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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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The breast implant is removed with the surrounding scar tissue (=capsulectomy) where possible. The surgery is more complex than the original insertion of the implants. An additional breast lift improves the shape where ptosis (=droopiness) following surgery is a concern. Breast lift scars are usually anchor shaped = around and underneath the areola.
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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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A fluid collection after more than a year following implant surgery can be an indicator of BIA-ALCL (Breast Implant Associated – Anaplastic Large Cell Lymphoma) which is a rare cancer associated with rough (=textured) implants. The usual treatment is removal of the implant and a total capsulectomy.
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Scars
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Anchor shaped: Around areola & vertical 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 discoloration, 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, Contour irregularities, Unfavourable nipple shape / position, Need for further surgery, 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
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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, Implant removal without lift
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