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 lift and augmentation techniques you will 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 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 for removal of your previously placed implant and placement of a breast implant sizer. The breast implant pocket is assessed and 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 nipples. This is done on both sides of the chest and the breast implant sizers are then filled to the desired volume. The breast lift procedure is then performed utilizing the previously made markings that were drawn by Dr Motykie prior to your surgery. The standard technique for those with severe ptosis is with an anchor-shaped incision that surrounds the areola, descends vertically to the where the breast crease meets the rib cage and then crosses along the lower portion of the breast at its natural crease (inframammary fold). Dr Motykie is very careful to not extend the incisions beyond the bikini line or into the cleavage (the “bikini triangle”). The breast mound is then reshaped and the patient is sat upright in the operating room to assess the overall breast shape and symmetry. The patient is sat upright in the operating room in order to better evaluate the final implant position, breast shape and breast symmetry before choosing the size and shape of the permanent breast implants. Because a breast lift procedure is performed along with revision of the breast augmentation, any final breast size can be chosen for the breasts. If a patient desires to have smaller breasts, smaller breast implants (or none at all) may be used during the replacement surgery. If a patient desires larger breasts, larger implants may be used during the surgery. Implant type may also be changed from silicone to saline or vice versa. Once the final size and shape of the implants has been determined, the patient is laid down once again, the implant sizers are removed and the permanent breast implants are placed into the breast pockets. Either saline or silicone gel-filled breast implants can be inserted through this incision although saline implants may be preferable due to their superior ability to adjust for asymmetries as well as help shape the breast mound. The breast lift incisions are closed with fine dissolvable sutures that are placed underneath the skin to minimize post-operative scarring. Once the procedure is completed, small surgical tapes will be placed over the incision sites. A surgical brassiere and compression ACE wrap is placed before you leave the operating room in order to help decrease swelling and bruising 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.