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Breast

Without doubt one of the features that mostly gives femininity and sexuality, a symbol of youth and therefore one of the main reasons fo consultation in the years 2013 and 2014 and breast augmentation surgery is the number 1 procedure performed in the United States according to American Society of Plastics Surgeons ahead of nose surgery and liposuction.

The main aesthetic problems of the bust is hypotrophy or low volume, droopy breast or breast ptosis, breast hypertrophy or very large bust that usually is accompanied by ptosis also.

After a specific planning according to the expectations of the patient's anatomy we have available the following procedures.

Breast Augmentation

It is offered for those patients who are dissatisfied either with the shape, volume or symmetry of their bust. To achieve the desired aesthetic appearance we have available silicone gel breast implants.

Presurgical Consult  Procedure               Recovery          Before & After

Presurgical Consult 

To prepare for your surgery and posterior recovery a comprehensive assessment will be made, your complete medical history and physical examination is preferably carried out within 30 days prior to your procedure. This appointment is scheduled in the facilities of Premier Medical Center. Each patient is studied and valuated depending on your medical history, type of surgery.

In this consult everything will be explained, about your surgery, your doubts, the risks and benefits, and a series of instructions will be provided to prepare you for your operation.

In certain cases another consult will be scheduled to review laboratory studies, referrals and to finish explaining questions or assess details.

Please for your presurgical appointment bring the following if available:

  1. Family member or friend who will be accompanying you on the day of your surgery.
  2. Any study of the heart that you have done (electrocardiography EKG, stress test)
  3. List of medications and supplements you are currently taking.
  4. Any lung study that has been performed (x-ray).

Procedure              

It involves placing a breast prosthesis in the anatomical area of the breast to achieve an improvement in form, size and symmetry. It is performed on an outpatient basis with a stay at the surgical center or hospital no more than 12 hours typically, the procedure takes 1-2 hours depending on the case, the incision options are through the areola, under the breast, axillary and transumbilical, the best place will be different for each patient and the case will be explained on the day of the consultation. After the incision a pocket is created for the implant placement, as options we have behind the gland, behind the muscle and a combination of the two. It ends with a closure of the pocket with absorbable sutures, skin stitches and sterile gauzes and bandages.

If you decide to perform the procedure as an outpatient basis it means that you will be discharged form the hospital the same day, chances are that the surgery will be performed in the morning and get the afternoon to recover. You will not be discharged until you are in a stable condition and with a smooth recovery, if required to be kept under monitorization then you will be hospitalized so you are recommended to have your suitcase ready with clothing and personal items along with a companion to assist .

At your checkout you will be provided with the following:

  1. Detailed instructions for your care at home
  2. Oral medications prescriptions for your needs.
  3. Contact number for any questions.

Recovery         

Immediately after surgery

You'll find yourself with a bandage on your surgical area which will be constantly monitored by nurses, it is normal to have mild to moderate pain which is controlled with medication.

Before your check out a change of gauzes and bandages will be performed and a special stabilizing breast garment will be provided for your security and comfort.

The 1st week after the surgery an appointment is made, sutures are removed if present, usually you are in a better condition to return to work and resume normal activities from the 5th day but it is recommended not to make big efforts, not activities such as gym yet.

2nd to 3rd week you are able to do moderate exercises, it is not yet recommended to do any upper limb lifting.

4th to 6th week with an almost full recovery, you can gradually resume your activities as exercises including lifting with upper extremities.

Before & After

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Breast Lift
(Mastopexy)

Breast ptosis refers to the fall of the areola and nipple with a migration and a stretching of the skin and gland due to an elongation, atrophy and loss of elasticity of the breast tissues in a meaningful way compared to a juvenile bust.

This happens progressively with time and is influenced by the effects of gravity, hormonal changes,weight loss, pregnancy and menopause.

Mastopexy or breast lift is a procedure designed to improve the position, shape and consistency and to restore it a more youthful and attractive appearance.

Candidates Procedures       Recovery    Before & After

Candidates

The ideal candidates are those women who desire to address the details of his bust in regards to the drop, shape, firmness and excess skin, however if an accentuation of volume is desired also, it will have to be combined with a breast augmentation procedure. It is important to clarify that subsequent pregnancies or weight changes could have a negative effect on the results, it is recommended to be performed when the desired number of children or ideal body weight is achieved.

Procedures      

Depending on the particular case of the patient an assessment is made and then it is decided which procedure is best suited to address the details of the bust, it can last about 2-3 hours.

Types of incision

The best incision will be chosen by Dr. Rodriguez according to each case, we have several choices among the most common are listed below:

Crescent: Above the areola, only minimum lifting, in which with the use of breast implants an ideal volume is achieved.

Periareolar or Benelli: It consists of making an incision around the areola where the excess skin and areola are removed and also we have the possibility of modifying the shape of the breast if necessary.

Vertical: the same setting as periareolar but accompanied by a vertical incision below it where skin and breast tissue can be removed achieving a better remodeling. 

In Anchor: Is the complete lifting of the bust, better when a wider resection of glandular tissue and skin along with superior migration of the areola is needed.

If you decide to perform the procedure as an outpatient basis it means that you will be discharged form the hospital the same day, chances are that the surgery will be performed in the morning and get the afternoon to recover. You will not be discharged until you are in a stable condition and with a smooth recovery, if required to be kept under monitorization then you will be hospitalized so you are recommended to have your suitcase ready with clothing and personal items along with a companion to assist.

At your check out you will be providd with the following:

  1. Detailed instructions for your care at home
  2. Oral medications prescriptions for your needs.
  3. Contact number for any questions.

Recovery   

Immediately after surgery

You'll find yourself with a bandage on your surgical area which will be constantly monitored by nurses, it is normal to have mild to moderate pain which is controlled with medication. 

Before your check out a change of gauzes and bandages will be performed and a special stabilizing breast garment will be provided for your security and comfort. 

The 1st week after the surgery an appointment is made, sutures are removed if present, usually you are in a better condition to return to work and resume normal activities at the end of the week but it is recommended to take 10 to 14 days before doing house chores, not activities such as gym yet.

2nd to 3rd week you are able to do moderate activities, it is not yet recommended to do any upper limb lifting. The wound is now more mature in the healing process 4th to 6th week with an almost full recovery, you can gradually resume your activities as exercises including lifting with upper extremities.

Scars are permanent but usually hide very well within your own skin lines and folds in most of the cases this tend to diminish and vanish over time.

Before & After

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BREAST REDUCTION

Also known as reduction mammoplasty and it consists in the removal of fat tissue, mammary glandular tissue and skin in conjunction with the definition of its shape and the placing of the mammary gland and areola in a juvenile position.

Candidates  Pre-op Consultation Risks and Safety Information    Procedure Recovery

Candidates 

Patients that have physical and emotional problems. Patients with physical pain, discomfort, disability to perform determined activities due to the excessive weight or association to a problem with self-image related to the presence of a big and pendulum breast.

Pre-op Consultation

You will get an integral evaluation. It is important to know all the details of your health, your habits and it is equally important to know your expectations.

MEDICAL HISTORY

1. Medical condition, diseases, medication, previous surgeries, any record of breast cancer in the family.

2. Tobacco, alcohol, vitamin supplements, dietary supplements or any other treatment consumption.

3. Previous breast tests performed (mammography, ultrasound, etc). 

You will get the following:

1. Evaluation and complete clinical examination.

2. Breast examination and shape, position, skin quality, areola and nipple analysis.

3. Requesting of pre-surgical tests necessary to assure that your health condition is the adequate for the procedure.

4. Pre-surgical pictures taking.

Along with everything previously mentioned, the best treatment options for you will be discussed to offer you the best outcome possible in relation to your needs and expectations.

Risks and Safety Information   

This procedure can be considered to be very safe but still it entails risks that have to be taken into account for you, if the benefits and advantages are higher than the risks you will have to accept them and sign a consent form where you state that you understand all this and that you decide to continue with the process. 

The most common risks and complications of the breast reduction are the following:

1. Hemorrhage

2. Infection

3. Seroma or liquid accumulation.

4. Asymmetry

5. Necrosis or skin tissue loss including the areola and nipple.

6. Sensitivity reduction in the breast, areola and nipple.

7. Unfavorable cicatrization.

8. Suture allergy or reaction to suture material or medication.

9. Limitation or incapacity to breast feed depending on the surgical technique used.

10. Profound vein thrombosis, thromboembolism or cardiac arrest.

Procedure

Incision options:

- Periareolar or Benelli: It consists of making the incision around the areola where the excessive breast and areola tissue is removed, besides there is the possibility of modifying the mammary gland shape if necessary.

- Vertical: The same periareolar adjustment is made but it is performed along with a vertical incision where mammary tissue and extra skin is removed with a better remodeling of the breast.

- Anchor: Is the complete lifting of the breast and it is adequate when a largest amount of mammary tissue and skin removal is needed along with an upper migration of the areola. After the incision is made comes the performance of and adequate resection of the skin and glandular tissue as well as the migration of the nipple to its new position creating the new shape desired, the sutures are placed to get the incisions faced and in some cases drains are placed.

Generally, this procedure is performed as an ambulatory one with a stay in the surgical center or hospital no longer than 12 hours.

If it is decided to have this procedure as an ambulatory one that means you will be discharged the same day, most likely your procedure will be performed during the morning and will have the afternoon to recover. You will be discharged only if you are in a stable condition and had a favorable recovery. If you require to be under post-op supervision then you will be staying the night at the hospital, therefore we recommend you to have a light bag ready with a change of comfortable clothes that zips up or buttons in the front, personal items, comfortable shoes or slippers and someone to be by your side to assist you during your recovery.

At your discharge you will be given the following:

- Detailed instructions for the after care at home.

- A post-op oral medication prescription as needed.

- A phone number to contact us if having any doubt or concern.

Recovery

Right After Surgery

You will have a bandage over the surgical area the one will be constantly supervised by the nurse staff. It is normal to have light to moderate pain the one is handled with medication. 

Before you get discharged you will get the dressings and bandages changed, wound curing, a change of gauzes and a stabilizer post-surgical brassiere will be put on for safeness and comfort.

1st week after surgery

The first follow up consultation takes place; sutures will be removed if present. The possibility of removing the drains will be evaluated and it is recommended to keep yourself from work activities and the gym.

2nd week after surgery

Regularly in better general conditions. No arm movement above the shoulders is allowed. The breast wounds are completely closed in general but slightly sensitive. The edema and swelling has gone down substantially.

3rd and 4th week after surgery

With a satisfactory recovery, you will be able to resume ordinary everyday domestic activities and to slowly start working out progressively at the gym. The wound will be more dried up and in the process of scar fading.

Usually the scars lose between the same breast natural lines and folds but in some cases they are noticeable in the surface, these are permanent but in most cases they fade and improve with time.