How This Surgery is
Performed (continued)
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The
tissue expander is filled approximately one and one-half
(1 1/2) times the desired end volume. The breast
and connective tissues will slowly separate from the
underlying muscle for sub-glandular placement or from
the chest wall for sub-pectoral placement. Your
surgeon will may further situate the tissues with manual
compression and by pushing the implant to each quadrant
of the pocket. This will create an oversized
pocket necessary for natural movement. After the
tissue has been successfully expanded, the expander will
be deflated and removed. |
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Your
surgeon will then insert a long fill tube into an empty
breast implant and will then be rolled up just as the
tissue expander was. |
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After
the implant has been rolled up it will then be inserted
into the end of the endotube. This way the breast
implant will be inserted and placed just as the tissue
expander was. |
After
the breast implants have been positioned inside their
respective pockets either under the pectoralis major
muscles or as in this case, in the sub-glandular
position your surgeon will prepare to fill them.
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Using
a large syringe in combination with a closed delivery
system, sterile saline is then injected into the breast
implant. Your surgeon will take note of the cubic
centimeter (cc) amount of sterile saline which will have
been determined beforehand for your desired size goal.
Your fill tubes may be left in until the last phase of
the surgery.
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Your
surgeon will then possibly elevate you to a sitting
position to further determine if more saline is needed
in either side, to check for symmetry and placement of
the implants. If the amount of saline is correct
the fill tubes are removed by a gentle but firm tug of
the tubes and the implant valve is then sealed. If
not, more saline is injected to create a symmetrical
appearance. All patients have a degree of
asymmetry although some may have more pronounced
imbalances than others. The diagrams depict a posterior-valved
(the valve on the back, being up against the chest wall)
breast prosthesis although most commonly-used saline
implants (by Mentor or McGhan) have anterior valves (a
valve in front of the implant, facing out).
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Your
surgeon and his operating room staff will then perform
an instrument and sponge check to determine all items
are accounted for and the incision lines is then sutured
closed. Some surgeons may insert a small latex or
silicone drain or tube. Sometimes the drain is
left in for 1-3 days and will be removed at your first
post-operative check up. Some surgeons, such as
Dr. Grossman do not feel that a drain is warranted in
most cases.
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are then possibly dressed in post-operative gear such as
surgical bras and possibly further wrapped in an ace
bandage. Some patients may not be dressed in these
garments for reasons such as in very small-breasted
patients which may need gravity assistance for proper
settling of the implants.
After you
have been placed in your support garments the
anesthesiologist will cease intravenous feed of the
anesthetics and you are gently awoken and brought to the
recovery area. Please visit our recovery
section for what to expect during the healing phase. |
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