Breast Augmentation

Tips for Achieving the Best Results

There are a number of things that can be done before, during, and after breast augmentation surgery to ensure the lowest complication rate, the speediest recovery, and the best results. Explained below are a number of the steps Dr. Loftus takes. Ask your doctor if he or she takes these extra steps. If the answer is no, ask why.

Getting the Most out of Your Breast Enhancement Consultation

Evaluating your breasts carefully:
During your initial breast enhancement consultation, Dr. Loftus will examine your breasts and take careful measurements which will guide her in advising you about your breast augmentation options.

She will make special note of nipple position, breast volume, breast width, distance between your breasts, breast shape and projection, and height of the fold beneath each breast.

She will point out asymmetries (no two breasts are symmetric), and she will explain which of your breast features she can improve and how.

If your doctor does not evaluate your breasts carefully and make careful measurements before your breast augmentation surgery, you should question him or her.

Using sizers to get the results you want:
Sizers are extremely useful in determining your final breast size and help eliminate uncertainty and anxieties. Dr. Loftus recommends bringing two tight sports bras to your breast enhancement consultation session so that you can use implant sizers to determine the volume of breast implants that will give you your desired result. Dr. Loftus will offer guidance on implant size, but you will make the final decision.

Customizing Your Surgical Plan:
Each woman differs in their physical features and goals. Therefore each woman deserves a surgical plan tailored to her needs. Dr. Loftus will explain all the breast augmentation options and will design a plan that is best suited to your needs.

Reducing Your Risk of Complications

Reducing Infection:
Reducing the risk of infection after surgery should be a primary concern. The following are steps that Dr. Loftus takes to reduce teh risk. If your doctor isn't taking the same precautions, ask why.

To reduce the risk of infection, Dr. Loftus will give you two different antibiotics (Ciprofloxacin and Kefzol) at the time of breast augmentation surgery (most doctors prescribe only one antibiotic). Together, they cover virtually every possible bacteria. Additionally, they EACH provide combined coverage for the most common cause of infection, which is Staph.

Dr. Loftus recommends that you have your breast enhancement operation in her state-of-the-art surgery suite (which is known for exceptional privacy, comfort, and safety), where the risk of infection is substantially lower than in the hospital, as hospitals are laden with antibiotic-resistant bacteria.

To ensure the highest degree of sterility, Dr. Loftus' staff will sterilize the instruments she will use during your breast augmentation surgery upon your arrival, rather than days or weeks ahead of time. The instruments will be brought directly from the autoclave onto the operating room table, as opposed to being stored between the time they are sterilized and used (which is done in other operating rooms).

Dr. Loftus' nurses will then carefully perform the "prep," which is where the operating room nurse scrubs your skin prior to surgery with bacteria-killing solution.

Finally, during your breast augmentation operation, Dr. Loftus will be the only person who handles your implants (and before she handles them, she changes gloves), thereby reducing the possibility of contamination. All of these steps have enabled Dr. Loftus to have a zero rate of infection (so far). Given that she performs hundreds of breast augmentations each year, this is a very impressive record.

Reducing Capsular Contracture:
No one knows exactly why capsular contractures form around saline implants, but most plastic surgeons think that they are related to bacterial contamination that occurred at the time of surgery.

Therefore, every step taken to reduce the risk of infection (see above) should translate into reduced risk of capsular contracture. Dr. Loftus has found that, indeed, all of the efforts she has made to reduce infection have resulted in a reduced risk of capsular contractures. In fact, although the national risk for capsular contracture is 10-50% (depending on which study you read), Dr. Loftus' own rate of capsular contracture is less than 1%.

Dr. Loftus thinks that breast implant displacement exercises are important for keeping your breasts soft and natural. She will instruct you on these after surgery and will work with you until you are comfortable performing them.

For an explanation of capsular contracture, visit Breast Augmentation risks and Complications.)

Reducing Deflation:
Dr. Loftus will reduce your risk of deflation by overfilling your implants, according to the manufacturer's recommendations. (This usually means 25-30 cc's, which is equivalent to an ounce of fluid.) To accomplish this, Dr. Loftus will select an implant that is smaller than the size you chose and then she will overfill it to the amount that you chose. By doing this, Dr. Loftus has had a less than 1% deflation rate over 10 years.

Reducing Rippling (Wrinkling):
Dr. Loftus will reduce your risk of rippling by overfilling your implants (see "deflation", above) and by recommending smooth implants (textured implants have the distinct disadvantage of increased rippling). These two simple measures markedly reduce the risk of rippling.

Additionally, if you have a modest amount of breast tissue, Dr. Loftus will recommend that you consider placing the implant under the muscle to avoid rippling in the upper half of the breast.

Reducing Sloshing:
Sloshing, quite simply, is reduced by overfilling your implants. There is no disadvantage to overfilling our implants. You should clarify this issue with your surgeon to ensure that your implants will be overfilled.

Reducing Nipple Numbness:
The national average of permanent nipple numbness occurs in 15% of all women who have breast augmentation. The numbness is due to damage to the nerve that provides sensation to the nipple (the 4th intercostal nerve). As this nerve is small, it is often not visible during the operation, hence making damage more likely. To minimize the possibility of damage to the nerve, Dr. Loftus avoids "cutting" or "cauterizing" anything in the area of the nerve, which is on the side of the breast nearest the armpit. Instead, she gently stretches tissues apart to make room for the implant. By stretching rather than cutting, Dr. Loftus is more likely to stretch rather than cut the nerve. Because stretched nerves are unlikely to develop permanent numbness, whereas cut nerves are likely to develop permanent numbness, Dr. Loftus has a less than 1% rate of permanent nipple numbness in her practice.

Be certain to ask your doctor about his or her practices on this issue.

Reducing Asymmetry:
Dr. Loftus says that even though she looks at breasts all day long, she has never seen a pair of symmetric breasts. She will point out to you where your asymmetries exist so that she can help you understand which asymmetries she can fix and which ones she cannot.

Regardless of the degree of your asymmetries, Dr. Loftus will strive to attain the best result for you and the highest degree of symmetry possible. She will actually sit you up during surgery to see how your breasts look while you are in an upright position (we all know that breasts appear quite different when one is lying down versus standing or sitting up). This enables her to make final adjustments to ensure the closest degree of symmetry possible and the best result for you.

Speeding Your Recovery Following Breast Augmentation

Reducing Pain:
It has been shown in multiple medical studies that blocking the initial pain a patient feels after surgery markedly reduces their overall pain and speeds their recovery.

Breast implant placement under the muscle can be very painful with an unpleasant recovery period....OR it can be minimally painful with a much faster recovery. Dr. Loftus takes some very important steps to ensure minimal pain and fast recovery in her patients.

After anesthesia is administered and you are asleep, Dr. Loftus injects long-lasting numbing medicine (similar to Novocain, but much longer lasting) on all sides of each breast. This "blocks" the nerves from sending pain signals to your brain after surgery.

Before Dr. Loftus closes your skin, she puts a large dose of the same numbing medicine directly into the area where the implant is sitting. This essentially "marinates" the tissue surrounding the implant with numbing medicine. For a variety of reasons, the body is very slow in absorbing the numbing medicine around the implant, and it therefore can last for several days. Don't worry, though, because once it wears off, you do not suddenly feel pain. In fact, most do not even notice when it wears off.

Some plastic surgeons advocate placing a pump in the surgical site to infuse numbing medicine for a few days following surgery. Although this is effective in controlling pain, it is no more effective than placing a large single dose into the pocket at the time of surgery. Further, it introduces a much higher risk of infection, as the pump tubing communicates the outside world with your implants for as long as the pump is in place.

Finally, Dr. Loftus will see to it that you are given prescriptions for Demerol (meperidine), which is a powerful pain medication, as well as Celebrex, which is a powerful non-narcotic pain medication. Working together, they are very effective in combating pain and discomfort.

Reducing Nausea:
One of the most common causes of nausea is pain. Dr. Loftus has found that taking steps to reduce pain has markedly reduced the incidence of postoperative nausea and vomiting, even in those who are prone to it. Further, Dr. Loftus advocates a number of simple medications which are very effective in reducing nausea.

All of Dr. Loftus' patients receive decadron (a steroid which reduces nausea), Zofran (an anti-nausea medication that is so effective that it is routinely prescribed for cancer patients), Scopalamine (a medication which helps motion sickness), and Pepcid AC (this over-the-counter medication is a fabulous drug which further inhibits nausea in surgical patients). By taking all of these steps, Dr. Loftus has effectively reduced the rate of nausea and vomiting in her surgery center. In fact, although the national average for postoperative nausea and vomiting is 33% and 22%, respectively, the incidence of nausea and vomiting at the Loftus Plastic Surgery Center is less than 7%.

Breast Augmentation

Breast Implant Risks and Complications

Recovery from Breast Augmentation

Before and After Photos of Breast Augmentation

Photos Page 2

Photos Page 3

Breast Surgery Procedures

All Plastic Surgery Procedures