Breast augmentation patient information
- Introduction to Breast Augmentation
- Incision Location
- Implant Placement: Over or Under
- Breast Implant: Size and Style
- Breast Implant: Size and Fill Level
- Breast Implant: Saline or Silicone
- Options for Pain Control
- Pre-Operative Instructions—Getting Ready for Surgery
- Starting Now
- Personal Information Sheet
- Instructions and Medical History
- Activity Restrictions
- Sports Bra
- Pre-Operative Instructions—The Day Before Your Surgery
- Pre-Operative Instructions—The Morning of Your Surgery
- Clothing and Personal Items
Introduction to Breast Augmentation
We want our patients to be comfortable with the decision to have breast augmentation surgery. Please read this information carefully and ask us any questions you may have. During your visit, Dr. Zevon will show you before and after photos of patients who resemble you. We will arrange for you to meet with a member of our staff who has had the breast surgery, if possible. We can put you in contact with patients who have had the breast surgery if you would like references. We will offer you a tour of our surgical suite, which is certified by the American Association for the Accreditation of Ambulatory Surgical Facilities (AAAASF). As discussed more fully below, you will have the opportunity to try on implants of different sizes to make sure you are comfortable with your choice of size. We will give you a quote for your breast augmentation surgery, and information about financing options, if desired. If at any time you have questions about this breast surgery, please do not hesitate to ask them. You should feel comfortable discussing your goals and expectations with Dr. Zevon. An educated patient is the ideal candidate for plastic surgery.
Your Choice of Incision Location
Dr. Zevon will discuss with you the options for inserting and positioning your breast implants. These options depend on your anatomy, your preference, implant type, and whether you are also having breast lift surgery. Three locations are the most common: 1) inframammary crease—in the crease at the bottom of the breast; 2) peri-areolar—around the areola (the dark skin surrounding the nipple); or 3) transaxillary—via the armpit. Dr. Zevon will make every effort to assure that the location of the incision results in scars that are as small and inconspicuous as possible.
Implant Placement: Over or Under
Your implants may be placed in front of or behind the pectoral (chest) muscles. Women whose breast implants are placed behind the muscle can expect to have post-surgical pain for a few more days, although we do offer new options for effective pain control with medication. The appearance of the breasts after breast augmentation surgery in women with low body fat is better with placement behind the muscle, as the muscle covers the edges of the breast implant. This is of less concern in women with more breast tissue or higher body fat. Placement behind the pectoral muscle may also result in a lower incidence of capsular contracture, a complication that Dr. Zevon will explain when you review your informed consent for this procedure. Placement of the implant beneath the pectoral muscle may allow better mammography than breast implants above the muscle. Dr. Zevon will discuss the pros and cons of breast implant placement and incision options with you during your breast augmentation consultation.
Breast Implant: Size & Style
Dr. Zevon will talk with you about your desired breast size. You will “try on” different sizes of breast implants. Taking into account many physical factors, including your height, weight, existing breast volume, shoulder width, chest wall, body fat, breast position, nipple position, any asymmetries, spacing between the breasts, laxity of skin, as well as your desired bra size, Dr. Zevon will recommend a breast implant size and style for you. There are many options available in size and style including round, smooth, anatomical, and textured breast implants. Round breast implants are available in 3 profiles: high, regular, and low profile. Dr. Zevon will recommend the breast implant he thinks will look natural, proportionate, and balanced for your frame.
Breast Implants: Size & Fill Level
Manufacturers usually size saline breast implants over a range of approximately 30 cc; fill to the uppermost end of the range is considered “overfilling.” The concept of overfilling has arisen due to changes in manufacturers’ labeling of breast implant sizes in response to FDA dictates. Today, an implant of size 270 cc to 300 cc would be considered overfilled if filled to a volume of 300 cc. Dr. Zevon believes that correct fill volume is key in the prevention of rippling. Rippling refers to the occurrence of wrinkles or “ripples” in the skin over a saline breast implant. Accordingly, Dr. Zevon will overfill unless considerations of symmetry or other anatomical issues outweigh issues of fill volume. This means that if you choose to augment your breasts by a volume of 300 cc it may be achieved with a breast implant size 270 cc filled to 300 cc.
Breast Implant: Saline or Silicone
Some people believe that silicone breast implants are more natural in appearance and feel than saline breast implants. Others continue to believe that silicone breast implants pose more health risks than saline breast implants. Until November 2006, due to concerns about product safety, the FDA limited the availability of silicone breast implants to women enrolled in an authorized clinical silicone breast implant study. Dr. Zevon is an investigator for the silicone breast implant studies. In November 2006, the FDA decided to allow certified plastic surgeons to use silicone implants in cosmetic patients over the age of 22 and in reconstructive patients. Dr. Zevon is trained and certified to use silicone breast implants. During your consultation, Dr. Zevon will discuss the risks and benefits with you. You can weigh the pros and cons of silicone vs. saline breast implants and make your own decision.
If you are over 35, we recommend that you get a mammogram before having breast augmentation. Choose a mammography facility that has experience with breast implants. Regardless of your current age, when you schedule future mammograms, tell the mammography facility that you have breast implants. Ask for additional breast imaging using a technique called “implant displacement views.” These views afford a better view of breast tissue. If you think you may move to a different geographic area in the future, you may wish to obtain a copy of your baseline (pre-augmentation) mammogram as well as the radiologist’s report.
Options for Pain Control
Dr. Zevon prescribes oral pain medication for all breast augmentation patients. We recommend taking the oral pain medication before going to bed the first night after your breast augmentation surgery. At this time, you are in a transitional period when your breast enlargement surgery anesthesia is wearing off and the post-surgery discomfort is increasing. It’s easier to be comfortable if you don’t allow yourself to experience too much pain—that is, if you feel significant pain increasing, take the pain medication before your pain is “out of control.” We have a new pain control option available for patients who are having submuscular breast implants. This option, called a “pain pump,” consists of a source of non-narcotic local anesthesia Dr. Zevon can insert at the end of your breast augmentation surgery. The pain pump will produce a steady flow of medication during the first week after your breast implant surgery. If you think you may be interested in the pain pump, tell Dr. Zevon at your pre-operative visit so he will have it available for use during your surgery. Dr. Zevon will remove it 1 week after breast augmentation surgery.
Pre-Operative Instructions—Getting Ready for Surgery
Please read and familiarize yourself with Dr. Zevon’s Breast Augmentation Patient Information. By following all instructions carefully, you will assist in obtaining the best possible result from your breast augmentation surgery. If questions arise, do not hesitate to communicate with Dr. Zevon and discuss your questions at any time. Re-read your General Instructions for Cosmetic Surgery.
Personal Information Sheet
Locate your Personal Information Sheet and complete it so that we will know who will escort you home after your breast augmentation surgery, how much time to call ahead for your pickup after surgery, and where you can be reached the night of your surgery. State law requires someone to pick you up after breast augmentation surgery with anesthesia. If you prefer to hire someone to perform this task, ask us for a referral to a nursing agency. Dr. Zevon will call you the evening after your surgery. It will be easier for him to reach you if you fill out the form completely and print clearly.
Instructions and Medical History
Read your green sheet of Pre-Operative Instructions and make sure you know where it is for easy reference. During the two-week period before your surgery, don’t take aspirin, ibuprofen, NSAIDs, or Vitamin E. Also, don’t take any medications, vitamins, or nutritional or herbal supplements without Dr. Zevon’s permission. When you arrived in our office the first time, you were given a Medical History Questionnaire, inquiring about any medications, allergies, personal and family medical history, and smoking and drug use. If you aren’t sure you disclosed all allergies, medications, past medical history, existing conditions, and smoking status, or if any of the foregoing have changed since your initial visit, be sure to discuss any omissions, changes, and/or new information with Dr. Zevon.
Read the Activity Restrictions in your Post-Operative Instructions so you will understand what you will not be able to do during the first few weeks after your breast augmentation surgery. Since you will not be able to raise your arms above your shoulders and will not be able to carry heavy weights and bags, make sure you have everything you need at home on a level where you can reach it easily. Collect phone numbers for home delivery of items you may want to have delivered. Since you may be at home for a few days, have some books, tapes, DVDs, CDs, or other home entertainment on hand. Some patients feel more comfortable with ice on their breasts after breast augmentation surgery. You can use well-padded ice packs for this purpose or bags of frozen peas. Whatever your preference, make sure you have the ice readily available as you may wish to use it during your first few days at home.
We will give you a sports bra to wear after your surgery. If you like, you may wish to purchase another one for convenience so you can change, or if you want a bra in a different color. Choose any soft, supportive, broad-banded bra. You will have to wear the sports bra for several weeks and should avoid wearing any underwire bras until you are well healed.
Fill your prescriptions before breast augmentation surgery and make sure you know where they are.
Pre-Operative Instructions—The Day Before Your Surgery
Nothing to Eat or Drink Before Midnight
If your breast augmentation surgery is in the afternoon, ask us as to what or when you may eat or drink before surgery.
Remember it will be uncomfortable to raise your hands above your head for a few days after your breast augmentation surgery. If you prefer to wash your hair in the evening, do so the night before your surgery.
Make sure your escort has our address, directions to the office, and information about parking if needed. Tell your escort we will have an extra copy of your Post-Operative Instructions for him/her to pick up and read. If your escort or location for the first night has changed, call our offices with the new information.
Pre-Operative Instructions—The Morning of Your Surgery
Shower or bathe with anti-bacterial soap. Wash your breasts and under your arms thoroughly. If you want to, wash your hair as it may be uncomfortable to lift your arms for a few days after your breast surgery. Do not apply any moisturizer, deodorant, talcum powder or other products afterward. Do not use hairspray or perfume.
Clothing and Personal Items
Wear simple, comfortable, loose-fitting, dark-colored clothing that does not go on over your head. Wear tops with easy-to-fasten front closures, such as buttons or zippers, bottoms that are easy to pull on and comfortable, easy-fitting shoes and socks. Do not wear new clothes. Sweat pants are ideal. No high heels or pantyhose. Do not bring jewelry or valuables with you. Bring a case for contact lenses if you wear them, and bring glasses if you need them as it may be awkward to put your contact lenses in immediately after your plastic surgery.