What to expect after surgery
Liposuction does leave a few scars, as small incisions have to be made in order to extract fat. However, the scars are very small, a few millimeters in length and are made in discreet locations. These scars also tend to fade away over time.
Mastopexy, (also know as a breast lift, scars take a much longer time to fade than liposuction scars due to the size of the scars. Dr. Urzola uses an anchor lift for his explant patients. It’s the oldest mastopexy technique, considered by many surgeons to be the “gold standard” for women requiring a significant amount of skin to be removed in order to achieve a better shape and perkier breast. It’s also the most invasive method and leaves the largest scar. This technique involves 3 incisions: one around the edge of the areola, one vertically from the bottom of the areola to the breast crease, and one along the inframammary fold where doctors try to hide it in the breast crease.
No one wants extra scars that are not necessary and many explant patients try to avoid a breast lift at all cost even when it is needed. This sets them up for a poor result and possibly more surgical procedures in the future. Dr. Urzola will not recommend a breast lift unless he feels it is necessary for the best outcome.
If doing explant only, Dr. Urzola will do his best to use your existing scars if implants were placed under the fold of the breast.
– Keep your arms close to your side after a breast lift
– Wear the compression garments that you have been instructed to wear. These will reduce inflammation and minimize scarring.
– Once the scars are healed, massaging them with a fingertip can prevent tissue hardening.
– Protecting scars from the sun can keep them from darkening in color.
– Avoid smoking, which can worsen the appearance of scars.
– Wearing your tape can flatten and fade scars.
*Different types of skin tones and hereditary traits can affect how the scars appear.
We do our best to make our patients comfortable, but patients should know that this is not a pain free surgery. The amount of pain a patient suffers varies from patient to patient. It will range from mild to severe and it will depend on the extensiveness of the liposuction procedure, existing scar tissue, difficulty with removing your implants and capsule and each individuals pain threshold.
Recovering from liposuction can be painful and it is slower for some individuals than it is for others. Try to keep your spirits up by realizing that what you are experiencing is a common and very normal response to surgery. Healing in many cases is slow and gradual and it is important to always bear in mind the reasons you decided to undergo the surgery in the first place.
Dr. Urzola and his staff have available all the necessary drugs used world wide to treat pain. A basic pain protocol is started for each patient after the consultation with the anesthesiologist and it can be modified depending on each individuals needs. It is important to let know Dr. Urzola or someone in his staff if the pain protocol is insufficient so that the proper re-arrangements in the pain control protocol can be made to provide you with a more individualized pain control if needed. Dr Urzola’s anesthesiologists are available 24-7 if it’s necessary to consult them.
Our bodies are naturally asymmetrical, to include our breasts. Fat transfer and proper surgical techniques can help to achieve better symmetrical breasts, but never perfectly symmetrical breasts. A few factors play into this, amongst them: the natural symmetry of your breasts, previous capsular contractures, scaring, and fat reabsorption. During your healing it will be common to have asymmetrical breasts due to swelling, but after your full recovery in most patients the symmetry accomplished is very acceptable and aesthetically pleasing.
Swelling and bruising
Swelling is common after the surgery and the amount will vary from patient to patient. Expect swelling to last anywhere from three weeks to three months and in some cases even longer. Swelling can be decreased by wearing your compression garment over the areas that have been operated on for a period of 4 weeks. Massage of the liposuction areas also helps to resolve the swelling faster. Remember it is important NOT to massage the breasts specially if fat was transferred during the first month.
Bruising is likely after liposuction. You should expect it to take two days to four weeks to go away.
Hard lumpy areas are common in the first several weeks after liposuction but they normally disappear in 6-12 weeks with final results taking 6-12 months. Areas of increased inflammation, scaring and collections of fluid cause these irregularities and are all by-products of liposuction. This is especially frequent if patients have had previous liposuctions or if they are not great candidates for liposuction due to excess skin.
It is quite common to have lumps after en bloc. Many times this is scar tissue created by en bloc and/or a breast lift. Massage to these areas is important to eliminate these lumps, but it should NOT be performed during the first month.
Lumps can also form after fat transfer to the breasts. Massages to the area can help the body to eliminate the fat necrosis. Dr. Urzola will direct you on how and when to perform massages if you had fat transfer.
Numbness or hypersensitivity
The nerves to areas after en bloc and liposuction are traumatized therefore numbness after these surgical procedures is expected for several weeks to months following surgery. It can take up to one year to regain sensation in some rare cases it might never come back.
If there is an alteration of the sensitivity, the most frequent scenario is to experience transitory hipo-sentitivity or hypersensitivity, performing continuous superficial massages everyday to the nipple-areola complex will help you regain the normal sensitivity.
Nerve regeneration: Itchy skin and postop spontaneous pains
Shortly after surgery patients often describe a sharp, stabbing, shooting or electric shock pain that can be very uncomfortable. These symptoms usually resolve in 6 to 9 weeks without intervention. Whenever nerves are cut, they have raw nerve endings that need to heal. During the process of healing, these raw endings spontaneously fire signals to your brain that can be perceived as anything from stabbing pain to an itch to burning sensation. These feelings should subside as the nerve endings heal.
Reabsorption of fat
The biggest risk of fat transfer is that not all of the transferred fat may remain in its new location. The fat that is transferred may not survive, or it may calcify. The body may absorb it, it may become a cyst, or it might cause inner scarring. When fat is newly transferred its very delicate, since it is deprived of its vascular supply it has to survive on the little oxygen it gets from the surrounding tissues. Right after the fat transfer is performed the platelets with which fat is mixed before is transferred start to produce angiogenic factors that speed up the process for new blood vessels to grow and provide the blood with the required oxygen for their survival. During this period, which takes around 15 days, the fat transferred is very delicate and any physical activity, strong movements, hiking, trips to the market, beach or other important movements will result in the fat dying with fat liquefaction and the need to drain it.
Having explant alone is a very emotional experience for many women. It’s not only a physical change but an emotional change as well. You just spent a lot of money, you’re in pain and the results are not there yet. Add to that the natural stress hormones produced by the effects of anesthesia combined with any pain medications and you have the perfect formula for feeling very depressed and emotional, be rest assured that it does pass.