Questions & Answers
There are several aspects of healing that can be compromised by exercise. 1. In the first 10 days after surgery, there is a risk of pulling open a blood vessel and getting bleeding into the wound. For this reason, we encourage limited exertion and movement in the surgical area after any surgery. 2. The first three weeks after surgery are critical to the skin/fat layer reattaching to the fascia/muscle layer. If the two layers don’t reconnect, there can be a permanent space that will fill with fluid (Seroma). We recommend use of an abdominal binder as a splint to remind our patients to avoid movement across the abdomen for the…
There are many reasons that patients travel to seek out surgery- lower expense, greater expertise, and privacy are common and legitimate advantages often stated by patients. These advantages must be balanced against the potential disadvantages of travelling for surgery. Travel carries the risk of deep vein thrombosis (clots forming in legs a.k.a DVT) and embolism to the lungs (PE). There is increased risk of DVT/PE with surgery in general, and this is multiplied if you are stuck stationary in a plane or car for hours. Your surgeon should give you advice on precautions to take on both your trip to and from surgery to minimize this risk. Travel can…
It is not unusual for patients to present to our practice with problems for which cosmetic surgery is an ideal solution, but they hesitate to proceed with a procedure for fear of the tiny risk of a bad outcome. Everyone has a different way of approaching risk, but it is vital that you consider the risk of inaction, and not just the risk of action. The risk of inaction? Let’s say it’s a face lift you are considering. Without the face lift, you are judged (unfairly) to be too tired for that promotion at work, your appearance and diminished feelings of attractiveness interfere with your personal relationships, and you become depressed by the…
Loose eyelid skin can compromise your vision, cause headaches, and make you look older than your years. Blepharoplasty (aka eyelid lift) may eliminate your need to raise your brows to keep your lids open. This helps to minimize forehead creases, and eliminate headaches arising from constant contraction of your forehead muscles. At your consultation, a careful analysis of your forehead function, globe shape and position, eyelid mechanics, and many other factors allow us to make effective recommendations and develop a treatment plan that is right for you.
Our careful analysis of this patient led us to offer a closed technique to reduce the dorsal hump of cartilage and bone, and to use a separate technique (modified Weir excision) to create a more narrow appearance to the nasal base with better nasal tip projection. Not every nose needs to be ‘fixed’, but in this case our patient’s facial appearance was compromised by the extremes of her nasal shape, and she had much to gain from rhinoplasty.
Rhinoplasty (nose reshaping surgery) is one of the most powerful techniques we have for improving your appearance. We use the ‘open tip’ technique when the nasal tip requires multiple maneuvers to achieve the best result. Healing takes a little longer, but by 10 days most patients have little if any bruising and beautiful results can be had by two to three weeks. No nasal fracture was required for this patient. Our key to good results is a careful analysis of the cosmetic problem, and then choosing the techniques that can reliably achieve the appropriate correction.
How long does facelift last?
A facelift can turn back the clock, however it does not stop the clock. You will continue to age, but will always appear younger than you would have had you not had a facelift. For this reason, a facelift might be repeated every 10 years, give or take.
Why do breast implants have to be replaced?
A saline implant is obvious when it requires replacement, as any leak will result in the breast losing volume. Silicone gel implants (the only silicone-filled implants available since 1999) are not obvious when the shell tears, as the silicone gel remains within the fibrous pocket (capsule) made by your body and volume is preserved. About 20 % of gel implants are found to have a hole at 5 years, MRI over-diagnoses implant holes about 20% of the time (false-positive), and the presence of a torn implant causes no medical problems in the vast majority of patients. Implant manufacturers will pay for a replacement implant if a tear is found (or suspected on MRI). Our advice is to be grateful if your implants are causing you no problems, and leave them alone. If you have hardening, swelling, or mass appearing in an implanted breast, or an illness that defies all explanation, see your plastic surgeon to discuss whether implant replacement is a good idea for you.
Why do breast implants hurt?
The miracle of surgery is that tissues (including nerves) can be cut/burned/stretched, and that generally any pain experienced after the surgery is gone within a few weeks. Breast implants that develop capsular contracture (a hard wall of fibrous tissue and sometimes calcium) can cause pain because the presence of this hard mass puts pressure on the surrounding tissues. By analogy, a stone in your shoe is not the source of the pain, but when it pushes on the surrounding tissues it causes pain. Another cause of pain can be due to damage to a major sensory nerve to the breast. If you have an areola/nipple that stays numb even months after surgery, this suggests your primary nerve to the breast was damaged and it may be a source of pain if/when it ‘wakes up’.
Why do breast implants need to be replaced?
If you experience swelling or a mass or painful hardening in an implanted breast, you should be seen by a plastic surgeon to discuss management of your implant. If an MRI or ultrasound suggests a torn implant, this presents an opportunity for implant replacement in which the manufacturers warranty would cover the implant cost, even if you are just replacing for cosmetic purposes. A torn cohesive gel implant that is not causing any symptoms does not require replacement. Textured implants have caused some concern as 1/3000 patients may develop a cancer termed ALCL, but if this disease is treated (implant removal and capsulectomy) when early signs (swelling or breast mass) appear, it is curable. If you do not have swelling or mass formation, there is no need to have a textured implant removed, and most women have had excellent experience with these implants.
Which breast implants are more expensive?
The structured saline-filled implants are most expensive, followed by silicone gel and then saline-filled implants. The differences in cost are not significant, and the additional effort involved in handling a saline implant (smaller incisions, testing and filling the implant) will generally result in total surgery fees comparable to the use of silicone gel implants. The choice of implant should not be based on the relative cost of the implant ($500-$1000 each).
Which breast implants cause cancer?
Textured implants have been associated with a very rare cancer (anaplastic large cell lymphoma), with ALCL occurring in about 1/3000 patients with textured implants. Whether the implant is causing the cancer is not clear- perhaps the more aggressive healing process around a textured implant is the cause. Whatever the case, use of a textured implant should be considered only if use of a smooth implant will not be successful.