Breast augmentation is one of our most popular procedures. If the patient has scheduled a consultation and comes, they talk with one of the RNs, then I go in and discuss with them the different types of implants we use, the different incisions that we can use, the placement of the implant either under the muscle or over the muscle. So we have all those decisions made before surgery. It is particularly helpful for me if the patient will bring in photographs of what they want to look like after the surgery. If one were to go online and spend an hour, you can find literally hundreds of pictures of before and after results and you can usually find several people who have about the same built of the same shape, the same breast size and the pictures that they bring in, that they say to me, “I like that look,” that is what we try to do. It is much more helpful than saying I want to be a C cup or D cup because there is no standard C cup, or D cup or B cup. So, the plan is already in place before we go to the operating room. In the operating room we have a board certified anesthesiologist who is there for the patient’s safety. They start an IV; they put the patient very lightly asleep so you do not feel any pain or discomfort. We make the incisions. We dissect out the pocket. We put in temporary implants and then we bring the table back up to a sitting position, in that way we can see what it is going to look like when you are sitting, when you are erect which is really the most important time. It is much more important than what it looks like when you are lying down. The two RNs are Janet and Kathy and Lauren our scrub tech, we will all together look when the patient is sitting up to see if we like the look and we will compare what she looks like to the pictures on the wall. We may want to put in a slightly larger or slightly smaller implant. Sometimes if the chest is asymmetric, one breast is larger or smaller we put different size implants in. We can adjust the fill if we use the saline implants. Then once we are happy with the shape of the breasts and the size of the breasts, we will lower the table, we will put the permanent implants in. So, everything up you have gauze that is layered anteriorly across your chest and then a compression bra that holds you in place and then you go to the recovery room with one of the nurses for about an hour.
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