Pre-Operative Marking Prior to your surgery, you will have the opportunity to speak with Dr Motykie about any part of your surgical procedure and/or recovery process. You will be asked to change into a surgical gown and Dr Motykie will place surgical markings on your chest. All markings are performed in the standing position to ensure proper reference points such as your current nipple height and breast fold location. Lastly, wear loose fitting clothing the day of your surgery that is easy to get in and out of such as sweat pants and a shirt that zippers in the front.
Anesthesia and Operating Facility For almost all breast augmentation techniques you most likely receive general anesthesia (you are asleep) for your own personal comfort, safety and surgical ease. It is Dr Motykie’s opinion that the safest and most effective way to perform revision breast surgery is under general anesthesia since it allows for ease of breast pocket creation, relaxation of the chest muscles, additional comfort as well as allowing you to be sat up during surgery to assess final breast volume, symmetry and shape. It is not in your best interest to undergo breast surgery using awake anesthesia.
Dr. Motykie uses only Board Certified Anesthesiologists to administer anesthesia and monitor your safety during your surgery. You may be given medication before reaching the operating room so you will feel relaxed before surgery. The surgery takes approximately one hour to perform in its entirety. Every surgery is performed in a fully accredited, state of the art (AAAASF) surgical facility where your safety, comfort and privacy are of the utmost importance. Deep vein thrombosis (blood clots) precautions are taken with every patient and include a minimum of anti-embolic stockings and sequential compression devices (SCDs) on the lower extremities during the entire length of your procedure.
After general anesthesia is administered (you are put to sleep), an incision is made around the nipple (Benelli procedure) in order to gain access to the breast implant pocket. The breast implant pocket is entered, the current implant is removed and precise pocket modifications are made that could include lateral pocket tightening, capsular contracture (scar tissue) release, internal lifting, cleavage correction and internal pocket symmetry procedures. The best location for placement of the breast implant sizer is underneath the chest muscle in order to preserve the natural, healthy blood supply to the overlying nipple. This is done on both sides of the chest and the breast implant sizers are then filled to the desired volume. The Benelli lift is then completed by placing a permanent purse-string suture around the outside of the areolar incision. The periareolar scar is generally well accepted and it is certainly more readily accepted and less visible than the scars of the traditional mastopexy. The amount of lift obtained from the procedure is limited by the fact that more aggressive skin resection can lead to flattening of the breast, distortion of the areola and spreading/pleating of the scar. The fundamental step for achieving success with this approach is placement of the permanent purse-string suture around the areola prior to closure in order to prevent its expansion/spreading during the recovery process. You will then be sat up in order to better evaluate the breast shape and breast symmetry before choosing the size and shape of your new breast implants. Once the final size and shape of your implants has been determined, you are once again laid down flat upon the operating table, the implant sizers are removed and the permanent breast implants are placed into the breast pockets. Both saline and silicone gel-filled breast implants can be inserted through this incision. The purse-string suture is tightened until the desired size of your areolas is obtained on each side. Once the procedure is completed, small surgical tapes will be placed over your incision sites and you will be fitted into a surgical brassiere and compression ACE wrap after the procedure.
Recovery Room After surgery you will be brought to the recovery area where you will be allowed to rest and completely recover from anesthesia. Nurses will be on staff by your bedside to make sure you are recovering properly as well as being able to provide you with pain medications and small amounts of water and/or ice chips while you are becoming more awake and alert. After you have fully recovered from anesthesia, you may be released to home with a responsible adult or you may choose to stay overnight in an outpatient recovery retreat where there are nurses on staff 24hrs to assist you with post-operative care and medications.
The most comfortable position to recover in after surgery is a reclining chair with your head elevated. Over the first night you will most likely find yourself having to use the bathroom frequently. This is normal and is due to the intravenous fluids you received during your surgical procedure. Leave all dressings intact until the next morning when you will return to Dr Motykie’s office to have your dressings changed and receive further instruction for the rest of the week. The night following your surgery, you may experience some pain and discomfort that can be controlled with your prescribed pain medication. The majority of the sutures used during your surgery will be dissolvable and all of them are covered by thin surgical tape that should be left in place for the first week after your surgery.