Frankness is crucial at this early stage. Patients should not withhold information about their life habits or about medications they use. The surgeon should be equally forthright about any and all potential risks and how those potentials can be ameliorated. For instance, in some procedures smoking may inhibit healing and it may be advisable for the surgical candidate to quit several weeks before the surgery and to abstain from smoking for several weeks afterward.
Pre-surgical consultations should also include a full description of the procedure itself as well as information about the type of anesthesia to be used. The patient should know where the surgery will be performed and understand all associated costs, especially since breast enlargement surgery is generally not covered by medical insurance. Patients should follow all instructions carefully and observe prohibitions against the use of any specific foods, drinks, vitamins, or prescription drugs. It is not unusual for the surgeon to ask the patient to have a pre-surgical mammogram to ensure breast health and to serve as part of the complete surgical record.
Patients will be asked to affix their signatures to consent forms indicating they understand all aspects of the surgery including potential risks and are willing to proceed. The same form will include consent for emergency care in the event of complications although such instances are quite rare. It is routine to be asked to designate who will drive the patient on the day of the procedure and provide care for them during their recovery.
The surgery itself may be performed in a hospital or in a private facility as an out-patient procedure. A general anesthetic will be used although some patients do opt for a local so they will aware of what is going on. In that case sedatives are used to keep the individual relaxed. Normally incisions are placed either around the aureola, in the crease where the breast and chest join, or under the armpit. Saline breast implants are sometimes inserted via an incision at the navel. Care is taken to minimize any scarring.
Following the placement of the incision the skin and breast tissue are lifted to create a pocket either behind the breast tissue or beneath the pectoral muscle of the top chest wall. The implants are placed in the pockets and the incision closed with gauze bandages applied to keep the area clean. Normally the work can be completed in one to two hours with no overnight hospitalization required.
Patients will feel fatigued and sore but will be up and about within a day or two. Pain is managed via prescriptions. The dressings will be removed within a few days and patients may be asked to wear a surgical bra. A burning sensation in the nipples is common for as much as two weeks, but will fade along with the bruises. Stitches are removed within ten days, but patients may continue to see swelling for as long as five weeks. Physical stimulation of the breasts should be avoided until all soreness has disappeared. Any scars will fade in time, but they will not disappear completely. Generally patients will miss several days of work (more for physically demanding professions.)
All normal measures for breast health and care should be continued following enlargement surgery including monthly self-exams and regular mammograms.
