Some of the most common questions I get from my patients after breast augmentation have to do instructions after breast augmentation. Most of my patients are feeling pretty good by the 3rd or 4th day and they want to get back into the gym or resuming normal activities.
I always caution my patients that even though they are feeling great – they still need to be very careful and take it easy while they are healing. It’s fine for patients to return to work and drive after about a week if they are off all pain medication as long as they don’t have to use their arm muscles in their job or to drive their vehicle. When driving, especially with patients with SUV’s I tell them to be careful when getting in and out of the vehicle and not to use their arms to pull themselves in or out.
I have my patients try to use their arms as little as possible for the first 2 weeks. I tell them to pretend that their elbows are glued to their sides and to try not to raise their arms out to the side. I remind them when getting out of bed or a chair not to push off with their arms, to use their stomach muscles or have someone help someone support their back. This is to prevent the implant from migrating, or excessive movement that may cause some internal oozing or bleeding. They also shouldn’t do anything that will raise their blood pressure because this can cause oozing too. Definitely no smoking after surgery while the body is healing and also refrain from alcohol for about 2 weeks. The best thing is to take it easy after surgery and relax! Eat healthy foods that are high in natural vitamins and protein that are the building blocks for your body to heal.
After 2 weeks, patients can resume most normal activities even light cardio at the gym. It’s ok to take vitamins, herbals, and any other medications that were held before surgery. At a month, I lift almost all restrictions including carrying things. I wait until 6 weeks after surgery for patients to do exercises that really use the pectoralis muscles.
Although it’s easy to get impatient – post op care is critical to minimize complications and insure preservation of your beautiful results!
Dr. Catherine Begovic
Posted in: Breast Augmentation, Breast Lift, Fitness & Health, Labiaplasty, Liposuction, Mommy Makeover, Plastic surgery and Pregnancy, Tummy Tuck, Vaginal Plastic Surgery | November 22, 2013 | Comments Off
As a new mom myself, I know how challenging it can be to get back to your pre-pregnancy body. Even if you’ve managed to lose all the baby weight, there are still some things that you may need some help with. Gaining weight and then losing it really changes things. You are not alone! Here are some of the common procedures that moms get to help them do something nice for themselves for once!
Breast augmentation can help restore volume and fix the deflation that occurs after pregnancy and nursing.
Breast lift will bring your nipples back up to where they once were as well as create a more youthful shape.
Tummy tuck will remove excess skin, tighten your stomach muscles and remove any stretch marks that are below your belly button.
Liposuction can help remove those stubborn pockets of fat and help create a more feminine shape [Liposuction picture]
Labiaplasty will help shape your labia which after pregnancy can cause discomfort or create a visible bulge in tight pants or leggings.
I always tell my patients that diet and exercise are always essential to being healthy after pregnancy (even though we all know it’s hard to find time for this!) However, with these mommy makeover procedures can definitely help new moms kick-start themselves back into shape.
Dr. Catherine Begovic
Fat is an extremely versatile filler. It is easy to harvest through liposuction and it material that comes from your own body. Thoughsome of it is absorbed by your body, whatever becomes incorporated is permanent and is living tissue, just transplanted to a new part of the body.
I use it in almost all my facelifts to fill in hollows of the cheeks and to plump up the cheekbones since aging is not only a result of gravity, but also fat loss. Fat contains stem cells, and though it hasn’t been scientifically proven – anecdotally, many of my patients see restorative effects on the skin.
I also use fat in large volumes for Brazillian Butt Lift. This enhances the shape of the buttocks and provides more volume and creating a lift. I also use fat grafts to fix dents and irregularities on poorly done liposuction – almost 20% of my practice is repairing liposuction on patients who come to me after having liposuction done elsewhere.
Fat is also used for natural breast augmentation. It creates a natural look and can help patients who don’t want implants to achieve about a cup size increase.
One of the places you might not expect fat to be placed is the hands. Fat transfer to the hands helps fill out the hollowing that occurs with age and smoothes out the appearance of veins. Patients feel it improves the appearance of the skin.
Fat grafting takes a high degree of technical skill to ensure that the grafts take and to minimize complications. Each micro-droplet of fat must be placed in a different layer of tissue and in even, small amounts to survive and get it’s own blood supply. Improper placement can result in fat necrosis or poor take. However, when properly done and shaped, fat can be used in many different places in the body to create lasting effects.
Dr. Cat Begovic
In 2009 the FDA approved the Keller Funnel – a sterile funnel (looks like a pastry funnel) used to insert silicone breasts implants in a“no-touch” technique. I use a Keller Funnel for all my breast augmentation surgeries. The implant goes from it’s sterile container, into the sterile funnel, straight into the pocket without contacting skin or any other surgical instruments. Studies have shown that there is at least half the amount of bacterial contamination from breast tissue when using the funnel.
The reason why this is important is because capsular contracture – scar tissue formation around breast implants is one of the most problematic complications of breast augmentation surgery and it occurs in 10-15% of all women usually resulting in reoperation. Capsular contracture has been in part attributed to a biofilm of bacteria formed around the implant. Therefore minimizing bacterial contamination should help prevent capsular contracture.
Also use of Adam’s solution – a triple antibiotic solution of cefazolin, gentamamicin and bacitracin – has been shown to decrease capsular down to 1.8 % in study groups.2 I use Adam’s solution to clean out the breast pocket, clean all surgical instruments involved in implant placement, clean the breast skin, soak the implant, and also fill the Keller funnel with it. I use it everywhere I can.
It has also been shown that exposed nipples are sources of implant bacterial contamination during breast augmentation.3 The terminal ducts at the nipple and areola are colonized with bacteria. Therefore, I cover the nipples with a Tegederm nipple shield during the surgery to decrease the chance of bacteria from the nipple spilling into the surgery site.
I also make sure the breast pocket is completely free of any blood and minimize any instruments used and don’t put gauze or lap pads into the pocket during surgery even though there haven’t been any good clinical studies to prove that these steps help. I may be excessive and obsessive about all these little things, but as a woman with implants myself – my greatest fear is capsular contracture, which can occur even years after the surgery – so I try to do everything possible to try to prevent it’s occurrence.
- Dr. Catherine Begovic
1. Moyer HR, Ghazi B, Saunders N et al., Contamination in smooth gel breast implant placement: testing a funnel versus digital insertion technique in a cadavar model. Aesthet Surg J. 2012 Feb;32(2):194-9.
2. Adams W, Rios J, Smith S et al. Enhancing Patient Outcomes in Aesthetic and Reconstructive Breast Surgery using Triple Antibiotic Breast Irrigation: Six-Year Prospective Clinical Study. Plast Reconstr Surg. 2006;118(7 Suppl):45S-52S.
3. Wixtrom R, Stutman RL, Burke RM et al., Risk of Breast Implant Bacterial Contamination from Endogenous Breast Flora, Prevention With Nipple Shields, and Implications for Biofil Formation. Aesthetic Surg J. 2012: Sept 10 [epub ahead of print]
I recently spoke with a friend who is a newborn ICU nurse who asked me whether or not woman were able to breast feed after breast augmentation surgery. She told me that the nurses in her hospital were not encouraging post breast augmentation patients to breastfeed because they thought they weren’t able to. In a study performed by Mentor as part of their FDA post-approval study, only 8% of women who had breast implants had trouble breast feeding. Although I always tell my patients there is a possibility their breast augmentation surgery can impair their ability to breast feed, most women are able to breast feed after their surgery (including myself!), so they should definitely be encouraged to try.
Another study presented at the American Society of Plastic Surgeons annual conference found that many women who had breast augmentation surgery were concerned that breast feeding may alter the appearance of their breasts and this contributed to their trouble with and reluctance to breastfeed. However, although breasts generally sag with each pregnancy, there is no evidence that breastfeeding worsens these effects in women whether or not they have implants.
Also, for women with silicone implants, there is a concern whether the silicone passes orally to their child in breast milk. Multiple studies have shown that the amount of silicone in breast milk from women with silicone implants is not statistically significantly higher than breast milk from women without implants. In fact, the levels of silicone found in grocery store cow’s milk (709 ng/ml) and infant formulas (4402ng/ml) was significantly higher than breast milk even from women with implants (55ng/ml)!
Dr. Catherine Begovic