General Facts about Breast Enhancement 
              (Augmentation or Reduction)
      By Dr. Lisa Santos
                                  
     The purpose of aesthetic surgery is to help you look as good as possible. Plastic surgery is a combination of art and science. It is not an exact science. Some of the factors involved in producing the final results (such as the healing process) are not entirely in the control of either the surgeon or the patient; therefore, it is impossible to guarantee results. However, results from breast surgery are more predictable in some patients than in others. This is determined by such factors as size, condition of the breasts, thickness and condition of the skin, heredity, hormonal influences and other factors.

Surgery intended to improve sagging, small or asymmetrical breasts does leave scars. Despite what you may have read or heard, all surgical scars are permanent and cannot be erased. The job of the plastic surgeon is to place scars in the natural lines of the breast where they are least noticeable.

     For Specific Facts on Breast Augmentation see below
          For Specific Facts on Breast Reduction click here

Duration of the Surgical Result
Augmentation of the breasts results in a permanent enlargement. With time and hormonal changes breasts may change in size, but this is a natural event experienced in all breasts. Pregnancy followed by breast feeding will change breast size and shape. The breast prosthesis that we are currently using is a saline filled implant.

Complications
With any type of surgery complications will occur. Those that occur in aesthetic breast surgery are most often minor in nature. The most common complication after breast augmentation surgery is a hematoma.  A hematoma is a collection of blood under the skin. If it occurs, this collection of blood must be removed in the immediate post-operative period. An infection may occur following any kind of surgery. If it occurs following breast augmentation, it may be necessary to remove the prothesis for a period of weeks in order to completely eradicate the infection.

Firmness
Breast firmness is an anticipated result in some patients following augmentation. The incidence of breast firmness varies in the surgical literature from 3 or 4 percent to 40 or more, depending upon the series reported and the criteria for breast firmness. Some patients develop breasts which are firm or hard when touched. If a great deal of firmness develops the breast may actually be painful. While  painful  breasts  following augmentation is rare, it does occur.

The firmness that occurs is not due to a change in the texture of the implant as it is anticipated to remain at its original texture for many decades. When firmness occurs it is due to the fact that the body forms a fibrous capsule contracture around the implant. In other words, the body develops a scar tissue capsule around the prosthesis forcing it to occupy a smaller space than the space created at time of surgery. Since the prosthesis is squeezed into a smaller space (the fibrous scar tissue capsule) the breast feels firm when touched. If firmness does occur a second surgical procedure can be performed to release the scar tissue contracture. However, the odds are probably a 50% chance of developing scar tissue a second time.

At consultation in my office, I will discuss fibrous capsule contracture with you and the most recent developments regarding breast implants and auto-immune disease.

Photographs
Pre-operative medical photographs show your breasts  in every detail. They help me in the evaluation of your breasts as I study them before your surgery. They are mounted in the operating room for reference during the operation. This aids greatly in the surgical performance of technical variations as indicated for a given individual and they remain strictly confidential as a part of your medical record.

A general anesthesia is used for breast augmentation. General anesthesia requires the services of an anesthesiologist who charges a separate fee. The anesthesiologist fee is explained in the preoperative  instructions given to you by my office. The actual surgical time will vary with the amount of surgery necessary for each patient.  Breast augmentation usually requires about 2 hours.

Ambulatory Surgical Facility
If I think it appropriate in your case you may choose to have your surgery performed in the ambulatory surgery facility at the hospital. You will arrive the morning of surgery and remain two to five hours after surgery.  You will be discharged the same day as surgery. This is entirely safe providing you follow instructions and use common sense.

What to Expect
*  A bandage is applied to the breasts after augmentation mammoplasty.  These remain until you are seen in the office.  After suture removal you will be instructed on the use of a bra.
*  Most patients do have some pain and discomfort following breast augmentation surgery.  I will make sure you are taken care of in this regard.
*  Stitch removal begins on the 5th to 14th day following breast augmentation surgery.  Removing stitches is quick and uncomplicated, but you must remain in the Houston area for a minimum of 14 days following surgery until the stitches are removed. Normal activities can be resumed immediately and light exercise (walking) may be resumed after two weeks.

I PERFORM ALL SURGERY on my patients and am assisted by a hospital operating room technician.

The After-Surgery Period
You must remember that before you see the improvement you are expecting you will go through a standard post-operative period in which you will look quite battered and bruised followed by another period of time when you may look "strange" to yourself. This varies with each individual. In some patient's there is a temporary period of slight emotional depression immediately following the surgery while you anxiously await final results. This is quite normal and should not alarm you. Fortunately, this period usually passes rather quickly.

If you have any questions, or if there is anything you do not understand, contact my office prior to your surgery date. We will be happy to talk to you by phone or have you visit the office. We want you to be a well-informed and happy patient.

                                       For a list of What to Take to the Hospital
                                    Call the Doctor's Office: 713-529-9020 or email