Before and After Combination Breast Augmentation and Breast Lift (Mastopexy) Surgery

Before Your Combination Breast Augmentation and Breast Lift Surgery

Before you undergo a combination of breast augmentation and breast lift surgery, Dr. Pautler will ask you to do the following:

Have a mammogram: If you are 30 or older, Dr. Pautler will send you for a mammogram. A mammogram is a special way to take a digital image of your breasts. Having a mammogram is purely a precaution to make sure that there are no suspicious areas in your breast. If there is a positive finding on the mammogram, Dr. Pautler will consult with you and refer you to a general surgeon before proceeding with breast lift surgery. If you have a very strong family history of breast cancer, Dr. Pautler may send you for a mammogram even if you are younger than 30.
Stop Smoking: Cigarettes contain nicotine, a powerful substance that decreases blood circulation especially in the areas that need it most: your plastic surgery wounds. Smoking after your combination of breast augmentation and breast lift surgery, your plastic surgery wounds heal slowly, infection risk increases, and recovery from combination of breast augmentation and breast lift surgery may be prolonged. You need to stop smoking at least four weeks before and six weeks after your planned combination of breast augmentation and breast lift surgery. In many cases, Dr. Pautler prescribes a smoking cessation medication called Zyban, however, it is not always covered by insurance drug plans. Nicotine-containing chewing gums and patches are as harmful as cigarettes, so do not use them. If you absolutely cannot curb your smoking, Dr. Pautler asks that you be honest about it and let her know because she may need to alter her combination of breast augmentation and breast lift surgical plan for you.
Take Vitamin C: This vitamin helps boost plastic surgery wound healing. It is available over-the-counter and is helpful to take two weeks before and two weeks after combination of breast augmentation and breast lift surgery.
Stop taking aspirin, ibuprofen or other non-steriod, anti-inflammatory medications including herbals and supplements that cause blood-thinning such as Ginko Biloba: These types of medications and supplements can increase your risk of a bleeding complication during and after combination of breast augmentation and breast lift surgery, so avoid them. Aleve, Advil, Motrin, Naprosyn, Bufferin, Anacin, Toradol and Alka Seltzer and similar products are examples of products to avoid before and after combination of breast augmentation and breast lift surgery. Inform Dr. Pautler of all medications and supplements that you take to see what you need to avoid. Tylenol is permitted, as are the pain medications that Dr. Pautler prescribes after combination of breast augmentation and breast lift surgery. Examples of blood thinning medications include Plavix, Lovenox, or Coumadine and their generic alternatives. Inform Dr. Pautler if you are taking this type of medication, as these will need to be stopped as well for combination of breast augmentation and breast lift surgery.
Discontinue birth control pills three weeks before combination of breast augmentation and breast lift surgery if you are a current smoker or if you have a history of blood clots, high blood pressure, or heart disease. Resume the birth control pills three days after combination of breast augmentation and breast lift surgery.
Bring button-down top to wear home from combination of breast augmentation and breast lift surgery: Pullovers are cumbersome and can cause discomfort or damage at your plastic surgery wound sites as you raise your arms to get the top on and off. Wear button-down tops during your recovery from combination of breast augmentation and breast lift surgery because they will be easier to put on and take off without risking injury from your combination of breast augmentation and breast lift surgery.

After Your Combination Breast Augmentation and Breast Lift Surgery

After your combination of breast augmentation and breast lift surgery, there are several items to do and consider for your own health and plastic surgery wound healing. They are:

Refraining from taking aspirin, ibuprofen, other non-steroid anti-inflammatory medications, blood thinners and other herbals and supplements for at least two weeks after your combination of breast augmentation and breast lift surgery.
Diet: No restrictions. You can eat what you like provided you don't have an upset stomach from the anesthesia you received during your combination of breast augmentation and breast lift surgery.
Limit activity: Refrain from any exercise or strenuous activity for the first two to three weeks after combination of breast augmentation and breast lift surgery including: housecleaning, vacuuming, anything with requiring arm movement, and brisk walking. The day after combination of breast augmentation and breast lift surgery, it is permissible to go out or run errands but do not carry any heavy bags. Limit your lifting to no greater than 12 pounds. Do not lift or carry small children. Instead, have someone else put them on your lap and you can hold them. Two weeks after your combination of breast augmentation and breast lift surgery; Dr. Pautler will remove your sutures, assess your level of plastic surgery wound healing and determine whether or not you can increase your activity level. Typically six weeks after combination of breast augmentation and breast lift surgery, restrictions are halted and exercise can be resumed. For less extensive combination of breast augmentation and breast lift surgeries, lifting restrictions should occur before six weeks.
Wear compressive bras: If you go home from combination of breast augmentation and breast lift surgery in a support bra, you should wear it day and night for the first two weeks. If you have a compressive type of sports bra that fastens in the front and is seamless, you can switch after the first two weeks. Bring this bra to your two-week check-up after combination of breast augmentation and breast lift surgery so that Dr. Pautler can verify that its support is adequate. You should continue to wear your bra day and night until Dr. Pautler informs you otherwise (usually after two weeks or so the bra does not need to be worn at night). In general, a compressive bra should be worn for six weeks after the surgery, and thereafter for exercise and other strenuous activity. Going without a bra after six weeks is strongly discouraged. The amount of time you do not wear a bra should be very brief, especially for extensive combination of breast augmentation and breast lift surgeries. If your combination of breast augmentation and breast lift surgery is minimal, compressive bras are not necessary for as long a time. In some cases, especially if you have a large cup size, you should even wear a light compressive bra while you sleep.
Stop smoking: NO SMOKING FOR AT LEAST 6 WEEKS AFTER combination of breast augmentation and breast lift surgery! Dr. Pautler strongly advises that you stop smoking altogether for your overall health as well.
Bathing: It is permissible to shower two to three days after your combination of breast augmentation and breast lift surgery. NO BATHS OR SWIMMING until your wounds are healed and it is approved with Dr. Pautler.
Scar maintenance: You should massage your plastic surgery scars a few times a day with a product such as vitamin E oil, cocoa butter or Mederma applying pressure while massaging the scars. The pressure during the massage is more important than the type of cream product used. Combined with massage, these emollients can help accelerate softening, fading, and maturation of scars from combination breast augmentation and breast lift surgery. Silicone preparations are also available, but costly, and more suitable for patients that have a known tendency to form poor scars. Every individual is unique. Some women heal quickly and some heal slowly. In general, skin type determines the quality of the scar. Despite the most meticulous technique, some individuals heal poorly, while others heal beautifully. Age can also play a factor in healing time after combination breast augmentation and breast lift surgery. The older you are the less red and tender your combination breast augmentation and breast lift scars may appear while younger women may have pink or reddish scars that will be tender for several months and may take up to a year to fade.

Risks with Combination Breast Augmentation and Breast Lift (Mastopexy) Surgery

The following is a description of the possible complications that could occur following a combination breast augmentation and breast lift (mastopexy) surgery:

Numbness of the breasts: There will be some numb areas on your breast, including the nipple. This may or may not be permanent, but sensation can return in most breast areas even up to 2-3 years after the combination of breast augmentation and breast lift surgery.
Asymmetry of the breasts: Some asymmetries may appear as the breasts settle. With time, evening-out of the breasts can occur. If not, a touch-up or additional plastic surgery may be necessary if the asymmetry does not correct itself.
Scars on the breasts: These may be quite pink initially. With time, massage, and use of emollients, they should improve and fade considerably. See Scar maintenance in the After combination of breast augmentation and breast lift surgery directions.
Tissue loss: Rarely, due to some compromise of circulation to the breast tissue (such as smoking, diabetes, or steroid use), there can be some tissue loss from combination of breast augmentation and breast lift surgery. Even more rarely could this combination of breast augmentation and breast lift surgery complication involve the nipple or areola. Some of the dead skin or tissue may need to be removed in the office and with plastic surgery wound care, healing should proceed quickly. The shape and appearance of the breast is usually not affected, but the combination of breast augmentation and breast lift surgery scar in one area of the breast may be a little wider or pinker.
Dog-ears: Little cones of excess skin can form at the end of the combination of breast augmentation and breast lift surgery scar that goes under the breast. These cones usually show up after the settling and healing of the breasts is concluded. If bothersome to the combination of breast augmentation and breast lift surgery patient, they can be removed in the office.
Delayed plastic surgery wound healing: In some cases, plastic surgery healing from combination of breast augmentation and breast lift surgery takes longer than two weeks and usually involves the upside down 'T' part of the combination of breast augmentation and breast lift surgery scar under the breast. This combination of breast augmentation and breast lift surgery complication can occur in the shape of a small triangle under the breast with a tight lift (which is very desirable) and some swelling of the skin, causing some separation of the combination of breast augmentation and breast lift surgery incision. The area can seep and even bleed a small amount. This combination of breast augmentation and breast lift surgery complication is very common and should not affect the overall result of breast appearance. This combination of breast augmentation and breast lift surgery complication simply requires dressings and ointment applied for a few weeks. If the area of delayed plastic surgery wound healing is very large, Dr. Pautler may perform a combination of breast augmentation and breast lift surgery scar revision anywhere from 6-12 months after plastic surgery healing.
Changes on mammogram: With some combination of breast augmentation and breast lift surgeries, the breast tissue may get rearranged internally causing scar tissue to appear on a mammogram that was not there before the combination of breast augmentation and breast lift surgery. When you go for your first mammogram after your combination of breast augmentation and breast lift surgery (usually 6-12 months after combination of breast augmentation and breast lift surgery) tell your radiologist about the combination of breast augmentation and breast lift surgery. This new mammogram will now serve as your new baseline for comparison against all subsequent mammograms.
Hematoma or seroma within the breasts: Rarely does a collection of blood or body fluid become large enough to necessitate aspiration or removal with plastic surgery. If so, it needs to be done to prevent infection or plastic surgery wound healing problems. Small collections of blood or body fluid are normal but watched carefully until they absorb on their own.
Bottoming out of the breasts: If this combination of breast augmentation and breast lift surgery complication occurs, it does so months after the combination of breast augmentation and breast lift surgery, and the nipple and areola may appear higher on the breast mound. This combination of breast augmentation and breast lift surgery complication can happen in individuals who have very stretchy skin or heavy breast tissue. If necessary, the breast appearance can be corrected by removing a wedge of skin under the breast through plastic surgery techniques.
Shape change of the breasts: The breasts will be quite snug after combination of breast augmentation and breast lift surgery and need to be supported to maintain shape. However, gravity cannot be eliminated, and despite best efforts to compress with bras and tape, the skin may stretch with time. Usually a flatter, upper-portion of the breast appears. For combination of breast augmentation and breast lift surgery patients who have very stretchy skin, Dr. Pautler may perform the combination of breast augmentation and breast lift surgery in such a manner to account for eventual shape change of the breasts. Consequently, the breasts may initially have an unusually full, upper-portion of the breast after combination of breast augmentation and breast lift surgery. By anticipating the settling and stretching of skin during combination of breast augmentation and breast lift surgery, the fullness dissipates and the desired breast shape eventually evolves.
Breasts feel slightly harder, uncomfortable or are sitting slightly higher; it may be a capsular contracture: This is the rare case of a tightening of the natural capsule that your body forms around the breast implant. The capsule may need to be loosened or removed to provide a more pliable pocket where the breast implant can be positioned. The capsule where the breast implant was placed can shrink or contract and become thicker and tougher causing the breast implant to feel firmer. This can happen soon after combination of breast augmentation and breast lift surgery or years later, in one or both breasts. What causes this combination of breast augmentation and breast lift surgery complication to occur is unclear, but some sources believe that a very low grade infection or blood around the implant could contribute. This combination of breast augmentation and breast lift surgery complication is not a health risk and minor cases usually do not need further treatment, but if severe, a procedure called a capsulotomy may need to be done. This plastic surgery procedure opens up the capsule to loosen it, so the breast implant feels soft again. The risk of capsular contracture from combination of breast augmentation and breast lift surgery cannot be eliminated, but Dr. Pautler minimizes the risk during surgery and with early massage of the breast implant.
Infection: Highly unusual, but possible. An infection from your combination of breast augmentation and breast lift surgery requires treatment with oral, or possibly intravenous, antibiotics. Mild infections will resolve quickly. A more serious infection may require removal of the breast implant, and delay replacement of the breast implant for 6-8 weeks. Warning signs of a possible infection are warmth, redness of the breast, more pain on one side than the other, and non-healing of the incision made during combination of breast augmentation and breast lift surgery. If you are contemplating any dental work before or after your combination of breast augmentation and breast lift surgery, please discuss with Dr. Pautler, as this could possibly increase your risk for infection from combination of breast augmentation and breast lift surgery.
Wrinkling or ripples appear on the breasts: The breast implants can be visible with patients who are extremely thin, even if the breast implant is placed under the muscle. Typically, you can only see the breast implant in certain positions). Although not visible in clothing, breast implant rippling or wrinkling can be bothersome. Possible solutions include placing additional fluid in the breast implant (rendering it a little harder in feel), replacing the breast implant to a different shape or type of breast implant, or breast implant removal. This risk tends to occur in extremely thin women who desire dramatic breast augmentation.
Breast implant palpability (ability to feel the breast implant): It is normal to feel the breast implant at the bottom of the breast and all patients experience this sensation to some degree.
Breast implant rupture. A breast implant can develop a leak or rupture. With silicone breast implants, it is recommended to monitor possible breast implant ruptures through an MRI starting 3 years after receiving your breast implants. With saline breast implants, it is obvious that a breast implant has ruptured. In either case, further plastic surgery to replace the breast implant is required.
Breast implant distortion: When the breast implant is placed under the pectoral muscle, flexion of this muscle can temporarily change the shape or flatten a breast implant but resumes its normal breast shape when the muscle relaxes. This is a normal condition of breast implant placement underneath the pectoral muscle and is not harmful.
Breast implant displacement: A more common risk with shaped breast implants, but can also occur with round breast implants. This combination breast augmentation and breast lift surgery complication refers to dislocation of the breast implant from a variety of factors including: trauma, lifting arms over the head too early after surgery, or breast implant pocket stretching from a seroma or hematoma, described previously. If the breast implant displacement appears unappealing or causes a very obvious asymmetry, additional plastic surgery may be needed to reposition the breast implant.
Loss of cleavage: Extremely rare, this combination of breast augmentation and breast lift surgery complication occurs when the breast implant pockets come in contact and the skin and muscle on the breastbone is lifted. This combination of breast augmentation and breast lift surgery complication is correctable with a plastic surgery procedure, but may necessitate temporary removal of breast implants or placement of post-operatively adjustable breast implants to allow the breast tissues to re-adhere to the breastbone. The risk is slightly higher for this combination of breast augmentation and breast lift surgery complication when large breast implants are placed on a relatively small chest or when breast implants in the breast tissue are removed and replaced under the muscle during the same plastic surgery procedure.

View our Glossary of Breast Surgery key terms Here.

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