FAQ – Risks Of Surgery

 

Why discuss the risks of breast surgery?

 

Will I benefit from understanding the risks of breast surgery?

 

Why don’t most websites talk about risk as much as this website?

 

Is breast surgery risky?

 

How are risks communicated to me?

 

How are risks minimized?

 

Is this section a comprehensive review of all risks of surgery?

 

What is capsular contracture?

 

Does a capsular contracture require treatment?

 

Can breast implants break?

 

How long do breast implants last?

 

What if a saline breast implant ruptures?

 

What causes a breast implant to break?

 

Can a silicone gel breast implant leak?

 

What is breast implant malposition?

 

Can poor breast implant position be corrected?

 

What is “bottoming out”?

 

What is breast implant “rippling“?

 

How is rippling avoided?

 

How is breast implant edge visibility avoided?

 

Do all patients wish to avoid breast implant edge visibility?

 

How is the risk of implant infection minimized?

 

What is the risk of poor scarring?

 

What is the risk of bleeding during and after breast surgery?

 

How is a major hematoma treated?

 

What is a deep vein thrombosis?

 

What is the risk of DVT during breast surgery?

 

Why is the risk of DVT important?

 

What is the risk of pulmonary embolus after breast augmentation surgery?

 

What is done to minimize my risk of DVT and pulmonary embolus?

 

What is Symmastia?

 

What is a “double-bubble”?

 

How is a “double-bubble” deformity avoided?

 

What is a “snoopy” deformity?

 

Are there any risks with very large implants?

 

What is Mondor’s Disease?

 

Why don’t most websites talk about risk as much as this website?

 

Is breast surgery risky?

 

How are risks communicated to me?

 

How are risks minimized?

 

Is this section a comprehensive review of all risks of surgery?

 

What is capsular contracture?

 

Does a capsular contracture require treatment?

 

Can breast implants break?

 

How long do breast implants last?

 

What if a saline breast implant ruptures?

 

What causes a breast implant to break?

 

Can a silicone gel breast implant leak?

 

What is breast implant malposition?

 

Can poor breast implant position be corrected?

 

What is “bottoming out”?

 

What is breast implant “rippling“?

 

How is rippling avoided?

 

How is breast implant edge visibility avoided?

 

Do all patients wish to avoid breast implant edge visibility?

 

How is the risk of implant infection minimized?

 

What is the risk of poor scarring?

 

What is the risk of bleeding during and after breast surgery?

 

How is a major hematoma treated?

 

What is a deep vein thrombosis?

 

What is the risk of DVT during breast surgery?

 

Why is the risk of DVT important?

 

What is the risk of pulmonary embolus after breast augmentation surgery?

We obtain a history from you to assess your overall risk. We also ask you to discontinue hormone therapy, such as birth control pills, at least two weeks before surgery. In surgery and in recovery, we place compressive stockings and pneumatic squeezing devices on your legs to maintain circulation. And, after surgery we ask you to stay mobile and walk for short intervals every two hours to maintain good circulation in your legs.

What is done to minimize my risk of DVT and pulmonary embolus?

Symmastia, is when the implants slide together to the center of the chest, giving the appearance of a bread loaf or one single breast. Treatment typically requires surgery to reposition the implants and create normal appearing cleavage. This is a rare complication in our practice.

What is Symmastia? What is a “double-bubble”?

A “double-bubble” is when the implant and breast tissue do not appear as one unit. That is, the bubble of the implant can be seen and the overlying breast tissue appears as a separate shape. The classic example of this is in women with droopy breasts. In such cases, the implant may be in good position or slightly “high” on the chest. But, the sagging breast tissue may drop off the bottom of the implant. This condition can also occur in women after they have had breast implants for a while if the breast tissue sags (such as after pregnancy) and the implant remains high on the chest.

In addition, a reverse example of such a “double-bubble” can also occur. This happens if the implant is placed too low on the chest (below the breast fold) and breast tissue and skin are tight and firm on the upper part of the implant. In these cases, the breast tissue has a shape above the lower breast fold and a separate “bubble” of the implant can be seen below the breast fold.

How is a “double-bubble” deformity avoided?

This can usually be avoided with proper recognition of patients that are at risk for a “double-bubble” based on their natural breast shape. This is discussed during your consultation and pre-op if you are at risk. Then, a special surgical plan will be devised to limit this risk.

What is a “snoopy” deformity? 

This term relates to the nose on the peanuts cartoon character Snoopy. This is another term for the “double-bubble” deformity described above.

Are there any risks with very large implants?

When determining implant size, it’s important that your body and its characteristics be taken into consideration. Women without sufficient existing tissue who opt for very large implants may end up with implants that are more easily seen and felt through the skin after surgery. In addition, irreversible tissue thinning and breast ptosis can be caused by excessively large implants.

What is Mondor’s Disease?

Mondor’s Disease occurs when veins below the breast become clotted and firm. This can be painful and a “cord” can be felt under the skin. These usually resolve in a few weeks.

What liposuction machine do you use?

Dr. Connall uses the Body-Jet liposuction system. The Body-Jet uses pulsating water at the tip of the cannula to dislodge and wash the fat away with gentle suction. There are many liposuction systems available these days. Many systems have catchy names and are advertized in newspapers and on billboards around Portland.

Dr. Connall chose the Body-Jet not based on hype and marketing cache, but because he found Water-Assisted-Liposuction to be the safest and gentlest way to perform liposuction. In addition, the Body-Jet is the premier system for removing fat that can then be injected into the breasts and/or buttocks for augmentation of those areas.

Who is a good candidate for liposuction?

The best candidates for liposuction are in good health and have areas of fat that don’t improve with diet and exercise. Liposuction patients must have realistic expectations of what the procedure can accomplish. Most liposuction patients are of average size and have good skin tone and no or minimal skin excess.

Who is not a good candidate for liposuction?

Patients with skin excess, stretch marks and significant excess weight are not good candidates for liposuction.

Is liposuction a reasonable treatment for obesity?

No. Liposuction is not a weight loss procedure. Liposuction is a body sculpting procedure.

Does liposuction produce permanent results?

The results of liposuction are essentially permanent. However, aging and weight changes can affect the areas sculpted with liposuction.

Does the fat come back in other spots after liposuction?

With weight gain the areas of liposuction can increase in size, but probably not to the same degree if liposuction had not occurred. With weight gain, the new fat will distribute essentially proportionally throughout the body.

How long does tummy tuck surgery take?

Normally a tummy tuck with take between two and four hours to perform. The length of surgery depends on your specific needs. A mini-tummy tuck may take about 2 hours, while an extended tummy tuck may take four hours or longer to perform.

What type of anesthesia do you use for a tummy tuck?

Anesthesia is achieved with a combination of local numbing medicine placed directly into the tummy fat and general anesthesia. The general anesthesia is given by a board-certified anesthesiologist. The local numbing medicine, combined with a pain medicine pump that is placed during surgery, greatly helps with pain control after surgery.

What is a tummy tuck scar like?

The tummy tuck scar will depend on the type of procedure you undergo. The scar is generally placed in the low-rise bikini line so it is covered with most clothes. The scar may be similar to a c-section scar or be a long scar going from hip to hip. The scar will be visible and permanent.

How long do the results of a tummy tuck last?

Your new figure after a tummy tuck should be constant for many years. However normal life events such as aging, weight gain and pregnancy will affect the appearance of your abdomen.

Is liposuction performed with a tummy tuck?

In most cases Dr. Connall performs liposuction with a tummy tuck to assist with sculpting the abdomen and love-handles. Many surgeons don’t perform liposuction as a standard part of the procedure and assess an additional charge to add the liposuction. If you are comparing prices between doctors it is important to ask if liposuction is included.

Who is a good candidate for a lower body lift?

A lower body lift is usually the ideal procedure to treat the skin and fat excess of the abdomen, flanks and buttocks in patients that have lost a lot of weight. Some non-weight loss patients with sagging skin around the trunk are good candidates for a lower body lift.

Is an abdominoplasty a good substitute for a lower body lift in the massive weight loss patient?

An abdominoplasty only treats the front of the trunk. Most weight loss patients have skin excess around the entire waist. Therefore, an abdominoplasty usually under treats the patient and will likely obligate the patient to a second procedure to correct the flanks, back and buttocks.

Do all plastic surgeons perform lower body lift surgery?

No. The lower body lift is a complex and lengthy procedure that many plastic surgeons do not perform.

Does Dr. Connall perform lower body lift surgery?

Yes. Dr. Connall has performed lower body lifts throughout his training and career. Dr. Connall has treated all body types with lower body lift surgery and is very comfortable with the procedure. In addition, Dr. Connall designed his surgery center to accommodate lower body lift patients.

Face Procedures

What is a face lift?

A face lift is a surgical procedure that rejuvenates the lower face and neck. A face lift smoothes loose skin on the face and neck, tightens the underlying tissues and removes excess fat.

Is a face lift different than a neck lift?

Yes. A facelift is a comprehensive procedure to rejuvenate the face and neck. Isolated neck lifting and tightening procedures are available. However, most patients needing significant neck tightening benefit with the full facial improvement a face lift provides.

Will my face lift look unnatural?

There are many examples of unnatural and odd appearing celebrities that have had face lifts. Dr. Connall performs natural face lift surgery. Dr. Connall’s goal is make you look younger, not different or “operated on”.

Is a face lift a big operation?

A face lift is a significant surgical procedure and must be approached with the utmost caution, expertise and respect. Dr. Connall performs full face and neck lift surgery, meticulously treating multiple areas of the face. Because Dr. Connall performs full face lift surgery, there is a significant recovery. But, a recovery with some bruising and swelling is necessary to give you real, lasting results.

Are quick face lifts and weekend face lift as good as a full face lift?

There may be some patients with minimal skin excess and aging that might benefit from a minimal procedure. However, generally a minimal procedure will yield minimal results. To achieve meaningful and lasting results a full face lift is usually needed.

When can I return to work and social situations after a face lift?

After three to four weeks most of the swelling has resolved and you can return to many activities. You may want to use aggressive cover-up makeup during the first month after your face lift.

What is a brow lift?

A brow lift elevates the eye brows into a youthful position. A brow lift opens up the upper eyelids.

What kind of scars occur with a brow lift?

Dr. Connall performs most brow lifts using small incisions in the scalp and an endoscope. Therefore, the scarring is minimal and usually not noticeable. In some cases a traditional brow lift is needed, leaving a scar along the front of the hairline.

Will I have a “startled” look after a brow lift?

Dr. Connall performs natural brow lift surgery and avoids locating the eye brows high on the forehead.

What is a Blepharoplasty?

A blepharoplasty is a surgical procedure to improve the appearance of the eyelids.

How is a Blepharoplasty performed?

There are many approaches to rejuvenation of the upper and lower eyelids and Dr. Connall will tailor his approach to meet your needs. With the upper eyelids excess skin and sometimes a small amount of fat are removed. The scar is hidden in the natural eyelid crease. The lower eyelid is approached with an incision along the lower lid margin. The fat is rearranged or removed and the excess skin is removed.

What is the Implicitguide® Surgical Suture System (iGuide®)?

The iGuide® has FDA clearance, for soft tissue approximation and elevation of sub-dermis and underlying muscle. In properly selected patients iGuide® provides a technique to improve the neck, jawline, and brow with minimal incisions as compared to traditional techniques—with minimal swelling, bruising, and scarring and decreased recovery time. The iGuide® was developed by board-certified plastic surgeon Dr. Gregory Mueller to improve neck, face, and brow contours resulting from aging and inherited through genetics.

How does iGuide® work?

The iGuide® is packaged in a sterile kit that is comprised of five unique surgical tools which allow surgeons to elevate and define any soft tissue areas by weaving a suture trampoline® underneath the jaw line. This is achieved through a series of needle punctures with one continuous thread, instead of cutting and repositioning muscles and soft tissue that can cause damage to the nerves and blood vessels of the neck, face, and brow. Using these unique tools, the system creates a trampoline-like structure that provides dynamic low tension support, elevating the skin, muscle and soft tissue as one unit.

What are the benefits of iGuide® over traditional, invasive procedures?

The iGuide® provides patients with a minimally invasive surgical option that delivers consistent, natural-looking results, while leaving minimal to no swelling or bruising, and reducing the possibility of muscle or nerve damage that can occur with traditional necklift procedures. Additionally, the iGuide® allows procedures to be performed quickly and in many cases using local anesthesia alone.

What is the average recovery time with the iGuide®?

Recovery times with iGuide® are short. Generally, patients are able to return to work within a few days and can resume physical exercise in a week or two. Your physician will be able to give you a clear idea of how short your recovery time will be.

Who is eligible for the iGuide® technology?

  • Male patients who traditionally have more muscle in the face and neck area.
  • Patients looking for a surgical “touch-up” to improve visible sagging neck muscles (better known as “turkey gobbler neck”) following a neck and face procedure or liposuction.
  • Patients needing a “bridge procedure” to sustain attractive neck or other contours, which helps avoid the necessity of undergoing invasive procedures more frequently.
  • Younger patients who are looking to improve abnormal or unattractive neck muscle contours acquired through genetics, without invasive surgery and visible incisions.
  • Patients who want a brow lift but would like to avoid procedures that require drilling into the skull.
  • Patients who want to reshape the eyebrows without invasive surgery and visible scars.
  • Patients who want a brow lift or neck rejuvenation procedure easily and safely using only local anesthesia.

Can the iGuide® be used in facelifts as well? And can patients who have undergone previous surgical procedures benefit from the iGuide®?

The iGuide® is intended for soft tissue approximation and elevation of subdermis and underlying muscle. iGuide® can be used as a stand-alone procedure or as a complement to a facelift or brow lift. It can also improve neck contours in patients who have undergone conventional neck and face procedures, can help conceal visible muscle banding that may become apparent after liposuction of the neck, and can be used to touch-up traditional face, and neck to improve contours of patients experiencing early recurrent or residual platysmal bands.

iGuide® can also be used as a “bridge procedure” to sustain attractive neck, face, and brow contours, avoiding the necessity of more frequent invasive procedures. It is as well, a minimally invasive system that allows younger patients to improve abnormal or unattractive neck muscle contours acquired through genetics.

What are the possible side effects of iGuide®?

In properly selected patients iGuide® provides a technique to improve the neck, jawline, and brow with minimal incisions as compared to traditional techniques—with minimal swelling, bruising, and scarring and decreased recovery time. Adverse effects associated with the use of this device include wound dehiscence, infection, minimal inflammatory tissue reaction, bleeding, nerve injury and transitory local irritation at the wound site.

As with any surgical device it is important for the surgeon to have proper surgical training and an understanding of how to utilize the iGuide®.