1. How are the breast implants put in?

Implants are placed through an incision in the skin. The incision sites that I use are either around the areola or on the inferior portion of the breast. Other surgeons sometimes use other incision sites (axilla or belly button), but I do not feel that these are appropriate when weighing the benefits and risks. The implants are then placed either under the chest wall muscle (my preference) or between the muscle and the breast


2. What is a"drain" and when is one used?

A drain is a device which is placed at the time of surgery to assist in removing any blood or other fluid which might accumulate in the operative area. I almost always use a drain when performing a tummy tuck or breast reduction, but I rarely if ever place a drain when performing an augmentation mammaplasty. A drain is always a "2-way street". It provides a means of introducing infection also and I do not find drains beneficial for most augmentations.


3. What about doing other operations at the same time?

It does increase the risk somewhat by performing multiple procedures. This is related to the period of time under anesthesia. I do feel that it is safe to perform a tummy tuck or liposuction at the time of an augmentation if the total operative time can be kept at a reasonable period of time. There are some economic benefits to performing two surgeries together (I usually will discount a second surgery and the facility where I perform most surgeries will also).


4. Why must I have an adult stay with me the first night?

It is a good idea to have someone spend the night with you on the night of surgery since patients sometimes require several hours to recover from anesthesia. It is also beneficial to have someone assist you with basic care for the first several hours post-operatively.


5. What measures can be taken to prevent capsular contracture?

I personally do not see capsular contracture nearly as often as I did several years ago. The main reason for this is the fact that I now generally place implants below the chest wall muscle. The normal use of this muscle during normal daily activities provides a continuous massage of the implant. Changes in the manufacturing process of the implants is also probably a factor. I do not have patients perform any particular exercises or massages to prevent capsular contracture at this time.


6. What is the "Band" or "Strap" that everyone talks about wearing after operation?

I have patients wear a band or strap across the upper breast area for several days post-operatively. There is a tendency for the implants to "ride up" to an abnormally high position on the chest (especially if the implants are placed beneath the muscle). This band or strap discourages rising of the implants and also assists in their descent to a more satisfactory location.


7. What is meant by the Rapid Recovery method? How much swelling is there after operation?

I have never heard of a Rapid Recovery method in breast augmentation. The period of recovery as well as the degree of swelling varies widely among different patients. Some women are able to return to work after 3-5 days whereas others may require 3-4 weeks. This is related to both job descriptions as well as different pain thresholds. I rarely see really significant swelling after a breast augmentation, although some modest swelling usually will be seen.