Questions & Answers
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What medications do I need to stop taking prior to surgery?
We ask that you stop aspirin or ibuprofen 2 weeks prior to surgery. Both cause the blood to thin and may promote bruising/bleeding. We also ask that you stop any herbal or diet supplements 1 month before surgery for the same reason. You may continue vitamins with the exception of fish oil or extra vitamin E above what is in a multivitamin. Please ask questions about medication you are taking to be sure you need to continue it or when to resume taking it after surgery.
How often do I use ice/cold after surgery and when do I start?
We ask that you start using ice/cold as soon as you are home and resting. 30 minutes on/30minutes off is the suggested use to help with swelling and pain. This is most beneficial the first week after surgery.
How long does the swelling last?
Swelling typically increases the first 4-5 days after breast implant surgery and then starts to decrease over the next 6-8 weeks. It may take another 2-3 months for all the swelling to dissipate.
When can I get the incisions wet?
You may shower the day after surgery. We ask that you refrain from soaking incisions under water of any kind (beach, lake, sauna, hot tub, bathtub, etc.) for at least 2 weeks. This allows the incision to be truly waterproof and healed before soaking.
When can I return to normal activities including driving?
Most patients take their pain medication for the first 3-4 days after surgery and therefore are unable to drive (you are still considered under the influence if taking narcotics). After 3-4 days most patients are taking over the counter medications to help with any pain or discomfort. At this time, you may drive and perform light household duties. We ask that you refrain from doing anything that uses your arms alot (vacuuming, raking, mowing, etc.) for at least 2-3 weeks to allow the scar tissue to form with no issues.
When can I return to my regular exercise routine?
We ask that you refrain from upper body exercise and running for the first 2-3 weeks. You may start walking as soon as you feel up to it. When you do return to running or anything that might make the breasts move up or down (Zumba, aerobics, horseback riding, etc.), Dr. Nein suggests wearing a good sports bra that holds you in place.
How long should I take off work?
This is different for each patient. If you have a desk job or a job that doesn’t have alot of physical activity, 4-5 days may be ample time off. If you have a physical job or one that requires alot of lifting, 10-14 days may be required. Everyone has a different pain tolerance level and recovery time frame.
Are there any stitches to be removed after surgery?
No, there are sutures on the inside that are absorbable and a surgical glue is applied to the skin to seal the incision.
What medications do you prescribe for breast augmentation?
Typically, Dr. Nein prescribes an antibiotic, a mild muscle relaxer, an anti-inflammatory medication and a pain medication. You will be taking over the counter pain medication as well. Most patients do well with these medications and some don’t need the narcotic pain medication at all.
Do I need to have a mammogram prior to the surgery?
Dr. Nein does not require a mammogram prior to surgery. However, if it is time for you to have one, he recommends getting it done before the surgery. Otherwise, he will recommend waiting at least 6 months after surgery to allow for healing and scar tissue formation to be complete.
Do I need to purchase any bras prior to surgery? Will I need to wear a sports bra, underwire, or no bra after surgery?
Dr. Nein does not recommend buying bras prior to surgery. It is not required to wear a bra the first few days after surgery. This will allow the breasts to settle in a natural position. If you feel uncomfortable without a bra, you may wear a sports bra or any bra that does not lift the breast/implant.
How long do breast implants last?
While they should last your lifetime, breast implants are manmade devices which do not typically last that long. There is no scheduled replacement for breast implants. They should be replaced if you notice a deflation or rupture.
Do my implants have a warranty?
Dr. Nein uses breast implants from the 3 largest manufacturers (Allergan, Mentor and Sientra). They all have lifetime warranties of the implants meaning they will provide a replacement implant if you have a deflation or rupture. They also provide financial assistance (up to $3500) if you have a deflation or rupture during the first 10 years after implantation.
Does smoking affect the healing process? Do I need to quit before surgery, and if so, how long should I be smoke-free before the surgery?
Overall it is to your health advantage not to smoke. Smoking does have a negative impact on the healing process. When smoking, you inhale carbon monoxide and nicotine. Both of these decrease the amount of oxygen delivered to the cells which has an impact on wound healing. Fortunately, for breast augmentation the impact is not severe enough that it is absolutely necessary to quit prior to surgery. If other procedures are involved, it may become important to cease smoking prior to surgery.
Will my breasts feel natural to me, as well as my significant other?
Modern implants are quite good in terms of reliability and feel. Modern cohesive gel silicone implants feel extremely similar to natural breast tissue and offer the most realistic result. Saline filled implants are also quite good but it is somewhat easier to identify the implant within the breast.
Will I be able to breast feed, and does the nipple/areola incision decrease my chances of breast feeding?
The ability to breast feed should be unaffected by the presence of breast implants. The implants are positioned behind the breast tissue and should not affect milk production. The use of the nipple/areola incision should also have minimal impact on breast feeding. Relatively few milk ducts are injured during the surgery.
Will my implants lose their shape and/or sag, after a long period of time?
Breast implants do not lose their shape over time and the implants do not sag. However, the breasts can change over time and if the implants are large and/or heavy they can cause the breast tissue to stretch and allow the implants to drop. The extent to which this happens will be different for each individual depending upon implant size and weight and the natural ability of breast tissue to support the weight of the implant.
Is there anything I can do to help my incision heal better?
These incisions tend to heal quite well with routine wound care if you carefully follow the directions given to you. Early on the incisions are typically covered by a special skin glue. This protects the incisions from bacteria and water. This glue typically comes off after about 10 days. Thereafter the application of silicone gel strips or ointment can improve the quality of the scar. Although nothing will erase the scar, silicone treatments have shown substantial improvements in scar appearance. Under no circumstances allow the scar to be exposed to UV radiation either from the sun or a tanning booth. UV radiation will worsen scar appearance.
Will I lose sensitivity in my breasts/nipples? What are the odds of this being permanent?
Any surgical procedure of the breast runs the risk of decreasing or losing nipple sensation. It is common early post-operatively to have altered nipple sensation; although most commonly we have observed extra sensitivity for a couple of weeks. Thereafter the sensation typically returns to normal. In cases of decreased or loss of nipple sensation this too typically returns to normal after a few weeks; rarely it can take a few months. We have observed very few cases of permanent loss of nipple sensation from a breast augmentation. However, the published risk for loss of nipple sensation is about 10%.
What type of implant do you recommend saline or silicone?
Currently manufactured saline and silicone implants are high quality devices with excellent durability and realism. It is my opinion that the current cohesive gel implants are softer and more natural in feel and appearance than the corresponding saline implants. However, beautiful results can be obtained with either implant.
What are the possible risks of breast implant surgery?
Any surgical procedure carries some risks and it is important to be aware of the potential risks. Fortunately, breast augmentation has a very low complication rate with the majority of women being extremely happy with their results. Major risks associated with breast augmentation include implant leakage, capsular contracture (tightening of scar tissue around the implant), loss of nipple sensation, bleeding and infection.
Are there possible breast implant complications that I should be aware of?
The implants themselves are not considered lifetime devices. Like all mechanical devices they can be anticipated to fail (leak) at some point. Although ideally the implants would last your entire lifetime, it is likely that they will need to be replaced at some time due to leakage. It is not necessary to replace them on a routine basis. They only need to be replaced if there is a problem. On the positive side, all the implants used by Dr Nein have a lifetime warranty from the manufacturer. Should the implant ever leak, the manufacturer will provide a replacement implant at no charge. Further, if the implant leaks in the first decade, the manufacturer will also assist in the surgical cost of replacing the implant.
Will I have general anesthesia and will a certified anesthesiologist administer it?
We prefer to perform this operation under general anesthesia. It’s easiest for the patient and allows us to complete the operation precisely, smoothly and safely. A board certified anesthesiologist will administer the initial portion of the anesthesia and the end. During the procedure, a certified registered nurse anesthetist will provide the minute to minute care although he/she is under the direction of the anesthesiologist who is always available for any questions or concerns. This system is used extensively throughout Nashville and most major hospitals and surgery centers.
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