Inform your surgeon of any allergies, all medical conditions, and any medication that you are taking (both prescription and non-prescription). Avoid aspirin and blood thinning medication such as brufen for two weeks prior to surgery to eliminate the chance of post op. bleeding. You should not smoke for 2 weeks prior to surgery as this may affect your reaction to the anaesthetic and prolong the healing process. Patients that suffer from hypertension must inform the surgeon prior to surgery. No food or liquid intake at least 6 hours prior to surgery.


Post operative Care and Recovery Expectations

While admitted, intravenous antibiotics are given to prevent infection and pain is managed accordingly. Wound dressings re changed as required. Upon discharge from the hospital, oral antibiotic, pain reliever and anti swelling medications will be provided. Compression garments are worn 24/7 in the first week. On the second to third week compression garment can be taken off at bedtime. Temporary bruising, swelling, numbness, soreness or burning sensation may be noted. Patient usually returns to work and resume normal daily activities after 5 to 14 days. Strenuous activities can be resumed after two to four weeks. It may take one to six months for the swelling and bruising to totally subside depending upon the amount of fat and the areas treated.

Common Name: Liposuction

Introduction: Liposuction is the removal of unwanted and exercise resistant fat deposits with a tube and a vacuum machine. It is usually performed as a cosmetic surgery with the objective of slimming and smoothing the contours of the body. Permanent fat cell removal with small unnoticeable scar is one of its benefits. Individuals with no serious medical condition and no contraindications to general anesthesia are good candidates for liposuction. Most common areas for liposuction are: neck, upper arms, the area above the breast, abdomen, waist, hips, buttocks, thighs, knees, calves and ankles.

Surgical Procedure: During the procedure surgeon makes a small incision which is usually hidden in areas like the joint crease and in the navel. Liposuction technique is performed after targeted fat cells are infused with a saline solution containing a local anesthetic and adrenalin to decrease blood loss, allow an easier removal of fat, as well as diminish postoperative discomfort.

In 2006, both Silicone and Saline implants were both approved by U.S. health officials. Implants manufactured by Inamed and Mentor – the two leading marketers of implants – were considered safe and effective for continued use.

Risks and Complications
Since 2006, statistics show that a low number of silicone or saline implant recipients have experienced complications.

Capsular contracture occurs if the capsule or shell around the implant begins to tighten and thicken. This will cause the breast to feel hard and appear unnatural. This can be prevented by regular self massage. Should this occur, removal of the capsule is required or perhaps implant may need to be
replaced.

If the breast does become infected from collection of blood or deflated, the implant must be removed immediately. You will need to wait for several months before repeating the operation. With the
advent of silicone gel filled implant, chances of deflation has been eliminated.

Despite bleeding generally being minimal during the operation, there is a possibility that continual bleeding after surgery may result in a blood clot formation which needs to be removed. This is
uncommon and it is suggested you remain in Thailand for approximately 2 weeks for your surgeon
to monitor your improvement after surgery. Infection is uncommon, but possible. Your surgeon should
provide you with antibiotics prior to surgery to eliminate this possibility.

Implants do not cause breast cancer but may obscure its detection. For women with silicone implants an annual mammogram is advised to ensure that implants are not leaking, as silicone leaks out slowly unlike saline – which is easier to rupture and will deflate fairly quickly. The new generation of cohesive gel will not leak out easily but can have some reactions. If there is a leakage
or break in the implant, it should be replaced. Inform the radiology technician that you have implants if you need an X-ray Autoimmune Risks According to scientific research, women with breast implants are not at any increased risk of autoimmune or connective tissue diseases. Although some patients have claimed of complications to their health due to ruptured silicone implants in the past, studies have not conclusively indicated that implants bring about increased risks of any rare diseases.

How to perform the breast massage

Remember to move your implant in all the four quadrants using a slow steady movement.

1) Position your palms on the outer quadrants of your breasts and press slowly inward. You can feel and see the implants bulge toward the inner quadrants of the breast. Press and hold for 20 to 30 seconds. Repeat four times.

2) Press the breasts slowly outward such that a bulge on the outward quadrants of the breast will be noted. Press and hold for 20 to 30 seconds, repeat four times.

3) Position your palms on the lower quadrants of the breast and push slowly upward. Bulging of the implant on the upper quadrants of the breast should be noted. Press and hold for 20 to 30 seconds. Repeat four times.

4) Do the same for the downward movement.

1. Drains, dressings, bandages are removed on the first or second day following the surgery. Afterwards you are free to bathe and shower as usual.

2. It is highly encouraged to start walking as soon as possible after surgery. This will help your circulation thus reduces swelling and eliminates chances of developing clots in your leg veins.

3. Bruising, swelling, soreness and discomfort are not uncommon on the first few days up to a week after surgery. This will resolve within 2 weeks.

4. Mild numbness, burning sensation and extra sensitivity to your nipples may be noted for a few days or weeks.

5. Upon discharge from the hospital you will be given oral antibiotics, make sure you complete the full course of antibiotic therapy. Wound dressing materials, pain and anti-swelling medications will also be provided. Change the wound dressing at least twice a day. But some surgeons do not need the patient to change the dressing until the follow up day.

6. Do not submerge in swimming pools, bath tubs for at least a week or while incisions are not completely closed. Small openings in the wound serve as portal of entry for bacteria which may cause infection.

7. A moist environment is inviting to some bacteria, so it is important that you keep the wound or the incision dry and stay in a cool room especially if you have the armpit incision.

8. Know the signs of infection. This includes fever (temperature over 37.8 C), pain not relieved by meds, redness, pus formation, excessive swelling, excessive tenderness. When signs and symptoms of infection is noted, call your doctor immediately.

9. Sutures will be removed at least 1 week post surgery.

10. Vigorous activities should be avoided for at least 4 to 6 weeks.

11. Wearing of sports bra day and night for the first 3 to 4 weeks is advised.

12. Underwire brassiere may be worn 6 weeks after surgery to prevent from rubbing against the incision.

13. Breast massage is advised differently depending on the surgeon or the type of implants. Usually it may be started on the third day
following surgery. This is performed at least twice daily, 10 to 15 minutes for each breast for 3 months.

If swelling is noted on the first few days of massage, you should stop the exercise and resume after a few days.

14. If you have the armpit incision Avoid sudden pushing of the breast upward for 3 weeks

15. You may be able to resume exercise and normal physical activities within a month or two, after any residual soreness has subsided.

When assessing the size and placement of the implant our aim is to augment your breasts in proportion with your body and to maintain a natural look. The size and placement of the implant chosen depends on many factors, such as your lifestyle, your desired cup size, your breast asymmetry, desired upper breast pole fullness, existing degree of breast ptosis.

If you have a small amount of breast tissue and want to augment as much as possible, it is recommended that a large implant is placed below the muscle, in order to prevent the feeling or appearance of the implant. There is also less chance of capsular contracture (hardening).

If you have large chest muscles and thick enough subcutaneous fat or breast tissue, the implant should be placed above the muscles in order to allow for comfortable movement and a natural look.

For patients with mild to moderate breast sagging, a larger implant would be placed over the muscle but your surgeon will evaluate and give you final opinion case by case. This enables a full and natural augmentation. In many occasions, breast lift or Nipple Areolar Complex Repositioning is recommended additionally for a better outcome.
Remember to :
1. Inform your surgeon of any medication/s that you are taking (both prescription and non – prescription), any allergies, all medical conditions (such as bronchial asthma, diabetes, hypertension, blood dyscrasias, coagulopathy, etc…)
2. Stop taking Aspirin, blood thinning medications like Ibuprofen, all vitamins and herbs for at least 2 weeks prior to surgery to eliminate the chance of post-operative bleeding.
3. Stop smoking for at least 2 weeks prior to surgery as this may affect your reaction to the anaesthetics and will prolong your healing process from vasoconstriction.
4. NO food and any liquid intake for at least 6 hours prior to surgery.
5. Absolutely no alcoholic beverages for at least 24 hours prior to surgery.
6. Make sure you do not wear any jewelries, piercings, make up and nail polish to surgery.

During breast augmentation, a breast implant is placed either under the breast tissue and over the chest muscle, or under both the chest muscle and the breast tissue. Your surgeon will advise you on the most suitable procedure for you. This helps to increase or balance the size of the breasts, restore breast volume, or restore the shape of breasts after partial or total loss. Please note that breast augmentation cannot correct significantly sagging or drooping breasts. In these instances, a breast lift is often necessary, which may be performed in conjunction with this procedure.

All breast implants are made with a silicone based non-reactive casing but they are filled with either silicone gel or saline. The outer silicone case may be smooth, shiny, polished, or a slightly rough texture. The type, style, and size of breast implants you choose are determined by your lifestyle, body contours, the amount of breast tissue you have, and the cup size and appearance that you would like to achieve. You should talk to your doctor about choosing the breast implant option that is right for you.

We offer the most commonly used methods of incision and insertion; at the nipple, under the breast or under the armpit and it may be more than a simple case of aesthetics as to which option is chosen. Your surgeon will advise you about best procedure to suit you.

Surgical/Procedure Name:  Augmentation Mammaplasty

Common Name:  Breast Augmentation, Boob Job, Breast Implants Surgery

Conditions to be treated:  Small Breast (Hypoplasia), Mild Involutional Changes (Glandular Ptosis) due to aging, multiple pregnancy, significant weight loss.
Introduction

Over time, age, genetics, pregnancy, weight changes, sun exposure, and gravity can cause the size and shape of breasts to change. Breast augmentation can help women who are dissatisfied with the size of their breasts, or who have experienced changes in the appearance of their breasts.

It is one of the most common plastic surgery procedures performed today, however you should carefully consider whether breast augmentation is suitable for you before deciding to go ahead. You may ask your surgeon any questions that you may have and he or she will give you guidance and advice to make sure that your choice is fully informed.