Improving the results of breast implant surgery Introduction Breast augmentation surgery using implants is one of the most common plastic procedures, chosen by more than a hundred thousand women yearly worldwide. Thanks to advanced medical technology and the variety of implants available nowadays, this has become not only very popular among women, but also a very safe procedure performed at the highest standards. The reasons for taking this step are varied, and they range from having naturally small breasts and wanting a boost in confidence, or wanting to get back in shape after pregnancy or losing weight. Choosing the right surgeon It is very helpful to research and study exactly what you should expect from your doctor and the surgery, what happens after, and all the details. Of course, you need to discuss everything with the chosen surgeon, but to be able to ask the good questions, you need to be informed. The first and foremost important decision you have to make is regarding the plastic surgeon you will entrust the way your breasts will look for the next ten years. It is not an easy decision, and you should not jump to the first one you meet, no matter how charming or convincing he or she is. You need to see more than one doctor to make an informed opinion on them. The result of your operation depends mostly on the surgeon that performs it, so it should be the best. Plastic surgery can be expensive, and you might be inclined to go for a cheaper doctor. A piece of good advice in this case would be to wait some more after you have enough money to get an experienced and certified doctor. The surgeon’s role is of utmost importance from the very beginning. During your initial consultation, you need to ask all the questions for all the things that are not clear and even for those that are since he or she is the doctor, and you will have to tell him or her what you want exactly: no more saggy or droopy breasts, no more small breasts, or no more asymmetry. Asking the right questions and assessing your general health is the plastic surgeon’s job. Furthermore, he or she will do a set of measurement on your natural breast size, chest width, tissue elasticity, and then combined with your frame, height and weight, they will be able to tell you exactly what size of implant will best suit you. This is an important aspect to take into consideration: if you insist on having a bigger implant than advised, you will probably have some complications like delayed wound healing, capsular contracture, symmastia, implant extrusion, etc. In the long term you can even develop a range of back problems and pains due to the extra weight of the breasts. Having to carry implants that are too heavy for your body type, figure, and tissue will only do damage, and most certainly you will have to replace them rather sooner than you expect. Some doctors will even refuse to operate if you insist on having implants that do not suit your size. You will also discuss other aspects with your plastic surgeon all related to the surgery itself, like place of the incision, implant placement, implant type, etc. The operation The operation is a simple one with few and rare complications (less than 10%), so it will be over in no more than two hours. Usually, it is done in an outpatient facility since you will not need to spend the night under medical supervision. During this procedure, the surgeon will make an incision on your armpit (transaxillary) or near your areola (periareolar) or in the crease under your breasts where they meet the thorax (inframammary). The last one is the most common type of incision, and it has the best result in terms of accessibility during the operation and in aesthetic ones since the scar will not show even in a bikini. After the incision, he or she will have to create a pocket inside your breast to insert the implant. The placement of this pocket can have an impact on the result of the surgery. The implant can be placed in a pocket made between the breast tissue and the pectoralis muscle, over the muscle, or subglandular. This type of placement will make recovery faster and the pain minimum, but in time it is not a very good solution. The other possible placement of the pocket is submuscular, meaning under the pectoralis muscle. This procedure will result in a longer recovery period and in a more painful one, but it is considered a better one because the implant is protected by an extra layer. Also, it is said that this placement will make future mammograms easier to perform and interpret. After the pocket is made, the implant is inserted and positioned in the intended place. Then the wound is sutured, and that’s it. You will be able to go home after some hours, exactly after the anesthesia effects are gone and your doctor gives you the green light to go home. Important steps in recovery It is crucial to observe all the recommendations given by your doctor. To make the best of your surgery, you need to do exactly as you are told and call him or her immediately if you notice or suspect there is something wrong with you. The first two to three days, you will have to rest as much as possible and take care of yourself. Eating well, sleeping enough, and taking things easy will help your body recover faster. If the pain is normal, then you will probably be advised to walk a little bit around the room to get your blood circulating and thus prevent blood clots from forming. It will be best if you can ask your partner, friend, or some close relative to be with you these days. You will not be able to carry any kind of weight and you will not be allowed to lift your arms up. Therefore, someone will have to bring you food, help reach for an item from an upper shelf, and even help you comb your hair. You will be able to shower only after 24 hours and will be advised to avoid still water (baths, pools, etc.) for about two weeks after. Humidity is the enemy of fresh wounds, so it should be avoided. You will have to wear a gauze dressing a few days after the surgery depending on your surgeon’s advice, and you will also have to wear a surgical bra. This bra should be worn for as long as your doctor tells you because it will help you with the swelling and also with the positioning of implants. After they tell you it is okay not to wear the surgical bra, you will need to wear a sports bra, and this should probably be for around 4 months or so. This will help your recovery and also prevent any complications from appearing and help the implant settle. Under no circumstances you should wear a wired bra. This will mess with the healing process, so avoid buying new bras until your implants settle, or as they call it, “drop and fluff.” Your surgeon might also recommend some light exercise with your hands to assist in settling the implants and preventing capsular contracture. You need to follow his directions precisely and do not make sudden movements. Massage also helps, and it is recommended by many surgeons mainly to avoid the occurrence of a complication called capsular contracture, which is a thick scar tissue that deforms the implant. If you are a smoker, you have to quit at least for six weeks before and after the surgery. Smoking and nicotine are not recommended in any type of surgery, especially with plastic surgery that implies tissue has been cut and pulled tight as in the case of a tummy tuck, breast augmentation, and facelifts. One of the worst effects of nicotine is the constriction of blood vessels, resulting in reduced blood flow through the arteries. When skin is damaged and by pulling it tight, blood vessels are cut and the circulation will be even more reduced. Oxygen will not reach the wound and it will not heal, or it will take a long time. So, take this as the best opportunity to hit two birds with one stone: quit smoking and get new breasts! Another important thing to consider is that for up to four weeks you will not be allowed to do any strenuous activity, including lifting a child. Do not resume your exercise routine before your doctor tells you to. Even if you put on a pound or two, you will be able to drop them as soon as you are allowed to exercise safely. There are a lot of risks and complications that come with straining your upper muscles and tissues after breast augmentation. Conclusion It is true that implants will not last forever, but you can make them last longer if you take care of yourself. Actively listening to your plastic surgeon’s recommendations will help you have a quick and easy recovery, but it will also help you improve the results of his work. There are operations that fail because of an inexperienced plastic surgeon, but there are cases when the results are not as expected by the patient because they thought the surgeon was only “recommending.” So, do what the doctor says, and you will be all right!