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Sleeping After a Breast Augmentation Procedure

Following breast augmentation, there’s always the potential for breast implants to shift and every effort should be made to avoid this problem. In the post-operative period, we recommend that patients sleep on their back for four to six weeks following surgery.

Sleeping on the abdomen or side in the early post-operative period has the potential to cause shifting of breast implants and should therefore be avoided. Sleeping on the back is difficult for some patients and they often move to their side without knowing it. For these reasons, we recommend that patients sleep in a recliner.

After six weeks, we allow patients to resume all their normal activities without restrictions.

What Is Coolsculpting?

Coolsculpting represents a significant advance in the treatment of problem fat collections. The technique has been clinically proven and has FDA approval.

The procedure involves placing an applicator over the involved area. Suction is then applied, which draws the soft tissue into the device where it’s held in place. The skin and fat are then cooled in a controlled manner. Upon completion of treatment, the involved area is gently massaged to smooth contour irregularities that have been created by the device.

When single anatomic areas are treated, the procedure typically lasts about an hour. Depending on the magnitude of the problem, multiple treatments may be necessary.

Commonly treated areas include the abdomen, flanks, hips, bra strap area, inner thighs, outer thighs, saddle bags and banana rolls.

In the vast majority of patients who undergo coolsculpting the results are excellent. The procedure is very safe and there appears to be no long term problems associated with the procedure.

Unfortunately, the procedure isn't for everyone. Patients with large amounts of fat or loose skin may need more aggressive procedures. In this group, liposuction or skin resections may be more appropriate. It is important to remember that the best results occur when there’s appropriate patient selection and expectations are realistic.

The Best Way to Prepare for a Mommy Makeover

The mommy makeover is one of the most extensive procedures performed in cosmetic surgery. For this reason, preparing for surgery in every possible way will not only improve your result, but the quality of the experience as well. It’s important to prepare physically, medically, and mentally for this procedure.

It’s important to be in good physical condition before proceeding with this procedure. Ideally, results are best when patients are within ten percent of their ideal body weight. In some cases, patients are unable to reach this goal. This group still benefits from the procedure. In addition it’s also important to maintain good nutrition, exercise regularly and maintain a healthy life style.

It’s also important to be medically ready for the mommy makeover. Patients should be extensively evaluated to rule out other medical conditions. Areas of particular concern include cigarette smoking, blood pressure management and the patient’s baseline hemoglobin.

Mental preparation for the mommy makeover is also extremely important and helps lower the anxiety levels before surgery. It’s important that you have a comfort level with your anesthesiologist, surgeon and the surgical facility. It’s essential that all your questions be answered so there are no surprises.

Arrangements for post-operative care also need to be in order. It’s important to have a care giver not only for yourself, but your children as well. Addressing as many of these issues as possible before surgery will significantly improve results and the quality of the experience. 

General Anesthesia vs. I.V. Sedation for Breast Augmentation?

It’s possible to perform breast augmentation utilizing either I.V. sedation or general anesthesia. Each approach has advantages and disadvantages and both approaches have advocates.

It’s important that the anesthesia be administered by a board certified anesthesiologist,
regardless of the type of anesthesia utilized. This is an important point, because I.V. sedation is occasionally administered without an anesthesiologist as a cost cutting maneuver. When this happens, your surgeon is also your anesthesiologist.

I generally prefer general anesthesia for a variety of reasons. I typically place implants beneath the muscle and feel that general anesthesia makes the experience more comfortable for my patients. With newer anesthetic agents, patients tend to recover quickly with less nausea and fewer side effects.

It’s important to discuss these issues with your plastic surgeon before proceeding with surgery. It’s important that both of you are comfortable with the choice of anesthesia. In some cases, it might also be helpful to meet with the anesthesiologist before proceeding.


Cosmetic Surgery and Nicotine Replacement Therapy

Nicotine causes vasoconstriction of blood vessels which results in decreased blood flow to the skin. Any procedure that requires the elevation of skin flaps can be adversely impacted by this phenomenon. For this reason we generally recommend that patients not use nicotine products for four to six weeks prior to surgery. This includes cigarettes, nicorette gum, patches or anything else that contains nicotine.

It’s important to understand that every patient’s situation is unique. For this reason, this approach may require modification from time to time based on the patients particular needs. Under these circumstances it’s always important to consider the patients risk benefit ratio. 

Simultaneous C-Sections and Tummy Tucks

Abdominoplasty isn't recommended immediately following a C-section for a variety of reasons. These include the inability to make aesthetic judgments immediately following pregnancy, the mother’s overall health status, and the demands of a newborn child on the mother.

The timing of surgery following pregnancy is important and several issues should be considered before proceeding with surgery. It takes time for a new post-pregnancy body to reach its new baseline following pregnancy, and during this transition, it’s impossible to make aesthetic judgments. During this period, stretched skin may contract, a swollen uterus may shrink, and the weight gained during pregnancy may gradually disappear. This process takes 3 to 6 months and needs to occur before abdominoplasty is performed.

Ideally, patients should be within 10% of their ideal body weight and in good health otherwise. The majority of women who have undergone C-sections aren’t in good physical shape and are therefore not optimal candidates for surgery for a variety of reasons. These may include severe fatigue, a depressed immune system, possible blood loss, an increased potential for infection and elevated estrogen levels which can increase the risk of blood clots.

Finally, the demands of a newborn would make the recovery from these combined procedures very difficult. For instance, the use of postoperative pain medications would prevent you from breast feeding. In other words, the abdominoplasty might impact your developing relationships with your newborn child.


For all these reasons, it’s obvious that C-section and abdominoplasty shouldn't be performed together. If you’re considering abdominoplasty it’s important to give yourself time to fully recover from your C-section. Once this has occurred it’s appropriate to consult a board-certified plastic surgeon.