Tuesday, 1 August 2017

Patient Case Study: Breast Implants

What’s it like to undergo breast enlargement surgery? If you’re thinking about having this procedure but unsure about what to expect, read our patient’s first hand account…


Deciding to have breast implants



I became unhappy with my breasts after having my son. Before pregnancy, my bra size was a full 32D and I’d always considered my breasts one of my best assets. However, post-baby they shrank to a small C cup. I’d lost volume from the top of my breasts; they were no longer full and I had to start wearing padded bras to fill out my tops. I just didn’t quite feel like me anymore.


I deliberated long and hard about the surgery - my son was five by the time I finally decided to take the plunge. I was worried about my boobs looking fake or too top heavy. I also feared losing sensitivity and complications. What persuaded me was looking at the before and after photos from Ocean Clinic and seeing how amazingly natural implants could look. I also researched the risks and was reassured that - with an experienced surgeon - these would be minimal.


I discussed my aesthetic goals with Dr. Kaye, telling him that I simply wished to restore my breasts to the size and shape they were previously and that I hoped they would appear as natural as possible.


Initially, I had thought about having anatomical “teardrop” shaped implants or saline implants that are not completely full so that they act like a natural breast when you lie down, rather than staying static on the chest.


However, after examining me, Dr. Kaye advised that these would not be the best option, since it was upper pole fullness that I wanted to restore - both of these implant types would place more fullness in the lower pole. Instead, he suggested round, silicone implants. He measured my chest to ascertain the correct size for my torso and suggested 300 cc. I tried sizers on under my top to get an idea.


Marked up for surgery 

Another important decision was which implantation method I should have. There are three types -
inframammary incision (under the breast crease), periareolar incision (around the nipple) and transaxillary incision (in the armpit). I was interested in the transaxillary approach as I didn’t like the idea of scars on my breasts, since I have very pale skin. Dr. Kaye said this would be a good choice for me because I also have small nipples, so a periareolar incision wouldn’t be the best option.


The incisions made in a transaxillary breast augmentation are made in the natural creases of the armpits, so are as good as hidden. I had heard that the implants could be harder to place via the armpit as the surgeon does not have direct access to the breast like they do with an inframammary incision and therefore the risk of malposition is higher. However, I learned that by inserting the implants endoscopically, the surgeon gets a clear picture of the entire pocket on a TV monitor making it easy to place the implants correctly.


Meanwhile, using round implants eradicates the risk of breasts becoming misshapen should implant rotation occurs (if a round implant rotates the shape of the breast stays the same, unlike with a teardrop shaped implant).


I told Dr. Kaye that I would like placement under the muscle (submuscular), as opposed to subglandular so that there was no chance the implant could be seen beneath the skin (also there’s a lower risk of capsular contracture with this placement). He agreed this would be suitable for me.


With all the details decided I just had to wait a month for my surgery!


The day of surgery



During the wait for my surgery I started to have second thoughts about how big I wanted to go. I am a keen horse rider and started to worry that implants might be uncomfortable when riding. I also didn’t want my boobs to be the first thing people noticed about me, so I decided to discuss the possibility of having smaller implants.


The doctor carrying out my surgery was Dr. Benito Ruiz and he came to meet with me in the morning. I shared my worries with him and he took various measurements before agreeing I could have 270 cc. This would fill out the empty bit of my breasts at the top, while not making them overly large - I would go up by roughly one cup size. I was happy and reassured by this and stopped worrying about waking up to find a huge pair of knockers on my chest!


The surgery was over in a flash. All I remember is lying down on the bed in the operating theatre, feeling a small scrape on my hand and then nothing. The next thing I knew, I was waking up in the recovery room. I was taken by wheelchair to my room and helped into bed. I had bandages wrapped around my chest and two drains (plastic tubes with a container on the end) coming out of each armpit to drain away any blood from around the implants.


I learned that Dr. Ruiz used a “Keller funnel” to insert the implants. This advanced technique means the implants do not get touched, which decreases the chance of skin bacteria being drawn into the breast implant pocket. This is something which can lead to a capsular contracture.


In terms of pain, the meds coming through the IV line were doing a good job but I did have great difficulty in trying to sit up. You don’t realise how much you use your chest muscles until they’re out of action. Getting out of bed to go to the loo, bringing the drip and drains with me, was quite a challenge. The worst thing about the recovery immediately after surgery was the nausea I felt. I felt very sick and wasn’t able to enjoy the lovely meal that was ordered for me. I let the nurse know and she explained it was probably the anti inflammatories that were making me feel ill. She gave me some anti-sickness medicine which really helped.


I slept overnight at the clinic and in the morning Dr. Kaye’s resident Dr. Paprottka came to check me so I could be discharged. He had to remove the drains which was pretty painful but over very quickly. He helped squeeze me into a special surgical support bra, which he told me I should wear constantly for a month. I was then able to go home.


The recovery



My pain levels were easily manageable at home with the painkillers I had been instructed to get (I had a course of antibiotics to take too), I just found myself a bit tired. It didn’t help that the weather was extremely hot and the big surgical bra was making me extra warm. At least I was free to take a shower. Although I had dressings under my armpits, I could get these wet and then dry them with the hairdryer.


I had a peek at my new boobs when I took the bra off to shower. They felt full and sore, similar to after I’d given birth and my milk came in, but I couldn’t believe how good they looked already! Although they were still swollen and sitting a little high (it takes a while for the muscle to stretch and for them to drop), there was next to no bruising and the placement looked great. I showed my husband and he was suitably impressed!

One month post-surgery

The first night, I realised I’d have to get used to sleeping on my back for a while (something I hadn’t thought about), but I was able to get comfortable enough by propping myself up on cushions. I also had to ask my husband for help taking my top off and reaching up for things in the kitchen cupboards. I’d been told I couldn’t drive for a week, so he had to do that too. Plus he had to take responsibility for walking the dogs because they pull on the lead. Luckily my son understood that I couldn’t pick him up.


I had my surgery on a Friday and because I have a desk job working from home, I was able to return to work on Monday. Downtime was pretty minimal - I even had a night out on the tiles for my friend’s birthday just one week later. I’d been a bit worried that it was too much too soon, but I was fine.


I did end up swapping the surgical bra for a maternity bra after a few days because it was simply too hot and uncomfortable. Dr. Kaye approved the bra when I attended the clinic for a dressing change but gave me a elastic strap to wear over the top to keep the implants pushed downwards.


My stitches were removed after 10 days and I could already see the scars were healing really well. I returned to the clinic once a week to have ultrasound therapy and lymphatic drainage, which helped to speed up healing and reduce swelling. After four weeks, swelling was almost gone, the implants had dropped a little and my breasts were starting to feel softer. My scars were already fading to white and I was able to swap to normal non-underwired bras and sleeveless tops (I could get back on my horse again too).


It’s now been five weeks and my new boobs no longer feel alien, they just feel like part of me. I know it could be up to a year until they have totally bedded in and softened up, but I’m already thrilled with them. I now fill out all my old tops, dresses and bikinis again and feel more confident. Despite all my fears and reservations, having the surgery was definitely the right choice for me.

Considering a breast enlargement? Book a free consultation at Ocean Clinic Marbella to discuss your options. Contact us today.

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