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Breast Surgery Procedures
If only the prostheses are being removed and replaced by new ones, the operation can be done under local anesthesia, sedation and local anesthesia, or general anesthesia.
If the capsules or scar tissue around the prostheses are also being removed, sedation and local or general anesthesia will be required.
Usually the operation will be performed through the old incision (scar).
If only implants are removed and replaced with new ones, pain will be minimal.
If implants and capsules (scar tissue) are removed, the discomfort will be similar to the discomfort experienced after the initial augmentation procedure.
Post-operative discomfort should be controlled with oral medication.
The patient will be discharged in an elastic bra.
Sutures are usually removed in 7-12 days.
Light activities can be resumed as tolerated. Aerobic activities can be started in about 3 weeks.
Moving or sliding the implants within the breast pockets during the post-operative period may reduce the frequency of wrinkling.
An additional procedure that might enhance the result is a Breast Lift (Mastopexy).
Removal of implants.
Possible removal of capsules (scar tissue) and residual silicone.
Placement of new Implants.
An additional procedure that might enhance the result is a Breast Lift (Mastopexy).
The specific risks and the suitability of this procedure for a given individual can be determined only at the time of consultation. All surgical procedures have some degree of risk. Minor complications that do not affect the outcome occur occasionally. Major complications are rare.
If your implants are being removed because of symptoms, implant rupture, or deformity, insurance coverage may be available. Our staff will assist you in making pre-authorization inquiries.
Desire to have previously placed breast prostheses (implants) removed for symptomatic or medical-legal reasons and to have new implants inserted.
Almost everyone has heard that they should look for "board certification" when seeking a qualified plastic surgeon (or any other physician for that matter). Most people don't really understand exactly what this means and what is involved in becoming "board certified."
Even fewer people know about certification of operating facilities, who certifies them and what protection such certification offers. We believe patients need this information to make informed choices in their search for the right surgeon, surgery facility and anesthesia provider.
At our office, we have gone to great effort and expense to ensure the highest standard of safety for our patients. As you consider plastic surgery, we hope the following information will help you to evaluate the choices available to you.
The American Board of Medical Specialists (ABMS) is the agency which oversees sub-specialty boards. More than 100 "boards" have been submitted to the ABMS for formal approval, but only 24 have met their strict educational and examination criteria. They are as follows:
| Allergy and Immunology |
Orthopaedic Surgery |
| Anesthesiology |
Otolaryngology (ear, nose and throat) |
| Colon and Rectal Surgery |
Pathology |
| Dermatology |
Pediatrics |
| Emergency Medicine |
Physical Medicine and Rehabilitation |
| Family Practice |
Plastic Surgery* |
| Internal Medicine |
Preventive Medicine |
| Medical Genetics |
Psychiatry and Neurology |
| Neurological Surgery |
Radiology |
| Nuclear Medicine |
Surgery |
| Obstetrics and Gynecology |
Thoracic Surgery |
| Ophthalmology |
Urology |
* The American Board of Plastic Surgery is the only ABMS board that has traditionally overseen the training and certification of cosmetic and reconstructive surgeons.
You may call the ABMS at 1-866-275-2267 to see if your surgeon is certified by the American Board of Plastic Surgery. Give them the name of your surgeon and they will tell you if and when he or she was certified. Certification by other boards does not give you the same protection. Other boards have less strict criteria for certification and some require only a fee. A few of the boards which have not been approved by the ABMS are as follows:
| Aesthetic Plastic Surgery |
Plastic Esthetic Surgery |
| Cosmetic Plastic Surgery |
Dermatologic Surgery |
| Facial Cosmetic Surgery |
Ophthalmic Plastic Surgery |
You may also want to call the local hospital and ask the Medical Staff Office secretary whether your surgeon has privileges to perform the proposed procedures in the hospital.
Whenever you are heavily sedated or have general anesthesia, you put your life in someone else's hands. Much of that responsibility falls to the person administering the medications and monitoring your vital signs. You need to know the qualifications of the person assuming that responsibility. Their training can range from specialization after earning a medical degree (anesthesiologists) to specialization after nursing training (nurse anesthetists) to nursing training only.
We have chosen to use board-certified anesthesiologists for all of our general anesthesia and for monitored anesthesia care. Some of our anesthesiologists are board certified in at least one other specialty as well. We choose physicians who are in active practice at a hospital because we believe their skills will be at the highest level in the event of an emergency.
CERTIFIED REGISTERED NURSE ANESTHETIST (CRNA): A CRNA is an RN who has completed an additional two years of specialized training in anesthesiology. Their certification is also overseen by each state's Board of Nursing. In contrast to an RN, a CRNA is able to administer general anesthesia.
YOUR SURGEON: In some centers your surgeon may actually be the person administering the medications to make you drowsy during your surgery. Almost never does he or she personally monitor your vital signs. This is usually done by a member of his staff, most often a nurse.
REGISTERED NURSE (RN): Each state has its own Board of Nursing, but there is a great deal of common requirements between states. He or she is licensed to administer intravenous drugs at the direction of the surgeon and monitor your vital signs.
CERTIFIED PLASTIC SURGICAL NURSE (CPSN): These nurses have worked full time for a minimum of two years in the field of plastic surgery before they are eligible to take a national certifying exam.
At the present time there are few local, state or federal laws requiring office-based operating rooms to be certified. Any physician may perform any procedure in an office as long as basic fire and safety codes are met. No level of sanitation, patient care, monitoring or peer review is required. Unfortunately, tragic consequences have occurred because of faulty equipment, lack of trained personnel and inadequate emergency equipment. As a result, there will most likely be requirements imposed in the future, but for now certification is purely voluntary.
MEDICARE:
An agency of the Federal Government with very strict requirements as to personnel, procedures and equipment.
AMERICAN ASSOCIATION FOR THE ACCREDITATION OF AMBULATORY SURGERY FACILITIES.
This accreditation certifies that the surgery facility meets nationally recognized standards through an accreditation program operated by the experts who set and evaluate the standards.
ACCREDITATION ASSOCIATION FOR AMBULATORY HEALTH CARE:
An alternative national accrediting body that most insurance companies recognize.
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