Delayed wound healing after breast implant surgery Introduction Breast augmentation is one of the most popular plastic surgery procedures performed all over the world. 98% of patients who undergo this operation declare themselves happy with the results and the choice they’ve made. Usually, this is not an easy choice to make since it involves not only the fear of personal pain and suffering due to surgery but also, the fear of backlash they will get from people they know for getting their “boobs done.” Reasons to get an augmentation are varied, but low body image and lack of confidence are the primary reasons leading people to this decision, and it seems it really does wonders in terms of the psychological effects. But before deciding to go through this, it is probably wise to be informed on everything you can regarding what you need to know before and after your surgery, what you should and shouldn’t do, and what complications could appear. There are a variety of complications that might appear after breast augmentation, but the good news is that only a very small percent of women experience them. One of the complications that appear in 1% of patients undergoing this operation is delayed wound healing. Though rare, it is necessary to know how to prevent it and how it can be fixed. Preventing delayed wound healing Most plastic surgeons will tell you that augmentation surgery is one of the most common operations done in their field and it is most of the time complication-free. A certified and experienced doctor that has performed many such operations over the years will tell you from the beginning that any operation involves an incision, anesthesia, cutting some tissue, a recovery period, and there is always a risk of complication. That is why choosing the doctor for this operation is of the utmost importance: he or she will be in charge before, during and after the operation, the way your breasts will look, and the way you will feel will be mostly depending on him or her. So, you should look very carefully for a good doctor. Go and see more than one and choose wisely, allowing yourself to be picky and ask as many questions as possible. Remember that you are not buying a pair of shoes, so they do not have to be pretty but cheap. You are actually buying a piece of your body, so it needs to be expensive and long-lasting. During your consultation, you and the surgeon of your choice will discuss all the aspects of the operation. He or she will have to assess your general state of health, discuss any possible chronic diseases, and family health history. Genetic predisposition to a specific response of your body to a cut or foreign object is a very important aspect a doctor should consider. There are people that have allergic reactions to stitches, and the wound, instead of healing, will become infected. The surgeon must be informed of this condition because there are special hypoallergic stitches that should be used in this case. Also, there are some persons that might have a rather exaggerated immune response to wounds like developing a thick scar tissue instead of a normal one. If you have ever experienced anything like this, you should promptly inform your doctor from the very beginning. This is a complication that can appear and is called capsular contracture when thick scar tissue forms around the implant and it squeezes and deforms it. There are possible ways to avoid the appearance of this complication, and if your surgeon knows beforehand, he will be able to discuss with you and implement all the necessary measures to reduce this risk to a minimum. Another very important fact you need to tell your doctor is whether you are a smoker or not, and it does not matter if you smoke two or twenty cigarettes a day or a week; you are still a smoker in medical terms. Nicotine is a vasoconstrictor, meaning that it causes blood vessels to tighten up. For a wound to heal it needs oxygen delivered through the blood vessels, so if they tighten up the amount of oxygen will be lower and the wound will heal much slower. In the case of plastic surgeries such as tummy tuck, breast augmentation, and facelifts, there is a new factor that adds to the whole oxygen supply issue: during this surgical procedure some skin is lifted and pulled tight, causing the removal of some blood vessels during this process and reducing the blood flow even more. Therefore, in order to avoid the risk of delayed wound healing, your surgeon will ask you to quit smoking at least 6 weeks before surgery and then 6 weeks more after it. It is important to know that no other replacement that contains nicotine will do. You need to stop using nicotine no matter how it gets into your body. The size of the implant is also very important when it comes to the process of healing. Many women are tempted to go big when it comes to getting an augmentation. They have suffered for many years for not being able to show cleavage or not having it at all, and they think they will just walk out of the operation room with D cup boobs. It is important to understand that you need to set some realistic goals when it comes to implant size. First, implant sizes are measured in cubic centimeters and not cups, and nowadays the sizes are so varied and so many that you can easily choose something that will make you happy and also not cause you any issues. Your natural breast tissue, your constitution, chest size, skin elasticity, these are all factors that are measured and assessed by the plastic surgeon. Compiling these measurements with the result you want, we’ll get you the best possible implant size that fits you. If you choose to ignore your doctor’s recommendations and get a bigger implant, then you will be exposing yourself to some possible complications, and one of them is the delayed healing of your wound. The implant will be too heavy for your tissue to support it, so healing will be impeded and you will even risk your wound to open. Recognizing and avoiding delayed wound healing Unfortunately, nothing in life is risk-free, so no matter how many measures your doctor will take to prevent any complications, you still might develop some. The operation will be over in no more than two hours, and most probably you will be sent home after you recover from the anesthesia. You will be prescribed some pain medication, and you will have to rest completely for at least 48 hours after the surgery. You will not be allowed to exercise at all, lift your arms, sleep on your chest or side, and you will need to wear a surgical bra for the first week. It is very important to follow your doctor’s instructions to a T because this will speed up your recovery and reduce risks at a minimum. It is very important to monitor your healing process and react to any issue or fact you consider not normal. Even if you call your doctor just for nothing, it is better to waste five minutes of his or her time than be sorry for not asking. It is necessary to know the healing steps and to monitor your incision closely. In the first two to three days the pain and swelling will be the most intense, then normally, the pain will decrease or even disappear. The swelling will remain for some more weeks but will gradually go down. The incision will be slightly red and swollen, and there might be some small amount of clear leakage near its site. This is normal. But if the redness is intense, the incision bleeds, it is too swollen and painful, there is drainage from the wound, and you have a fever, these are not good signs, and you should immediately call your plastic surgeon and go in for an examination. If the skin near the incision becomes red and feels hot, this could also be a sign of infection, so you also need to see your surgeon. If the swelling persists and does not seem to go down at all and if the pain is intense and you feel a burning sensation, you need to see your doctor because all these signs show that there is something not right. It is very important to try and avoid contracting any infections, and one essential factor in doing so is keeping the incision site dry, so you will not be able to take a bath or shower until the stitches are removed. You will also need to avoid any kind of activity that supposes raising your hands, such as arranging books on shelves or washing your hair. This kind of exercise with your hands will put pressure on the sutures, and the wound might open. You will not be allowed to take any blood thinning medication, because they cause excessive bleeding and will also delay the process of healing. Among these are aspirin, heparin, warfarin, but even some supplements and vitamins can cause bleeding, like Vitamin E, A, fish oil, ginger, etc. Conclusion If you do everything your plastic surgeon tells you and take care of yourself, there should be no reason for complications, but if at any time you suspect your wound is not healing properly, you should call your doctor, and only he or she can know for sure what to do. It is always better to prevent than treat, but the element of surprise might be present as everywhere in life. You might have a wonderful doctor and be a very obedient patient and still have the misfortune of contracting an infection. But staying alert and monitoring your healing process will help you quickly find any issues or complications you might experience and prevent further risks.