Q1 :
How do I organize my procedure and trip to Bumrungrad?
Organizing treatment at Bumrungrad is easy. The following is a step-by-step guide from appointments to admissions.
Making an appointment is the necessary first step. You can do this several ways.
All new patients need to register upon entering the hospital. To expedite this process, you are encouraged to complete the registration form in advance and bring it to the hospital. You are kindly asked to present yourself at the International Patient Center on the 3rd Floor to collect your hospital registration card and to confirm your appointment date and time. IPC staff will then direct you to the appropriate clinic in time for your consultation.
Your physician consultation is very important, because it is the moment when you can discuss your medical issues face-to-face with your doctor. If you are traveling from overseas, this will be the first time you meet with your doctor so it critical that he/she understands:
Most people have a good idea of what the procedure or outcome they want (“I want bigger breasts" or "a flatter stomach”), and the physician’s responsibility is to listen and then explain what can be done, the procedures or techniques to achieve your objectives, and the risks and costs involved.
You will have a lot of questions to ask, so preparation is key to make the most of your consultation. We suggest that you:
Note: have a look at the frequently asked questions for the specific procedure you are interested in, which are all listed below.
Prior to admissions and surgery, your physician will require you to undergo laboratory investigations and/or diagnostic examinations to ensure that you are fit for surgery.
These tests are standard hospital procedure and they do incur a cost. Some packages include pre-surgical tests and diagnostics as part of the total package price, while others do not. Please consult your physician.
If you are having surgery or any in-patient medical services, you are required to go through an admissions process. The admissions desk is located on the 2nd floor of the main hospital building.
A registered nurse is on hand to help you complete requisite consent forms, coordinate your room assignment and answer any questions you might have before being shown to your room.
At admissions, you will be required to pay a deposit for your medical treatment. Deposits range from 50% - 100% of the estimated procedure cost.
If you intend to use insurance to pay for your medical treatment, please be aware of the following:
Q2 :
How do I know which Plastic Surgeon to choose?
Q3 :
What are the risks of plastic and cosmetic surgery?
To minimize risk, please read the following:
Q4 :
What forms do I need to fill out?
Am I a candidate for Abdominoplasty?
An individual must be in good health, not have any active diseases or serious, pre-existing medical conditions and must have realistic expectations of the outcome of their surgery.
This is an operation which requires patience and stability in dealing with the healing period. There is sometimes a lull or depression after surgery and if there is already a pre-existing emotional problem, this low period can develop into a more serious issue. Please consider this before committing to a procedure. If the above describes you and you have the desire to rid yourself of loose sagging skin of the abdominal area, you may be a good candidate for Abdominoplasty.
Normally women seek this procedure after pregnancy - although it is advised to wait until you are finished having children to have this procedure as the skin and muscles can get stretched out again as well as the dangers of your newly taut skin being unable to accommodate another pregnancy.
How is Abdominoplasty performed?
Abdominoplasty is performed most commonly under General Anesthesia or Light Sleep IV Sedation. Local anesthesia is then used to numb the abdomen.
The Procedure is typically performing thus:
How long does an Abdominoplasty last?
This procedure can last for many, many years. If there are no large weight gains, and no pregnancies after the tummy tuck then the changes can be relatively permanent.
Relaxation of the tissues can reoccur but not to the extent prior to surgery
Is there a lot of swelling involved with a Abdominoplasty?
Q5 :
Is there much pain associated with Abdominoplasty?
The amount of pain associated with this procedure is quite variable. Some patients note a moderate amount of discomfort, but for some it is more intense.
Patients will often note some back discomfort due to the 45 degree positioning for 4 to 5 days after surgery.
Valium is sometimes given to alleviate muscle spasms of the back and for relaxation.
Q6 :
What are the different techniques for Abdominoplasty?
Q7 :
What are the risks of Abdominoplasty?
As with any surgery under anesthesia, primary risks are associated with the anesthetic.
There are more risks with Abdominoplasty due to the fat and its surrounding tissues becoming necrotic (dead tissue). If the fat becomes necrotic from lack of blood supply, the fat tends to turn orange-ish clear and a little may drain from the incision. Although this is very normal to have fluid this color drain from the incision. There will be fat damage, there will be fluid retention, and there will be blood-tinted drainage.
If the tissue becomes necrotic, or you have a massive die off of fat cells you must have the tissue removed before a major infection develops. This is extremely rare and taking precautions can certainly make a difference:
Sometimes Liposuction is part of the Abdominoplasty procedure. Even with the ultrasonic technique, patients have been known to receive actual burns from the ultrasonic technique. The fat is actually melted within the body by 'exciting' the fat molecules with high frequency radio waves and is suctioned out. There may be asymmetry, hyperpigmentation (permanent dark spots) from the bruising. Major blood loss is a factor is some cases.
Another risk is Pulmonary Thromboemboli - a blood clot that breaks free and travel to the lungs. This can put a patient into adult breathing distress and subsequently into cardiac arrest or coma. Pulmonary Thromboemboli can occur within three weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours. Pulmonary Thromboemboli can occur suddenly, without warning.
Q8 :
What does a typical Abdominoplasty consultation entail?
Q9 :
What is Abdominoplasty?
Q10 :
What should I expect post-operatively?
Patients are usually able to walk immediately after surgery and is in fact encouraged to do so 3 or 4 times per day for 1 to 2 minutes each time. Usuall y however, they cannot stand up straight, and walk with a hunched posture. The skin of the abdomen will be quite tight and patients are usually instructed to remain bent over at least 45 degrees for the first 4 to 5 days after surgery.
Patients will often note some back discomfort due to the 45 degree positioning for 4 to 5 days after surgery - Surgeon sometimes give muscle relaxants or valium.
The drains are removed 4 to 14 days after surgery. At the end of 4 days the patient may begin to straighten up and by six days post-op may or may not be fully straight.
You should not exert themselves for at least two weeks after surgery. While the drains are in, bed rest with a very small amount of walking as outlined above is recommended.
If drains are requored for an extended amount of time, patients are notexpected to sit in bed all day. An abdominal pressure garment may be given at a post-operative appointment. These are used for 3 o 6 weeks.
Some swelling and discoloration are normal but are generally minimal and dependent upon the individual.
Q11 :
When is Abdominoplasty usually performed?
Q12 :
When will I be able to see the results?
After the swelling subsides and the drains are taken out you will start to see a difference. However, underlying tissues have been cut and that an Abdominoplasty is a very invasive procedure. The body needs time to heal.
You will in time reap the benefits of this procedure.
Q13 :
When will the sutures be taken out and does this hurt?
Q14 :
Where are the scars located involving an Abdominoplasty?
This is not a scar-free surgery; and depend upon:
Indeed, in some cases, scarring can be severe. Most surgeons choose to offer their patients lesser scarring techniques that leave a well-hidden horizontal or slightly bowed scar which can be covered by a standard bikini.
What is Blepharoplasty?
Blepharoplasty removes the excess fat, skin and atrophied muscle from the upper and/or lower eyelids. It is a very popular procedure as hooded eyes seem to lack luster and seem old or tired by many patients.
Many individuals who choose this procedure are very aware that their upper eyelids have seemed to disappear within the herniated fat of the upper eye area. Fat herniation is quite normal and will happen to everyone with age. However some individuals have herniated fat in the upper area of their eyes even in their early teens.
Sometimes a blepharoplasty can improve an individual's vision. This is achieved by removing the excess fat and skin that may block an individual's peripheral field of vision.
Whatever the individual case, the purpose of a blepharoplasty is for the aesthetic appeal that wider, youthful eyes possess.
Will a Blepharoplasty get rid of my eye wrinkles?
At what age is Blepharoplasty performed?
How is the Blepharoplasty performed?
Blepharoplasty is usually performed using local anesthesia and light sleep sedation or General.
The incisions are made within the natural creases of the eyelids. The Surgeon removes the herniated fat and excess skin and sutures the incision with very fine hair-like sutures.
Removal of the entire fat pads underneath the eye should be discouraged. Excessive removal of this fat is disastrous in most patients, as it often results in hollowness or a dark, sunken appearance. Minimal removal has proven quite beneficial in those who may need it - in those who do not, only the excess skin should be removed.
Is there much scarring with a Blepharoplasty?
Some scarring should be expected, although the scarring associated with blepharoplasty is quite minimal and practically non-existent after several months.
The scars are placed within the normal creases and folds of the upper and lower eyelids so that when the eyes are open the scars are invisible. With lower blepharoplasty, where the fat is to be removed with no skin excision, the incision can be made either on the inside of the eyelid or under the lash line. Many surgeons prefer the transconjuctival incision with fat removal-only cases.
What are the risks of Blepharoplasty?
It is possible to develop asymmetry during healing or excessive scarring if you are prone.
You may experience difficulty in closing your eyes when sleeping. In rare instances this condition may be permanent.
If you have thyroid problems (hypothyroidism or Graves' disease) dry eyes or insufficient tearing, circulatory disorders or high blood pressure, having blepharoplasty may be more risky for you than an otherwise healthy individual.
Other disorders that may increase your risks are myasthenia gravis, cardiovascular disease, diabetes, a detached retina or glaucoma (and other high pressures of the eye), poor circulation and poor elasticity.
Sometimes the eye area will not heal correctly and you just may have to have an additional surgery to correct it.
There will be swelling and there may also be some bruising but some patients are prone to bruising more than others.
The eyelids may feel tight and sore as the anesthesia wears off, but medication should control discomfort. Vision may be a blurry for several days due to the swelling and eyes may be watery or may be dry. There should not be extensive pain.
The pain as associated with blepharoplasty has been described as mild discomfort, as if the skin was sunburned and the eysballs irritated.
When will my stitches be taken out?
Am I too old or too young?
Although there is no set age, it is best to wait until your breasts have finished developing. You can better determine this with your OBGYN if you are a longstanding patient of his or hers. This can vary and although you may think you have finished maturing by 18 or 19 - your breasts will continue to go through changes well into your early twenties.
The youngest is usually 18 although in special cases of pronounced asymmetry and reconstruction - prostheses can be used on persons younger than 18. These younger cases are very specific.
On the other side of the spectrum, women in their late 60's who have gotten breast implants. When we are older the only thing that may stop us from having breast augmentation surgery is general health so be sure to have a physical to see if you are in good health to properly heal and handle the anesthesia factor.
Can a woman breastfeed after Breast Augmentation?
The answer is yes.
A lot of women ask if they can breast feed after Breast Augmentation Surgery. For the vast majority of women who have BA breastfeeding is no more difficult with implants than without.
Breastfeeding is a growing concern with patients who have had Breast Augmentation surgery. In previous years, women who received implants were married and had already finished with childbearing. However, more and more single women, and women who have not finished or even begun childbearing are having the surgery.
In 1992, the first report of a Silicone Illness hit the media. At that time there was fear that breastfeeding with silicone implants would endanger the child. There has been studies performed to show this not to be the case. The main reason being that the silicone molecule is too large to pass into the milk ducts.
Particularly with the belly button approach, the breast tissue and ducts are not disturbed, cut or affected. The procedure literally takes place under all of the breast tissue, not going through it. There is no evidence that silicone from the implant shell enters the milk.
However, with other incision locations and techniques other than the TUBA and trans-axillary, it is quite possible to disrupt the mild ducts and lines resulting in blocked ducts during a pregnancy. This has been known to happen with a peri-areolar technique resulting in additional surgery to unblock the milk ducts.
Can implants achieve lifting of sagging breasts?
Although implants do not lift up a sagging breast, they do help mildly sagging breasts appear less saggy. They do this in two ways:
1. Implants take up some of the slack in loosened skin thereby increasing the volume and decreasing the saggy look. 2. Implants, to a mild extent, rotate the lower portion of the breast upward, making the breasts appear less saggy.
For moderate or severe sag, a lifting procedure or a lifting procedure with implants is usually performed.
Do birth control pills cause breast tissue growth?
An increase in estrogen/progesterone causes a subsequent increase in breast size.
If you are planning on taking birth control pills be advised that there are other side effects than simple breast growth.
If you smoke you shouldn't take the pill, if you have circulation problems or high blood pressure, you shouldn't take the pill. There are many contraindications and considerations involved with this.
Please see your OBGYN for more information and a complete exam before you take any type of hormonal supplement.
Do breasts with implants experience sagging over time?
All breasts relax as time goes by. This is because:
These three factors mean that breasts can be expected to relax and sag whether or not there are implants present.
The implants add some weight to the breast, which may increase the rate of relaxation, and yet implants and surrounding scar tissue can provide some internal support for the breasts.
The overall result is that usually the breasts sag less - more so if you wear a properly fitting bra regularly.
How big should I go?
This is totally up to you!
How can I tell my family?
How you tell (or if you choose to tell at all) is up to you. All families will react differently.
You can begin to tell them how you feel regarding your appearance, about your lack in breast size making you feel less feminine, etc.
Make a list of the reasons you want breast augmentation, go over these reasons in your head.
Let your family know how you feel, they may not be completely supportive at first - but they usually come around.
How much is breast augmentation going to cost me? What about if I need a revision?
This definitely depends upon your region, surgeon can range from $2,500. to $10,000. and up. Prices may vary due to region, surgery bids, the newness of practice, marketing ploys, the occasional "special", demand of surgeon, etc. These prices may or may not include, operating room coasts, anesthesia, lab work medications, and more so be sure to ask beforehand and get it in writing.
If you are in need of a revision there is little else you can do if nothing was determined beforehand, but pay the fees and move on. So please determine revision stipulations beforehand and get this in writing as well. Such things as CC, infection and others are usually not covered (although some surgeons do cover this). Surgeon error should be covered at the surgeon's expense so please review the practice's revision protocol before booking your surgery. It is better to prepare for the worst and hope for the best than be hit by an avalanche of additional postoperative fees in your time of misfortune.
I have fibromyalgia(or multiple sclerosis, etc), is it safe for me to get implants?
This is up to you and your primary care physician, although I have friends who have both disorders and breast implants, nothing has gotten worse (or better) since the implantation of their prostheses many years ago. The FDA released information stating that the IOM concluded that implants do not cause nor contribute to disorders such as these.
It must be said that those predisposed to have disorders may experience the onslaught of such after having been exposed to high levels of stress, trauma, surgery, foreign bodies, infections, high blood pressure, accidents, etc.
I have Poland's Syndrome (pectus excavatum, pectus carinatum, etc) and have been told breast implants will help me look "normal" - is this true?
I went on several consultations and every doctor had a different opinion of what would be best for me. What should I do?
All surgeons are different, hence different opinions. Don't expect every surgeon to agree, but do expect to have to do your own research as well to better understand what techniques and options can get you what you want.
Do remember that you are not the doctor and to listen, to take notes at your consultations and reflect upon each surgeon's recommendations.
Is there a warranty should an implant fail?
Is there much pain associated with breast augmentation?
Many patients report that their discomfort is described as pressure or muscle soreness. If you should experience any discomfort that seems out of the ordinary, contact your surgeon.
Although pain thresholds vary - breast augmentation pain is dependent upon the implant placement, incision placement and medication.
You can also cause yourself more pain by not abiding by your surgeon's instructions and over exerting yourself.
Should I pre-medicate before I have dental work, once I've had my Breast Augmentation?
Some may consider this a controversial subject and scoff at the idea of a bacteria-induced infection or case of Capsular Contracture (CC).
When an individual has dental work, even a routine cleaning, plaque and bacteria are released from their holds and introduced into the blood stream via your gum tissue. The gums are often lacerated, even slightly, during dental work creating a 'doorway' in which bacteria may enter.
When a significant amount of bacteria is present in the body, they will seek out weakness in the body to stronghold themselves and replicate. Any foreign presence within our bodies (i.e. breast implants, lip implants, hernia repair mesh, etc.) is a prime target for these infectious intruders.
Although it is not technically proven that dental work and Capsular Contracture (CC) are related there are increased instances of CC thereafter.
NOTE: It is even cautioned to those with pacemakers and aorta catheters to take antibiotics when going to the dentist so mammary implant recipients should be no different.
Q15 :
Should I try BRAVA or Breast Enlargement Pills before choosing to undergo BA with breast implants?
Q16 :
Should I wait to get my implants if I am considering weight loss?
Although you may wish to get your implants at any time, if you are considering losing any significant amount of weight (15 lbs. and up) be prepared to notice sag if you lose breast tissue.
If you have very small breasts and get implants then lose weight, there shouldn't be a significant problem with sage since your breast envelopes were not large to begin with. You could safely lose the weight and suffer no ill effects to your breasts if this is the case.
Q17 :
Should I wait to get my implants until after having children?
Although you may wish to get your implants at any time, if you are considering having children within the next year or two, it is advisable to wait since the effects of weight and breast tissue gain and loss will affect the appearance of your breasts.
However, if you plan on waiting on having children you should know that a postpartum lift is possible.
Q18 :
What are the risks of Breast Augmentation?
Although extremely rare, it is possible to bleed post-operatively resulting in another surgery to control and drain the collected blood. You could develop a post-operative infection and need to have the implant removed, the infection dealt with and still have to wait for several months before an additional surgery can be performed to re-implant. Loss of sensitivity is common, although temporary. Permanent sensation loss in the areola (nipple) area or breasts, in general, can and may happen. There is also the possibility of developing a Seroma which is a mass caused by the accumulation of serum fluid within a tissue or organ. Or a Hematoma which is a localized mass of blood that is typically confined within an organ, tissue, space, or potential space and may be a result from a broken blood vessel.
There is a risk of Capsular Contracture (the evil scar tissue encapsulating the implant, hardening around and squeezing the implant). This rarely ever goes away on its own. Nor does it tend to lay dormant after a revision surgery is performed. It may happen due to bacteria on the implant, surgical implements or airborne and the body attempting to place the foreign body as far away from itself as possible. Or it may develop after injury. If this happens, you can develop pains, hardening, deformity and deflation of the implant. It sometimes even happens again after the surgery to remove the scar tissue has be performed.
There is a chance of rippling (wrinkling or indentations from the implant) being apparent, especially when one has no breast tissue and chooses to go over the muscle. It is possible that the implant can shift and push through layers of tissue, showing through the skin. The implant can deflate or rupture from an injury or from wear and tear from an improperly under filled implant (even your breathing motions can cause creasing in the implant causing it to weaken at these creases). Even an overzealous doctor performing a mammogram can rupture your implant. You can have a complete deflation within several hours if it is an un-encapsulated saline-filled implant. If it is a silicone gel-filled implant, you may not know for months or years. Of course either way, they will have to be replaced. Then there is always a risk of hematoma and scarring. Also, difficulty in early breast tumor detection is possible when you have either silicone gel (more pronounced) or saline-filled silicone shelled implants.
There is also the risk of disappointment in size. A lot of women wish they would have gone bigger. Realize that when you are doing the rice test that they will have to add a little more to make up for the tissues and/or muscle flattening the implant a little if you choose the submuscular placements. When you pre-operatively try on the larger bras and fill them out a bit, they are on top of your body, probably lifted, as well, by an under wire. Take this into account and communicate with your doctor, the results you really want.
There is also the disappointment in the implants not lifting the breasts as you would like. This is not a breast lift this is an augmentation. If it is lift you want as well as augmentation, get them both. After your augmentation surgery, the breasts will be heavier than what you are accustomed to. The heavier weight will speed up the sagging process especially if you go around braless all of the time.
There is the possibility of extrusion of the implant, breast tissue atrophy from the force exerted by the implant. This is according to the F.D.A. and you can read the info on their site by visiting: Breast Implants: An Informational Update.
Q19 :
What type of anesthesia should I choose?
Q20 :
What types/brands of breast implants are used for breast augmentation?
The Plastic Surgery Department at Bumrungrad International uses Mentor® saline and silicone-based breast implants. The decision whether to use saline or silicone-based implants is up to each individual patient and can be discussed in detail with your plastic surgeon.
In December, 2006, the FDA approved the return of silicone breast implants to US markets, after finding no evidence that silicone implants were responsible for any serious diseases. Saline breast implants have up to 4% risk of leaking within the first four years after surgery. For more information about breast implants please visit www.mentorcorp.com
Q21 :
Will I have stretch marks after my Breast Augmentation? How can I keep this from happening?
The stretch marks are caused by an abrupt expansion of the tissues. When the expansion is very gradual stretch marks are practically non existent.
An individual's elasticity varies.
Some patients develop stretch marks from growth spurts during puberty, muscle tissue gain from weight lifting and pregnancy. Some individuals never develop stretch marks and still others are very prone to them.
Mature stretch marks are very difficult to remove. You can tell a stretch mark is mature by the age of course and by the color - which is usually white. Deep fissures which are purple in color can scarcely be removed with treatments short of excision. This means that those microdermabrasion treatments that you have been getting are probably going to do nothing but empty your pocket book. The white marks CAN be darkened using a flesh-colored pigment implanted using micropigmentation.
There is still no successful treatment for the removal of stretch marks. Some swear by Shea nut butter, others, olive oil. Some swear by Retin A as a solution to the red lines that may develop in the early stages of stretch mark formation. Ask your surgeon before doing anything other than what he or she instructs. There is no guarantee that stretch marks will not develop but medical science has faith that a proven method of removal will be discovered, eventually.
Q22 :
Will my areolae stretch after augmentation?
Stretching of the areolae is very common and sometimes unavoidable. This can create more sag in breasts that are already saggy although the usually stretching is from the pressure of a tight breast envelope. If you have less tightness, you will usually experience less stretching.
In persons with peri-areolar lifts and areolar reductions - some surgeons use permanent sutures which are usually made from prolene, mersilene or even Gore-Tex around the areolae to keep them from stretching again.
Q23 :
Will my implants feel like natural breasts?
This issue depends much upon a few factors:
Pre-existing tissue: The more natural tissue you have pre-operatively, the more of a chance you have of feeling "natural" post-operatively. However, if you have Cohesives or overfilled saline implants, regardless, your breasts will feel firmer than natural breasts.
Overfill amount: Too little volume will give you ripples, too MUCH volume will cause firmness and rippling. Discuss overfill amounts (percentages) with your surgeon pre-operatively.
Implant filler: Saline reportedly feels less natural than silicone gel or Hydrogel-filled implants.
Implant surface: Smooth-surfaced implants are thinner than textured-surfaced implants. Although very slight, patients having had both often report that they can feel a difference.
Implant placement: You may hear that unders look more natural than overs - when in fact, all cases are different. Overs actually move more naturally than unders but may have a pronounced upper pole fullness (especially in overfilled implants). Unders tend to "jump" and twitch when you use the pectorals during every day movements and working out. This may be a matter of opinion and preference rather than an effect which produces a blanket statement.
Thickness/thinness of skin: The thicker and springier your skin the less the implant edges will be felt. Thinner skin allows more a more palpable result. hence thin-skinned individuals often opt for under placement.
Am I a candidate for Mastopexy?
How is Mastopexy performed?
Many Mastopexy procedures are performed using light sleep or general anesthesia. The crescent Mastopexy calls for the removing of a crescent of skin above the areola moving the nipple upward and suturing the nipple into the new location. The full Mastopexy requires incisions fashioned in such a way as to actually create a new breast envelope. This allows for the repositioning of the nipple and the reshaping of the breast. Either of these operations can be performed in conjunction with a breast augmentation.
Roughly, Mastopexy takes 1 & 1/2 to 4 hours to perform.
The Crescent Lift: This technique involved removing a crescent-shaped piece of tissue above the areola and suturing the tissue higher. This creates a minor lift for patients who have slight ptosis.
The Benelli Lift: This technique is considered less invasive and was designed with the scars being around the areola. With the Benelli, a donut shaped piece of tissue around the areola border is removed and the surrounding tissue sutured to the areola. The incisions are normally closed with purse string sutures. Sometimes a little more tissue is removed above the areola to compensate for a lifting effect when it is sutured.
The Benelli-Lollipop: This lift is the same as the above but with straight incisions from under the areolae to the mammary folds (crease). This is for those who have medium ptosis, too much for the Benelli only and too little for a full anchor incision.
Full Mastopexy: The most commonly used technique is with an anchor shaped incision that starts at the base of the areola, vertically to the where the breast meets the rib cage. The incision then cuts out a crescent shape piece of skin right above where the breast meets the rib cage. Nipple re-positioning is necessary with this technique as the nipple must be removed. This is considered a major scarring technique but it sometimes necessary with severely sagging breasts.
In any case, the goal of the Mastopexy is to rid the patient of excess sagging skin and re-contour the breast in a fashion that is both pleasing to the eye and the touch. For the most part, the suture lines (scars) will fade within a year, and more so after 2 years. Those scars around and in the areola area seem to fade and flatten faster than in the regular unpigmented area. Silicone sheeting is sometimes used to hasten the flattening and fading of a scar
How long does a Mastopexy last?
Is there a lot of swelling involved with Mastopexy?
Your surgeon should attempt to make your scars as inconspicuous as possible. However, you must realize that Mastopexy scars are extensive and permanent. The scars will be red and raised for several months -- gradually fading in color and flattening out.
Nipple sensation is generally preserved with this operation. The incidence of loss is usually less than 5%. In many individuals where there is significant ptosis, the sensation has diminished prior to the operation. In these individuals, nipple sensation will sometimes increase after the procedure. However, swelling may decrease sensitivity in the nipple area and/or the breast tissue from the swelling blocking the verves ability to send and receive messages from the brain.
Is there much pain associated with Mastopexy?
Normally, there is not a severe sense of pain. Although, discomfort and soreness is what is most often described by patients. Your prescribed pain medications should alleviate the pain associated with Mastopexy. However, if you feel as if your pain is severe, do not hesitate to call your surgeon or the staff in call.
You will experience more pronounced pain if you are to remove your support bandages and bra for longer than what is necessary to sponge off. You may also interfere with your end result by going braless soon after your procedure. It is advisable to wear a bra at least for most part of the day and evening -- sleeping without -- if you must. Especially if your breasts are larger than an A cup.
What are the different techniques for Mastopexy?
The amount of sagging determines the best procedure to be performed. It is important to decide whether augmentation or reduction should accompany the uplifting procedure. The procedure that one elects to undergo is determined by several factors. First and foremost is the amount of sagging or ptosis (pronounced: toe-sis) present. When a slight amount of ptosis is present then a Crescent Mastopexy can be performed. The nipple can be uplifted 2 to 3 centimeters. The incision and therefore subsequent scar is around the top of the areola (pigmented skin). Should a greater amount of lifting be required an incision will be needed that completely surrounds the areola with a vertical line dropping down the center of the breast to the bottom of the breast and sometimes a horizontal incision at the bottom of the breast in the crease between the breast and the chest.
Also there are the undesirable scars of the Anchor (standard) Mastopexy, the Lollipop (or keyhole) Mastopexy and the newer technique invented by Louis Benelli, the Concentric Mastopexy. Also known as the Doughnut, Donut, Peri-Areolar or Concentric or Benelli Mastopexy.
What are the risks of Mastopexy?
It is possible to have a negative reaction to the anesthesia, excessive bleeding, infection, hematoma and seroma. Of course, it is given that scars will be apparent that are associated with Mastopexy. Permanent loss of sensitivity in the nipple area and breast skin is possible. If you smoke your risks are increased not to mention that your scars will heal slower and possibly wider than a non-smoker's would.
A big fear is tissue necrosis (tissue death). I am serious, you do NOT want this. Tissue Necrosis happens when either you smoke and you have poor oxygen-tissue saturation or the surgeon did not use a pedicle to keep blood flowing to your nipple or other skin sections that were reattached. It also could be just bad healing. This is an issue and by far the most worrisome and dangerous so do all that you can to keep this from happening -- like stop smoking several weeks beforehand!
Infections, although rare can happen due to bacteria such as Staph, which naturally lives on your skin. That is why it is important to wash your breasts, neck and torso with an anti-bacterial soap like Hibiclens or even Dial anti-bacterial soap for several days up until your surgery. This can reduce the amount of Staph on your skin.
What does a typical Mastopexy consultation entail?
At your consultation, your surgeon should measure your breasts and general torso area to determine a natural and aesthetically pleasing position for your breasts and areola/nipple complex post-op. You should provide your surgeon with photos of your breasts previously in life, if possible. If not, a bathing suit photo may help. Your surgeon should take into account your skin condition and (i.e. elasticity and thinness) and age. Sometimes a surgeon will offer the option of having an implant inserted if there is barely any breast tissue remaining.
Your surgeon should discuss with you the details of how a Mastopexy is performed, explain the possible risks and complications involved and any post-operative special care instructions. He/she should also discuss with you ALL costs involved so that you are not surprised by hidden costs. Discuss with your surgeon any questions or concerns you may have before deciding whether or not to commit to Mastopexy.
What is Mastopexy?
The Mastopexy or breast lifting operation is really several different procedures. Each of the different operations has as its intended purpose to lift the breast up and position the nipple in the position that it was in before sagging occurred. Sagging occurs due to three circumstances either alone or in conjunction with each other. First, after pregnancy and breastfeeding the breast has become stretched and the skin loosened. Frequently there is actual loss of some of the breast tissue and this allows for sagging also. Second, weight gain and loss can stretch the skin and also create sagging.
Third, the process of aging and the effects of sun and gravity tend to decrease the elasticity of the skin and this can be a significant factor creating sagging of the breast. The goal in all these instances is to move the nipple back to a higher position and to reshape the breast to create a more beautiful appearance. Most often the need for excess skin removal is apparent.
Sutures will have been placed underneath the skin. These will dissolve over several months. Sutures will have been placed onto the skin and these are most frequently the type that will dissolve in one week. A special tape is placed over the sutures to help protect the wound. A bra will be worn continuously for 21 days, 24 hours per day. Instructions on bra removal for washing will be given after the surgery. There is generally very little pain after this operation and only a moderate amount of swelling. The patient may return to work in 3 to 4 days unless the work involves bending or lifting. Walking may be resumed the day after surgery.
More than likely, a surgical will have been be put on you over your gauze bandages. This may be replaced by another bra or you may be asked to wear this particular bra for about 21 days - non-stop. This should be adhered to as non-compliance could affect your end result and or healing. Your stitches will be removed if they are of the non-dissolving kind. If not the special tape will be removed by you in the shower at the end of the 21 days.
It is quite possible to have loss of sensitivity in the nipple and breast skin due to the swelling. The swelling blocks the nerves ability to send and receive pain and pressure messages to and from the brain. This may resemble a numb feeling and is quite normal. Most sensation returns within 1 to 3 months or possibly up to a year or more. Unfortunately, some instances prove that the loss of sensation is a permanent one.
When can I return to work?
You may not feel like doing much for a few days post-operatively. Although after the first three days you may be up and about, walking around thinking you are feeling fine. But in reality you are still able to take your pain medications and have the option of lying down if need be. If you are at work and must work for 8 hours - or even half of that - the option of lying down and popping a few pain medications is more than likely ruled out. Just be sure that no matter what you do, do not lift anything over your head (including your arms) for at least 10 days or until your doctor specifies otherwise.
No strenuous activities, including hard labor or exercise, for at least three weeks. In some cases, you are not allowed to have sexual relations until at least 7 days, post-operatively.
When is Mastopexy usually performed?
Where are the scars located involving Mastopexy?
The scar from the crescent Mastopexy is placed directly at the junction of the areola (pigmented skin) and non-pigmented skin. It heals leaving a scar that is barely visible in most people.
The full Mastopexy involves more incisions. The anchor shaped scar is normally the chosen incision line. However different doctors have different techniques. The scars are generally very well tolerated by patients as the scars are far less unsightly than the sagging breast. Over the course of 12 to -24 months the scars fade dramatically and in many individuals are not very noticeable. In some individuals the scars will always be somewhat visible, generally seen as a lighter area on the breast.
The Benelli leaves just a scar around the areolae (darker pigmented area). The Lollipop (or keyhole) leaves a scar around the areolae and straight down to the natural crease where your breast meets your rib cage.
All patients undergoing Mastopexy should be certain that they understand the incisions and resulting scars. When the patient knows ahead of time what to expect, it is most likely that the scars are not nearly as noticed as is the much improved beauty of the breast due to improvement of the shape and positioning of the nipple.
How long will it take before everything gets back to normal?
How should I prepare for your breast reconstruction surgery?
Planning your breast reconstruction surgery.
Types of anesthesia for breast reconstruction surgery.
What are the risks?
What happens after your breast reconstruction surgery?
You are likely to feel tired and sore for a week or two after reconstruction. Most of your discomfort can be controlled by medication prescribed by your doctor.
What happens during breast reconstruction surgery?
What is breast reconstruction?
Reconstruction of a breast that has been removed due to cancer or other disease is one of the most rewarding surgical procedures available today. New medical techniques and devices have made it possible for surgeons to create a breast that can come close in form and appearance to matching a natural breast. Frequently, reconstruction is possible immediately following breast removal (mastectomy), so the patient wakes up with a breast mound already in place, having been spared the experience of seeing herself with no breast at all.
But bear in mind, post-mastectomy breast reconstruction is not a simple procedure. There are often many options to consider as you and your doctor explore what's best for you.
What types of breast implants are there?
Where will my breast reconstruction surgery be performed?
Who is a candidates for breast reconstruction surgery?
Still, there are legitimate reasons to wait. Many women aren't comfortable weighing all the options while they're struggling to cope with a diagnosis of cancer. Others simply don't want to have any more surgery than is absolutely necessary. Some patients may be advised by their surgeons to wait, particularly if the breast is being rebuilt in a more complicated procedure using flaps of skin and underlying tissue. Women with other health conditions, such as obesity, high blood pressure, or smoking, may also be advised to wait.
Your new look after breast reconstruction surgery
How is breast reduction performed?
For the liposuction technique, small incisions are made within the natural fold underneath the breast or perhaps on the outer side as well. Sometimes a tumescent technique is used where a solution of saline (delivery and tumescent agent ), Lidocaine (pain reliever) and epinephrine (prohibits excessive bleeding and excess absorption of Lidocaine) are injected into the targeted area. This technique's purpose is to engorge the tissues with the solution for a firmer working area and the fat cells (which are softer) are suctioned out. The epinephrine prohibits bleeding during the operation and less blood is lost during the procedure.
There is a liposuction technique which involves ultrasonic energy waves. These ultrasonic waves excite the tissues' water molecules (fat molecules being the target) and literally melt the fat into a liquid for ease of removal by suction. Unfortunately, each patient's molecules may react differently or in the case of unskilled surgeons, may improperly handle the equipment resulting in severe burns.
There is the manual removal technique which is often incorporated into with a breast lift operation. With this technique there will be scars associated with the breast lift more than likely anchor shaped as extensive tissue will more than likely be removed and proper re-positioning and re-contouring of the breast will be performed.
In any case, the targeted breast tissue and fat is removed, sutures are sometimes used in the closure of incisions for the smaller, liposuction-assisted breast reduction and most definitely for the traditional breast reduction techniques. Then, a support garment or surgical bra is worn for proper, compact healing. A surgical or soft bra will be worn for several weeks both day and night.
How many techniques are there for breast reduction?
There is a manual technique where surgeons remove tissue after having opened the breast along the tissue lines where surface tissue will be removed as well and lifted.
There is the tumescent technique that is in all actuality, liposuction in a lesser form. The liposuction technique can also be used with ultrasonic energy but has an increased chance of injury due to burns. Apparently the high frequency waves can over-excite the water molecules (or any fluid) causing them to boil beneath the skin as well as damaging superficial tissues as well. Unfortunately there is also the possibility that blind removal will accidentally disturb or remove milk ducts/glands in such a way that a patient's breast feeding chances are severely decreased.
Is breast reduction permanent?
Is it quite painful? Is there much bruising?
What are the risks of breast reduction?
There are more risks with this operation due to the fat and its surrounding tissues becoming necrotic (dead tissue). If the fat becomes necrotic from lack of blood supply, the fat tends to turn orange-ish clear and drain from the incision. If the tissue becomes necrotic, that's a whole other ballgame! You must have the tissue removed before a major infection develops, possibly causing gangrene. If anything happens regarding tissue necrosis or compromised vascularity please research Hyperbaric Oxygen Therapy (HBOT) it could save your breasts AND your life. I have a separate section on this.
Even with the ultrasonic technique, patients have been known to receive actual burns from the ultrasonic technique. The fat is actually melted within the body by 'exciting' the fat molecules with high frequency radio waves and is suctioned out. There may be asymmetry, hyper-pigmentation (permanent dark spots) from the bruising. Major blood loss is a factor is some cases. As is hematoma and infection. Unfortunately in most breast reductions, breast feeding will become a memory for any future children. Thankfully there may be newer techniques which may prohibit this type of loss. There is also the risk of loss of blood supply to the treatment area and permanent numbness due to nerve damage.
Another risk of breast reduction is pulmonary Thromboemboli, although not as high of a risk as it is with liposuction-assisted reductions or when liposuction is performed in combination with breast reduction. A thromboebolus is a blood clot and this blood clot can break free and travel to the lungs resulting in pulmonary Thromboemboli. This can put a patient into adult breathing distress and subsequently into cardiac arrest or coma -- leading to the loss of oxygen rich blood to the brain. Pulmonary Thromboemboli can happen within three (3) weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours. However, pulmonary Thromboemboli can occur suddenly, without warning. Most patients with P.E. collapse and begin rapid deterioration after attempting to climb a flight of stairs.
What does a typical breast reduction consultation entail?
Firstly, your doctor will discuss your goals with you and he will explain what can realistically be achieved. A surgeon should take into account what your hip size is. Your breasts may be a hindrance to you but removing too much will make your hips look large and give you a pear shape. Obviously you can request significant removal, just consider balance when determining your end size. Many women with large breasts just "want them out!" but may later regret having the majority of the breast volume removed. I am just suggesting thorough consideration before committing.
He or she will then show you photos of his work, you may also wish to show him photos that you have brought to the consultation of what you like and do not like. He or she should discuss the risks at length and the details that are associated with a breast reduction. There is no one size fits all technique when it comes to this procedure. It is all individual, just like you!
Protocol for a pre-operative appointment if you should choose to undergo a breast reduction: Prior to surgery, a complete medical history is taken in order to evaluate the general health of the patient. The breasts themselves are then examined thoroughly to determine the most effective surgical approach. The surgeon will go over the anesthesia to be used, the procedure, what results might realistically be expected and possible risks and complications.
Mammograms or x-rays may be taken as well as pre-operative photographs. Preoperative instructions often include the elimination of certain drugs containing aspirin for several weeks before surgery in order to minimize the possibility of excess bleeding. Birth control and other estrogen containing hormones may also be discontinued temporarily (depending upon the individual). Antibiotics, pain relievers and other medications prescribed a few days prior to your surgery for your convenience as we want you to be completely prepared for your surgery with no excess worry.
The patient may be placed in two bras as well as an Ace bandage. In some cases you may remove the top bra only and rewrap the breasts with the Ace bandage the day after surgery. Some patients are told not remove the Ace bandage or bra for 3 days. Patients may choose to wear the Ace bandage for up to 10 days if they find it to provide added comfort. Patients are usually instructed to wear their surgical bra for 21 days both day and night. Please ask your own surgeon for specific instructions.
During recovery, the patient is carefully monitored and is allowed to be driven home a few hours later. Although, a surgeon should insist that you remain near the vicinity in case you experience complications.
Some patients are instructed to ice continuously for the first 48 to 72 hours. If this is the case, you will put an ice bag (or bags bags of frozen peas) over the breasts to maintain the coldness continuously. This will reduce any discomfort and swelling significantly. The pain connected with the procedure is minimal to moderate and is controlled with oral pain medication. The antibiotics that were prescribed will be taken for several days post-operatively to prevent infection. Instructions for the day and night after surgery include bed rest with limited activities. Your surgeon will determine when normal activities can be presumed at your post operative visits -- normally at 3 weeks. Strenuous activities and heavy lifting must be avoided for several weeks.
You should notice a gradual reduction in discomfort. Sometimes swelling will increase over the first three days. Fever greater than 100.5 should be reported to your surgeon. Marked increases in tenderness after 48 hours along with redness may indicate an infection. This should be reported immediately.
You may only sponge bath for the first 3 days after surgery as you must not get the bandage wet. You can remove the bra after 8 days but only to put on a fresh one. Replace the bra quickly after washing. After 14 days a normal shower may be take. Be sure to replace the bra immediately after showering or bathing.
There will be swelling and your doctor may prescribe a pharmaceutical grade Arnica montana for the relief of this. There may be some bruising but the Arnica montana will help alleviate some of this.
You should be wearing your bra 24 hours a day for the first 3 weeks. After the 21 day period, the bra should be worn at least during the day time for 6 months. The tapes that are over the suture lines should not be removed as your surgeon will remove them in approximately 10-15 days.
Complications and slow healing are rare, however there are certain inherent risks connected with reduction mammoplasty which will be thoroughly discussed at your consultation. The risks and instances of slow healing are more significant in smokers.
When will I be able to return to work?
Where are the incisions made?
Am I a candidate for a Face Lift?
How is Face Lift performed?
The Face Lift operation is most frequently performed using General or Light Sleep Anesthesia. After your arrival additional medications are given intravenously which induce a profound state of relaxation. Patients usually sleep during the operation. Much of the time patients have very little memory of the operation itself. After this state is achieved then medicines are given to produce numbness of the surgical area. This type of anesthesia is most frequently preferred by patients. It causes almost no recovery necessary from the anesthetics themselves unlike general anesthesia which may produce nausea after the surgery. It also carries less risk of complications. If general anesthesia is preferred, this may also be used.
This procedure takes about 2 to 6 hours to perform. It may take longer if you choose to have a neck lift as well. For procedures 3 hours or longer, many surgeons advise General anesthesia. Depending upon your facial structure the incisions will be placed as inconspicuously as possible above the hairline. Some doctors still cut at the hairline so ask your doctor which incisions he prefers. The incisions usually begin above the hairline, at the temples, continuing in a natural line in front of the ear. Some doctors can make the incisions with the cartilage just in the front-inside part of the ear, ending behind the earlobe and lower region of the scalp.
The skin is separated from the fat and muscle below it. If the neck lift is being performed with the face lift, a small incision is placed inconspicuously underneath the chin and excess fat may removed by either trimming it by hand or by facial liposuction. More than likely, your surgeon will use the facial liposuction technique. The underlying muscle and fascia are tightened and the skin itself is pulled back, trimmed and sutured into place. Sometimes surgical staples are used within the scalp. The surgeon may place a small drain tube behind your ears for excess fluid and blood drainage
How long does a face lift last?
How long should I expect to be away from work?
Is there a lot of swelling involved with a Face Lift?
What are the different techniques in performing a Face Lift?
What are the risks of Face Lift?
What does a typical Face Lift consultation entail?
What is a Face Lift?
Although, there is normally no extensive pain related to the facelift operation, pain medication is prescribed before hand. You may feel a degree of numbness that will normally disappear within a 1-3 months.
Don't be alarmed at the presence of bruising and swelling. This is very normal and you must realize that your skin and underlying tissues have been stretched, pulled and cut. The swelling will begin to disappear within the first couple of weeks. Many patients return to work with the help of camouflaging cosmetics at about 10 days post-op.
Things to be alarmed about that are not normal:
When is a Face Lift usually performed?
There is no usual age that a patient requests a face lift. It can be from 30's to 80's. Although, a brow lift can work wonders for younger patients whose only complaint is horizontal lines on the forehead and sagging brows or slightly hooded eyes. Brow lifts are often requested in the late 20's-early 30's category and up. It is quite possible that a brow lift is all that is needed.
However, A face lift can produce better results in those who are more mature or need extensive lifting and tightening or rejuvenation. Seeking an entire lifting of the facial skin and/or structure to produce a more youthful and alert appearance. You can discuss your available options with your surgeon to determine what is best for your individual case.
Will there be scarring? If so where will the scars be located?
Plastic Surgery - Why the "Plastic"?
What is plastic surgery?
Will I be able to cope with the pain after the procedure?
How is cheek augmentation surgery performed?
The cheek augmentation surgery is most frequently performed using Light Sleep or General Anesthesia. Light Sleep Anesthesia is the use of medicines to induce a state of relaxation and a light sleep. General is more of a deep sleep and can either be in gaseous state (intubation) or intravenous.
This procedure takes from 1 to 1 and 1/2 hours to perform. It may take longer if you choose to have chin and cheek implants as well. Depending upon your facial structure the incisions will be placed as inconspicuously as possible within the hairline or within the mouth for cheek implants. Some doctors even place the incisions inside the lower eyelid area. The risk of infection is higher if an incision is placed within the mouth area but with proper post-operative care this risk can be decreased.
How long do cheek implants last?
How long is the "down time" for this procedure; how long should I expect to be out of work?
Is there a lot of swelling involved with cheek implants?
It is hard to say, but normally a face lift can last about 10 years. Of course, every case is individual and you will look younger regardless. This procedure can not stop you from aging but can lessen the appearance of your general sagginess and/or lines.
Originally cheek (malar) implants were used for reconstruction for birth defects and trauma related incidents. Now, they are being applied aesthetically to enhance a person's cheeks or to create symmetry within the facial structure. With cheek implants, the flatter face is transformed into one with chiseled features that can be very aesthetically pleasing.
There are also injectable options that do not create a bony structure but do augment the cheek area. Injectable fillers are often injected deep within the dermis and move when the skin and muscle moves. Permanent injectable fillers can not essentially be removed from the dermis without tissue excision if an infection, inflammation or discontent arises, Silicone and other implants, can be.
What are implants made from?
They are normally made from hard Silicone, however they can also be made from:
What are the different techniques in performing a Cheek augmentation?
There may be surgeons who only wish to use a certain implant type or a certain incision. Surgeons should give you a choice, as the updated techniques are less scarring than the previous ones. The doctor may prefer an intra-oral approach where the only incisions are placed within the mouth area. No visible scars are made with the inta-oral incisions, plus they heal much faster. However, oral techniques sometimes are plagued by a higher rate of infection. Especially in those with problems with apparent plaque build up or poor dental hygiene.
Check with your doctor on the preferred technique that he utilizes. He may very well prefer the traditional methods out of not being aware of the newer ones or he may very well offer only the newer ones, with the thought that the older techniques are simply, out of date. This subject varies with surgeon to surgeon.
What are the risks of cheek augmentation?
What does a typical cheek augmentation consultation entail?
Firstly, your doctor will discuss your goals with you and he or she will explain what can be achieved realistically. The usual goal is to augment a lacking cheekbone structure. Although, some of you may want to rejuvenate your face, others may change the structure of your face dramatically for that cat walk model cheek bone look. Discuss with your surgeon the goals and general result you would like to achieve. It is all individual.
Your doctor will take into account your facial dimensions and natural face shape. There are many types of malar and submalar implants. The placement as well as the size of the cheek implants will be determined by you and your doctor. Don't be afraid to speak your mind during this time. Computer imaging is helpful in conveying your desires and expectations but should not be relied upon.
Although, there is normally no extensive pain related to cheek implantation, pain medication is prescribed beforehand. You may feel a degree of numbness that will normally disappear within 1 to 3 months. You may continue to wear a support brace while you sleep to allow your tissues and implant to heal in the desired position and prevent shifting in the first few weeks.
Don't be alarmed at the presence of bruising and swelling. The swelling will begin to disappear within the first 5 to 7 days. Many patients return to work with the help of camouflaging cosmetics at about 5 days post-op. The swelling resembles inflammation of wisdom teeth or their removal and sometimes this excuse is used at the office. Although please realize that the swelling may be apparent for months and the defined, chiseled look that you so desire may not become evident for quite a while.
Are the results permanent?
How is Brow Lift performed?
What are the risks of Brow Lift?
What does a typical Brow Lift consultation entail?
When will the stitches be removed and does this hurt?
Can I go right back to the gym after surgery?
Could it be cancer?
How long does the surgery last?
How visible are the scars after excision
If this is caused by estrogens, does the tissue actually look like women's breast tissue?
Is gynecomastia common?
Is there any way to predict who will get gynecomastia and who won't?
Is this a dangerous condition?
Now, why would a pathologist look at the tissue--is this a type of cancer?
What are other risks of the surgery?
What is gynecomastia?
What's gynecomastia look like? Does it really look like women's breasts?
Which is better--excision or liposuction?
Why does gynecomastia happen only to males at certain age groups?
Am I a candidate for hair transplantation?
At what age should I start hair transplantation?
Can I afford hair transplantation?
Doesn't removing hair from the donor area on the back of my head leave a big gap?
Has hair transplantation been proven to work?
I am a woman, should I see my doctor prior to seeking hair transplantation?
If I am unhappy with a transplant performed by another doctor, can Bumrungrad International correct the problem?
Is it common for women to get hair transplantation to cover face-lift and other cosmetic scarring?
Is Rogaine® effective?
Since Propecia is now available, doesn’t that mean hair transplantation is a thing of the past?
What are follicular unit grafts and micro-grafts?
What are the reasons for female hair loss?
Do all hand problems require surgery?
Do stitches have to be removed in the office and is it painful?
If surgery is required, when is the appropriate time?
Ligaments and Tendons in Rheumatoid Arthritis - Can surgery alleviate the pain associated with damage to ligaments and tendons in the wrist and hands as a result of rheumatoid arthritis?
Missing Digits - What causes this and is there anything that can be done?
Replacement finger joints MCP/PIP - After surgery when can full function be expected. What are my new joints made of?
Supernumery digits - What exactly causes this abnormality and is it common?
What are nonsurgical ways to treat hand problems?
What causes congenital hand differences?
What is Dupuytrens Contracture and can anything be done about it?
When should my child be seen for a hand problem?
Will my child have a prolonged hospital stay after surgery?
How is liposuction performed?
Small incisions are made and the excess fat is suctioned out through these small incisions. Sometimes a tumescent technique is used where a solution of saline (delivery and tumescent agent ), Lidocaine (pain reliever) and epinephrine (prohibits bleeding) are injected into the targeted area. This technique's purpose is to engorge the tissues with the solution for a firmer working area and the fat cells (which are softer) are suctioned out. The epinephrine prohibits bleeding during the operation and less blood is lost during the procedure.
There is a technique which involves ultrasonic waves. These ultrasonic waves excite the tissues water molecules (fat molecules being the target) and literally melt the fat into a liquid for ease of removal by suction. Unfortunately, each patient's molecules may react differently or in the case of unskilled surgeons, may improperly handle the equipment resulting in severe burns.
Either way, the targeted fat is suctioned out, sutures are sometimes used in the closure of incisions, a bit of surgical tape or Steri-Strips? are placed over the incision and a support garment is worn for proper, compact healing.
How many techniques are there for liposuction?
There is the Tumescent technique which is widely used by doctors every where. With the tumescent technique, if the surgeon does not over inject the area with TOO MUCH Lidocaine solution, this technique is proving best. Once upon a time they just shoved the hose in there and sucked away. With the tumescent technique, they engorge the tissues with a saline/Lidocaine solution and suction the fat cells which are not engorged with the solution. This technique also hinders of suctioning out of tissues that are not targeted for removal and lessens bleeding. However, if a surgeon injects too much of the solution the patient can get Lidocaine toxicity which can cause sickness, complications and sometimes death. Although Lidocaine toxicity is most often seen in body sculpture where large amounts of solution in injected within the body and the operation my require a longer period of anesthesia.
There is also a Super-wet technique which is basically like the Tumescent but with not as much solution injected. It breaks down to about the same amount injected as the amount of fat removed.
There is also the Ultra Sonic technique (UAL) which is regularly leaving patents with serious post-operative burns. Apparently the high frequency waves are over-exciting the water particles (or any fluid containing) causing them to boil beneath the skin as well as damaging superficial tissues as well.
And lastly there is the Power-Assisted Liposuction (PAL or MicroAire Technique). PAL is a newer technique where the cannula eases through the fatty tissue (even fibrous) with less trauma than traditional techniques and with no burn risks as with the UAL techniques. This new machine uses a special high-speed "linear reciprocating" suction cannula. You see, with the newer cannula surgeons are able to perform more effective high-volume liposuction in a shorter time, without trauma, especially in more fibrous areas. Fibrous tissue has always been a problem in the buttocks, saddlebags (upper sides of thighs in women), back and the male breast (gynecomastia). The PAL system moves through these areas faster, with less trauma resulting in less work and strain for the surgeon and less pain and a faster recovery in patients.
Is liposuction permanent?
What are the risks of liposuction?
There are more risks with liposuction due to the fat and its surrounding tissues becoming necrotic (dead tissue). If the fat becomes necrotic from lack of blood supply, the fat tends to turn orange-ish clear and drain from the incision. If the tissue becomes necrotic, that's a completely different story. You must have the tissue removed before a major infection develops, possibly causing gangrene. Even with the ultrasonic technique, patients have been known to receive actual burns from the ultrasonic technique. The fat is actually melted within the body by 'exciting' the fat molecules with high frequency radio waves and is suctioned out. There may be asymmetry, hyper-pigmentation (permanent dark spots) from the bruising. Major blood loss is a factor is some cases. As is hematoma and infection. Liposuction is NOT the way to lose weight.
Another risk of liposuction* is pulmonary Thromboemboli. A thromboebolus is a blood clot and this blood clot can break free and travel to the lungs resulting in pulmonary Thromboemboli. This can put a patient into adult breathing distress and subsequently into cardiac arrest or coma - leading to the patient becoming 'brain dead' shortly thereafter or in a vegetative state from loss of oxygen to the brain. Pulmonary Thromboemboli can happen within three weeks of the surgery but will most likely show symptoms of shortness of breath and fatigue within the first 72 hours. However, pulmonary Thromboemboli can occur suddenly, without warning. Most patients with P.E. collapse and begin rapid deterioration after attempting to climb a flight of stairs.
*facial liposuction risks are far less than body liposuction due to the amount of fat that is suctioned and disrupted.
What does a typical liposuction consultation entail?
What is the success rate of dental implants?
What are dental implants?
Who is the ideal patient for dental implants?
How long after a dental implant is placed can it be used to anchor my new teeth?
Does it hurt when dental implants are placed?
How is otoplasty performed?
Except in children, the operation is performed using light sleep anesthesia. In children less than 8 years, the operation is always performed under general anesthesia. All incisions are placed behind the ear so there are no visible scars after the operation. If the ears are protruding they may be rotated back. If some of the natural folds are missing they are created. Missing or abnormal sections of the ear may be constructed from tissues taken from other parts of the ear or from other areas of the body. Ears that have been injured, most commonly in wrestling, and are thickened can be thinned and sculpted. At the end of the operation a pressure dressing is worn.
The operation is mostly performed in children around age 6. The child generally follows instructions well because he/she is so happy to have the problem repaired and pleased with the results.
What are the risks of otoplasty?
The risks of the operation are bleeding and infection. Both are exceedingly rare. With proper post-operative care this is a very safe and satisfying operation that carries very little risk, beautiful results, and almost no discomfort from the operation itself.
The patient should note that the ears can often feel numb for 2 to 3 months after the operation. The sensation returns slowly over that time. This is the reason that there is generally no pain in the post-operative period. This fact makes the operation exceptionally well tolerated in children.
What is Arnica montana, I have heard that it reduces swelling and bruising? Which is the best kind to take?
Also known as: Mountain Tobacco, Mountain Arnica, Common Arnica, Leopard's Bane and Sneezewort
Plant family: Asteraceae
Type: Herbaceous perennial
Parts used: Roots and flowers
Description: Arnica montana or Leopard's Bane is a perennial herb, growing close to the ground. The leaves form a flat rosette, from the center of which rises a flower stalk, 1 to 2 feet high, bearing orange-yellow flowers. The rhizome is dark brown, cylindrical, usually curved, and bears brittle wiry rootlets on the under surface.
Habitat: Indigenous to Central Europe, in woods and mountain pastures, although it has been found in England and Southern Scotland.
Warning: This herb should NEVER be taken in raw form. This plant, like many medicinal plants if ingested, can cause intestinal bleeding, abdominal cramping and sickness. Homeopathy is the medicinal use of tinctures and suspensions using herbs and other plants and should never be consumed without proper preparation. Only respectable homeopathic remedies and tinctures should be consumed. ALWAYS ASK YOUR SURGEON FIRST BEFORE TAKING ANY MEDICATION.
What is otoplasty?
When will I be able to see the results?s
Can my child have two different procedures done at the same time?
How long will my child be in the hospital after surgery?
How much should I tell my child before hand about surgery?
How soon after surgery may I see my child?
What is a hernia? Can the operation to fix a hernia make my son sterile?
It may be large or small, and usually appears as a lump or swelling in the groin or scrotum in boys, or in the labia in girls.
An umbilical hernia develops when the muscles in the abdomen, around the belly button, do not fully close before birth, and some intestine protrudes into the opening.
The operation is a perfectly safe procedure and will not cause a male to become sterile. Fixing a hernia can prevent damage to the testicle.
What sort of dietary restrictions will my child need to follow before and after the surgery?
When can my child resume full activity?
Are there any new techniques to repair a deviated septum. Is cauterization used? Does the nose always have to be packed after surgery?
There are many ways to fix a septum. Generally cautery is used only on the turbinates or the initial incision on the columella in open techniques. The septum is like a wall frame in a house. The skin (mucosa) over it is like wall paper, and the cartilage on the inside is like drywall. You place an incision in the front part of the nose where it is hidden and raise the wallpaper off the wall. Then you can perform the necessary correction to the drywall (cartilage) and when you put the "wall paper" (mucosa/skin) back it looks like nothing was done.
Usually packing will be required however, some patients are eligible for tubes or straws placed in the center of the packing on each side so that direct airflow through the nose is possible. Most patients find this a psychological discomfort rather than a physical.
How is rhinoplasty performed?
Usually, Light Sleep Anesthesia is utilized. A Rhinoplasty can also be performed under General Anesthesia. The patient usually arrives early and medications are administered and supplemented with intravenous medication. After you are asleep and your vital signs are determined as safe and stable, local anesthesia is then applied to the nose. Surgery generally lasts about one and a half hours. The patient experiences no pain during the surgery.
A splint or cast is applied and will be worn for approximately 7 days. Many patients remember very little about the surgery. After the procedure is completed, the patient then recovers in a relaxed environment and monitored for a couple of hours before being driven home by a companion. You absolutely can not drive yourself home after a ANY procedure.
How much does rhinoplasty cost?
How much would a rhinoplasty, without insurance ect...be? Is the average price range like $5000 to $6000?
It really depends upon your region and the amount of work performed. If you just need a Tiplasty, with no bone work then it can average about $3,800.US. and up. The averages are as follows:
The average prices for rhinoplasty and it's related surgeries: Primary open rhinoplasty $3,152. - $6,500.; Primary closed rhinoplasty $2,879. - $5,800.; Primary Septoplasty/Turbinectomy $3,500. - $6,500.; Secondary open rhinoplasty $7,000. - $9,000.; Secondary closed rhinoplasty $2,643. - $10,000.; with implant: $2,500. - $10,200. Although, fees vary from state to state, region to region. Some more - some less.
I am 16 and have been thinking of rhinoplasty for a long time. At what age is it safe to have a rhinoplasty?
Usually rhinoplasty is performed at the earliest, 13 or 14 years of age in girls and 15 to 16 years of age in boys. Reason being, and it is a known fact, girls physically mature faster than boys and the collective goal is to perform surgery when at least 90% of the growth is complete. There are major growth centers in the nose that affect the growth of the face.
In cases of severe disfigurement due to accidents, surgery is performed in an attempt to restore the alignment of those centers. For lesser deformities surgery is deferred until after the teen stops growing. Rhinoplasties performed on teenagers and young adults, it seems, are often beneficial to the social development and self confidence of the individual.
In other words, this depends upon the stage of growth in the face as well as the gender of the patient. A qualified surgeon can better help you upon personal examination.
I have thick nasal skin and a surgeon I spoke with said that I may not be able to see much detail with my rhinoplasty? Is this true? Should I see another surgeon?
For many patients with thick skin, the skin is thinned out in the surgery as the tip is worked on. This really adds a lot to help with definition . Excess skin length just shrinks away as the swelling decreases. Also, many patients with thick skin actually do better with rhinoplasties because the flaps that are elevated are so firm that you can do a lot more with the cartilages and it is better hidden. Very thin skin, shows every little imperfection.
Going on several consults and getting a second, third and even more opinions is a good idea in any case. Searching for surgeons is a serious matter and you should be as comfortable as you can be with a surgeon, his skill, and his bedside manner.
I have to get my cast off soon and wanted to know if it is going to hurt? Is there anything I can do beforehand?
Most patients report a little tenderness when the cast is removed but if your surgeon uses a cotton swab saturated with alcohol to help remove the adhesive from the tape and glue you should be okay. Although it really shouldn't cause you great discomfort.
The sutures that may be removed may hurt when someone else removes it due to them not actually being able to tell when they are hurting you. They also may snip your flesh slightly when the scissors are used to cut the actual suture. This isn't as rare as it as it should be and solely depends upon the surgeon's meticulous nature.
I recently had a rhinoplasty & septoplasty, its almost 6 months & on one of my nostrils I still can hardly breath. Is this normal?
I used to be addicted to cocaine. As a result, my past (I'm recovered) addiction left a hole inside my nose, between my nostrils. Can I have the hole filled?
I'm getting a deviated septum and a hump fixed all in one and I wanted to know what kind of scarring I should expect. Also, how long is it after the operation that I'll see good results?
Usually, there is no visible scarring unless it is an open rhinoplasty. Some surgeons perform all of their rhinoplasties, open -- some, all closed. It solely depends upon the surgeon. You will find that most surgeons tend to disagree when it comes to technique. They either prefer open or they prefer closed, OR if they are highly skilled, know that it is case-dependent and different patients have different needs. If it is an open rhinoplasty the scar would be on the columella (the skin that separates the nostrils) sometimes resembling a straight line or a flattened z.
You can expect swelling, especially in the tip if you are having tip work performed. The swelling usually begins to subside within the first month but the end result may not be seen until at least 9 months [post-operatively. Although this time period tends to lean towards a year and over.
I'm going to get my nose done soon and my doctor also recommended me getting a chin implant because he says my nose will still appear 'big' since my chin goes a little further in then it should...Do people get both these procedures at the same time? And d
Is it improper to ask to speak with previous patients who have had revision rhinoplasty done by the surgeon I am considering for the same procedure?
Not at all! And you absolutely should. All surgeons should have a referral list of prior patients to discuss particulars and trade stories. I personally spoke with patients beforehand and as a matter of fact am on my own doctor's referral list.
If you are wondering if all of the patients are going to be happy or receive compensation... I have found in my experience that there are about 1 to 2 patients who wish they had done more research beforehand or had gone to another doctor entirely so be advised that although this is unfortunate I think it is helpful to the patient considering the procedure to gain a well-rounded opinion.
Is it possible for someone to be allergic to dissolvable stitches? And if so, what would the reaction be?
This isn't as uncommon as you may think. There are usually two types that promote a response in those who are sensitive to these sutures. These two are usually Absorbable Poly(glycolide/L-lactide) Surgical Suture material and Absorbable Gut Suture material.
If you experience redness and itchiness and sometimes pus formation -- you very well may be allergic to the dissolvable type sutures. Sometimes the symptoms may not show up until about 3 to 4 weeks after surgery, if this happens, antibiotics can be given but it usually reoccurs. The best thing to do in some cases is to remove any of the left over material and replace it with nylon sutures. These sutures are usually removed in 10 days. Another option can be tissue glue although this isn't very mainstream for rhinoplasty.
Also be advised that when the skin gets red and itchy around a suture, be it absorbable or non-dissolving -- usually it is time for them to be removed. Your body knows and will tell you when your healing. Besides healing skin always turns itchy. Know the difference between typical irritation and an allergic reaction.
It's been five months since my surgery and now since I started to get back in shape and returned to my gym. I have notice that when I run and workout my nose drips. It is very runny, here I am walking away and every few min. I have to use a tissue. Is thi
My PS mentioned a shot of cortisone to help some of the scar tissue. Why is this and what will this do?
What are the risks of Rhinoplasty?
It is possible to develop tiny red marks and spots, this can be the result of blood vessels that may have burst under the skin's surface during the surgery. Although this is extremely infrequent it can happen and the spots may not ever go away. Scarring is minimal if the incisions are made inside of the nose, however when an "open" technique is used, or if narrowing of the nostrils is desired the scars made on the outside of the nose may be visible for am undetermined amount of time (usually until maturation). Even when a highly skilled surgeon performs your surgery, sometimes your body may not heal correctly or have adverse reactions causing undesired results. If so it is quite possible that additional surgeries may be needed. Some patients will lose their sense of smell, temporarily. Your nose may be slightly swollen and for over a year. Scar tissue may heal in a way that may cause a whistling sound to be heard when you breathe in and out.
This surgery has the highest rate of revisions. It seems that some people, especially mature people, may not readily accept the new look. Being accustomed to their old nose, they just can't seem to comfortably make the transition. Although there are a few rhinoplasties that just don't heal correctly, due to something as serious as human error (the surgeon's) or as simple as not having your head elevated enough or sleeping on one side a lot without a proper cast. The nose can pull to one side if the cast does not support it properly in the first week. Or quite simply, your body may just heal that way.
What does a typical Rhinoplasty consultation entail?
What is a "hanging columella"?
What is rhinoplasty?
Rhinoplasty is cosmetic surgery of the nose. It is also known as nasal refinement and the layman's term nose job. With rhinoplasty, 'defects' from either birth or trauma can be corrected by infracturing or breaking the bones of the nose and re-setting them in the desired shape, often narrow and straight.
A hump may be removed to give a more pleasing, symmetrical look. The cartilages of the nose can be molded and trimmed to create a more compact or pleasing shape. Rhinoplasty can soften an otherwise beautiful face by refining one's features.
After your surgery your surgeon will have placed a pressure dressing over your eyes and a gauze pad underneath your nose to catch blood and mucous. You will remove the pressure dressing after a few hours or as specified by your surgeon. You may become sick from ingested blood during the procedure and vomit, expelling a black mixture of stomach acid and blood. This will pass as soon as the blood is expelled. It really isn't that much so you shouldn't be sick for long unless you were under general anesthesia -- you may become sick from this alone. Your doctor can give you special medications to remedy or prevent this. If you continue to vomit and/or run a high fever, contact your doctor immediately.
You nose will be sensitive for approximately a month and a half although patients report no serious pain or discomfort. However, patients do report the discomfort of breathing with the packing and cast on the nose. Some patients feel claustrophobic feeling as if they cannot breathe. This feeling widely resembles a head cold or sinus infection. Only when the cast is removed do you feel slight discomfort, unless you bump it accidentally.
Q24 :
When can rhinoplasty be performed?
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Q26 :
When will the cast be taken off and does this hurt?
The cast is removed approximately 7 days post-operatively. You may feel a slight stiffness in the upper lift as the swelling moves downward. This will subside in a matter of hours. you must be very careful not to bump it as it is vulnerable to breakage. It isn't a bone china figurine but it isn't as strong as your nose was before the rhinoplasty either. Don't worry, the bones will completely mend within 2 months.
If you had a rhinoplasty where the nostrils were narrowed (in the case of flared nostrils) you will have your sutures removed. This may sting a bit, especially since it is in a sensitive area. Although most patients still feel numb in the tip area and report only minor discomfort.
Do people get both these procedures at the same time? And do you recommend I should do this?
Is this just part of the healing stage or need I bring this up to my doctor? Its really annoying! Has anyone experienced this at all?