If you are thinking about having breast augmentation surgery there are some things to consider. It is important to take steps to be an educated consumer in order to take steps toward a successful procedure.
When you come in to have surgery with Dr. Kim he will ask that you:
- Stop smoking (including ecigarettes)
According to the American College of Surgeons quitting smoking will reduce the risk of surgery-related complications, such as an infection at the surgical site. There is also a significant risk of having an anesthesia related complication. According to Dr. El-Hayek in an interview with the Cleveland Clinic, smokers have a much more difficult time breathing while under anesthesia and may require further use of medications. Furthermore smoker’s have a higher level of carbon monoxide, which lowers the body’s levels of oxygen which inhibits a wound’s ability to heal; in addition smokers have a higher level of toxins in the blood that can permeate the healing tissue further reducing the wound’s ability to heal.
- Disclose your full medical history
It is important to share a full medical history with your doctor including: lifestyle habits, past and current medical conditions, medications and supplements, previous surgeries, as well as any family history. The anesthesiologist and surgeon need this information in order to ensure that they will be able to provide the best level of care; ensuring that medications won’t interact with the anesthesia, information about how your body reacted to previous medications and anesthesia, as well as an awareness of your family history that may be relevant to surgery. Furthermore it is important to share your use of alcohol, tobacco, and any recreational drug use. This information is used to try and minimize complications; tobacco and some recreational substances can have deleterious interactions with anesthesia so it is crucial to share this information.
- Choose what implant you will use
Patients undergoing breast augmentation may be worried that the results won’t look natural or that the size won’t be what they had hoped for. However, these fears are quashed when patients are able to visualize the results using 3D Vectra camera technology [Galdano]. 3D technology allows the surgeon and the patient to have a visual agreement of the surgical goals. Dr. Kim will also help you decide whether to choose round or anatomic (shaped) implants. In 2012 anatomic implants were approved by the FDA and there has been significant research performed to determine their safety and efficacy. In a multi-institutional analysis of mastectomy reconstruction outcomes between round and shaped outcomes it was found that shaped implants were more likely to have a complication, although they were less likely to undergo a revision procedure [Khavanin].
- Discuss options for implant placement during surgery
There are two positions where the implant can be placed that can accommodate your unique anatomy, lifestyle, cosmetic preferences, and implant type. Implants can be placed over the pectoralis muscle (prepectoral) or beneath the muscle (subpectoral). Prepectoral placement has some cosmetic issues that may require reoperation, but it avoids other undesirable outcomes. The prepectoral position of the implant can prevent issues such as breast implant animation defect, movement of the breast resulting from arm movement due to the contraction of the pectoralis muscle [Madsen]. Subpectoral placement is recommended for very thin bodies, because the muscle will better conceal the edges or rippling of the implant [Madsen]. Deeper implant placement can help to camouflage any implant deformities as well as preventing bottoming out [Madsen].
Galdino, G. M., Nahabedian, M., Chiaramonte, M., Geng, J. Z., Klatsky, S., & Manson, P. (2002). Clinical applications of three-dimensional photography in breast surgery. Plastic and Reconstructive Surgery, 110(1), 58-70.
Madsen Jr RJ, Chim J, Ang B, Fisher O, Hansen J. Variance in the origin of the pectoralis major muscle: implications for implant-based breast reconstruction. Ann Plast Surg 2013 Sep 18.
Khavanin, N. Shaped versus Round Implants in Breast Reconstruction: A Multi-Institutional Comparison of Surgical and Patient Reported Outcomes.