if you cover your nipples and/or the stitches at 2-3 weeks. Tanning can make your scars worse or give you skin cancer (remember!)
Tubular Breasts – Almost triangular shaped breasts, not round like a typical breast. These can be frustrating to even out. Dr Jeneby will show you if you have “tubular breasts”.
Under vs. Over the Muscle – Under the breast muscle is more painful however, over is directly underneath the skin and therefore, shows the outline of the breast implant more. Mammograms are easier to read with implants that are placed under. I like partial submuscular (“dual plane”)to let them implant drop quicker and to give a more natural shape to the breast. Over the muscle is reserved for professional body builders and/or severely low breast who do not want a lift. There is more rippling and palpability with over the muscle and more risk of capsular contracture.
Underwire Bras -You can make a small snip in the bra and pull the underwire out It can indent the implant or rub against the incision.
Vit E. No scientific data. Silicone strips are better.