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    Day of Surgery

    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 revision 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.

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    After general anesthesia is administered (you are put to sleep), an incision is made in the location that was decided upon prior to surgery. The peri-areolar incisionis generally the first choice of highly experienced surgeons for revision breast surgery since it offers a variety of major advantages.  To begin with, the peri-areolar incision offers the best access to the breast pocket as well as the options to lower the breast fold (dual plane technique), several unique concurrent mastopexy techniques and breast reshaping in cases of breast asymmetry and deformity (tubular and constricted). In addition, the breast pocket can be developed under direct vision allowing less risk of bleeding and improved avoidance of nerves (preserve nipple sensation) as well as breast reshaping options and ability to adjust the breast fold. The peri-areolar technique also allows for more precise pocket modification and achievement of excellent breast pocket shape, symmetry and creation of cleavage. Both saline or silicone gel-filled breast implants can be inserted through this incision and the only true contraindication to this technique is a patient with very small areolas. An inframammary incision can also be utilized for breast revision surgery, but the axillary and transumbilical incisions are not typically utilized due to poor pocket visibility inability to provide direct excess to the entire pocket for adjustment of size, shape and/or symmetry. After the incision, the necessary corrective procedure is performed to the breast pockets, folds and/or scar tissue. A breast implant sizer is then inserted into the breast pocket and centered behind the nipple. Most times the best result and least risk of complications comes from have the greatest visibility of the breast pocket which is why the periareolar technique is often preferred for revision breast surgery by experienced surgeons.

    After the breast implant sizer has been inserted in to the breast pocket, you will be sat up in order to better evaluate the final implant position, breast shape and breast symmetry before choosing the size and shape of your new breast implants since gravity can alter the position of the implant relative to the breast mound. Once the final size and shape of your implants has been determined, the implant sizers are removed and the permanent breast implants are placed in to the breast pockets. In some cases of revision surgery, surgical drains may be placed in to the breast pocket in order to decrease the risk of scar tissue formation within the breast pocket after the surgery. 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 in order to help decrease swelling and bruising after the procedure.

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    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.

    To find out more about breast surgery please contact us at 310-246-2355