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Women over 50 or women with a strong family history of breast cancer should have a breast cancer screen prior to cosmetic surgery.
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Breast implants come in different volumes and projections (=profiles), can be round or teardrop–shaped (=anatomical / contoured), have a rough (=textured) or smooth surface and can be placed under the muscle (=dual plane) or over the muscle (=subglandular). Teardrop shaped implants look more natural but can rotate. Rough implants last longer (=less capsular contracture) but have a small cancer risk (BIA–ALCL). Implants under the muscle last longer (=less capsular contracture) and look more natural but surgery takes longer and causes more bruising.
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A breast lift (=mastopexy) removes skin, reshapes the breast and lifts the nipple area. The improvement is mainly in the central and lower breast areas. The implant gives fullness to the upper breast.
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I don’t use drains routinely. The wounds are repaired with sutures under the skin which don’t require removal and dissolve within four months. A support garment following surgery is recommended.
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Scars
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Anchor shaped: Around & below areola & in breast fold
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Operation time
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3 hours
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Anaesthesia
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General
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Hospital Stay
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Day Surgery > (Overnight)
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Benefits
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Cosmetic, Psychological, Functional, Symptomatic
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Risks
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Bleeding, Infection, Scar problems (stretched, thick, abnormal pigmentation, red, retracted etc.), Skin cones, Skin penetration, Wound separation, Slough, Necrosis (Nipple / skin / fat), Pain, Nerve injury (Numbness, weakness), Bruising, Swelling, Overcorrection, Undercorrection, Asymmetry, Remaining stretch marks, Recurrent redundancy / droopiness, Cosmetic imperfections (higher risk after subsequent pregnancies / weight changes / menopause), Seroma, Shoulder problems, Pneumothorax, Inability to breastfeed, Capsular contracture, Implant rupture or leak, silicone granuloma, lymphadenitis / displacement / rotation / extrusion, Anaplastic Large Cell Lymphoma, Rippling, Contour irregularities, Unfavourable nipple shape / position, Need for further surgery (including implant removal), Allergic reaction, Chest infection, Heart attack, Stroke, Blood clots in legs & lungs
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N.B. Most complications are unlikely and serious risks are rare
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Risk factors
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Smoking / contraception / flights within 6 weeks of surgery, overweight, high blood pressure, bleeding tendency, diabetes
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Optimising factors
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Diet rich in Vitamin C and protein, plenty of fluids, fresh air, scar massage, sun protection, support garments, breast band and massage (only if advised by me)
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Discomfort
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1 – 2 weeks
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Bruising
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2 – 3 weeks
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Recovery
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Light activities 2 weeks, Driving 3 weeks, Physical work / sports / sex 6 weeks, Unrestricted 3 months
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Acceptable appearance
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2 – 4 weeks for most patients (This is subjective)
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Final result
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6 – 18 months
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Alternatives
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No Surgery, Garments, Bra Enhancers, Implant Removal and mastopexy, Fat transfer instead of implant replacement, Implant exchange or removal without mastopexy
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