by Dr Rohan Page, MBBS FRACS (PLAS)
Specialist Plastic Surgeon
So you’ve decided to have breast implants? To help you understand what the procedure involves, here I explain the surgical and recovery process for breast augmentation with us at Assure Cosmetic Centre.
Pre-operative Surgeon Consultations
The first consultation with your specialist plastic surgeon will take approximately 45 minutes, with the key aim of developing an individualised surgical plan that will deliver the result you are looking for.
Your consultation is an important time to openly discuss your expectations with your surgeon, to ensure you are both on the same page.
A good surgeon won’t hold back on giving you their own honest recommendation, but they should also listen carefully to exactly what changes you are seeking.
Your surgeon will spend time explaining the surgical procedure; give you guidance on implant selection and placement options; discuss any potential risks; and outline your expected post-operative recovery back to normal activity.
You will also have the opportunity to view before and after pictures from other similar patients.
After the consultation, you can take your time to decide whether you want to go ahead and book surgery. If you decide to book, available surgical dates will normally be about 2-4 weeks out. We will typically arrange a second pre-surgery consultation with your surgeon to go over any remaining questions you have and to finalise your choice of implants.
The code of conduct governing specialist plastic surgeons entitles you to a 10-day cooling-off period between your initial consultation and surgery. The bottom line is that you should never feel rushed in the decision making process.
Day of Surgery
With Assure, your surgery will take place in a fully-accredited and licensed private hospital under general anaesthetic administered by an anaesthetist qualified with ANZCA (the Australian & New Zealand College of Anaesthetists). Your anaesthetist will typically contact you before the day of surgery to discuss your procedure and any questions you have. They will also meet with you before administering the anaesthetic.
Your procedure will usually take between 90 minutes and 2 hours.
You will wake up in the recovery room. Your surgical incisions will be closed with buried, dissolving sutures and covered with a supporting tape dressing, and your surgeon will have fitted your surgical support bra. A surgical drain may have been placed during surgery – your surgeon will often discuss this with you beforehand.
Nursing staff in the recovery room will ensure your recovery is as comfortable and safe as possible.
Breast implant surgery is often performed as a day surgery procedure, and once you have recovered from your anaesthetic and are comfortable, you can be discharged home with your partner/friend or relative to continue your recovery in the comfort of your own home. Occasionally you may be advised to stay in hospital overnight. This will usually be discussed with you during your pre-operative consultation.
First Few Days Post-Op
Once the anaesthetic has worn off, a certain amount of discomfort and pain is expected. This is different for everyone and can vary according to the implant site and size. Your anaesthetist will prescribe pain-relieving analgesic medications for you during your recovery in hospital and after your discharge home. By days 2-4 post-surgery, most patients will only require simple over-the-counter analgesics such as Paracetamol.
You are able to shower 24 hours after surgery. After showering, you should leave your dressings intact, but you should dry them thoroughly with a hair dryer on the cold setting.
It is normal to feel tired and sore for 2-3 days. You may feel extra weight pressing on your chest and breathing will take a little more effort. It is normal to feel that the breast implants are not part of your body. It takes a few weeks for your breasts to soften and feel more natural. They may also initially seem a little high. This is normal and most implants will drop a little over the first 3 months as the tissue stretches.
We encourage you to resume light activities within 12 hours of surgery. This includes raising your arms above your head, brushing your hair and teeth, and changing your own clothes. However, you should remember you have just had an invasive surgical procedure and we recommend taking things very slowly and getting lots of rest. Watching movies and television, reading and limited excursions are fine, but you should avoid any physical tasks for the first 3 days and ensure you don’t wear yourself out in any way.
Post-Op Appointments
You will be scheduled to see our cosmetic nurse in the first week after your surgery. They will redress your incisions and show you how to do this yourself on a weekly basis for the next 3-5 weeks. If our nurses have concerns, they may request that you come back for a second review by them after two weeks, however a single nurse visit is sufficient for most patients.
You will be scheduled to see your surgeon for a post-operative review 6-8 weeks after surgery. Your surgeon may also see you immediately after your surgery and/or at your first nurse dressing appointment.
Recovery & Returning to Routine
Depending on how you feel, you can resume work normally after a week, perhaps earlier for office work and a little longer for more physical roles. Most patients will take at least a week’s leave from work. You should avoid physical work and driving for the first week and resume only if you are no longer taking pain medication and/or are feeling unrestricted by pain.
You should avoid any activity that causes pain or discomfort and your breasts should not be massaged or manipulated in any way for the first 4 weeks. This will allow the implants to settle into the breasts and avoid displacement or rotation of the implants. You should sleep on your back if possible for the first 2 weeks.
You should avoid all exercise (heart rate >100) for the first 3 weeks. You can return to light exercise and usually may resume most exercise activities 4-6 weeks after surgery.
A surgical support bra must be worn constantly for the first 4 weeks. Thereafter, you can wear the bra of your own choice, though you should continue to wear the support bra when exercising up until the 3-month mark.
Minimising Scars
Your specialist plastic surgeon will have taken measures during your surgery to minimise visible scarring. However, good scar management in the post-operative period is essential to achieve the best possible result.
After applying a weekly tape dressing to your healing incisions for the first 4-6 weeks, we will recommend regular scar massage. Your cosmetic nurse will advise you how to do this effectively.
Scar massaging is also of benefit during this period and our nurses will show you how to do this effectively and what moisturising creams are suitable.
You should avoid direct sunlight to your incision for one year and thereafter always use a sunscreen with SPF30 or greater, because sun exposure can increase pigmentation of the scar.
Any Concerns?
If anything in your post-operative recovery concerns you, then both your surgeon and nurse will be easily contactable and able to assist you.
Breast augmentation surgery is very safe and carries few risks. It is however, an invasive procedure and so must be managed by both you and your surgeon in a careful and professional manner.
At Assure, our Specialist Plastic Surgeons offer breast augmentation patients an all-inclusive package for $13,490, which covers surgery performed safely under general anaesthetic in a fully-accredited Perth hospital. Click here for details.
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