Breast Augmentation through the Belly Button

The transumbilical approach to breast augmentation has advocates, but the vast majority of plastic surgeons prefer other surgical approaches. Surgeons, who prefer the transumbilical approach, feel that this procedure has a major advantage - less scarring. They believe that transumbilical incisions heal imperceptibly. They acknowledge that there’s a steep learning curve with this procedure and that there are potential problems with implant malposition. There’s no question that excellent results can be obtained with this procedure.

The majority of plastic surgeons prefer the transaxillary infra-mammary or peri areolar incisions. They feel that these incisions are associated with a decreased incidence of implant malposition. They also feel that scarring with these incisions is rarely a problem. 

They feel that the probability of implant malposition with transumbilical incisions is higher than the probability of adverse scarring with traditional breast augmentation incisions. 

It’s important to realize that surgeons have different comfort levels with different incisions.  They do their best work when they are able to use their preferred incision. Although good results can be obtained with transumbilical incisions there’s probably a good reason why the majority of plastic surgeons prefer traditional surgical approaches.   

Brachioplasty and Scarring

It’s not unusual for massive weight loss patients to develop redundant upper arm tissue. When this occurs it can represent a significant aesthetic deformity that can adversely impact self-esteem and self- image. When sag of this magnitude is present, the majority of patients require a full brachioplasty.

This procedure involves making an incision that extends from the axilla to the elbow. This approach removes excess skin in the vertical and transverse dimensions. Unfortunately, it’s virtually impossible to hide scars in this location. For this reason, brachioplasty patients are often dependent upon their wound healing characteristics for a good result. In other words, when wounds heal nicely, scars can be imperceptible; conversely, some patients will  have notable scars

                

The vast majority of patients tend to heal these incisions nicely, and the aesthetic results are excellent. Unfortunately, some patients form exuberant scar tissue, which can be very noticeable. When this situation occurs, these scars represent a significant aesthetic deformity which is difficult to hide. Under these circumstances, scar revision and long sleeve shirts may be the only options available for patients.

              

In the post-operative period, various maneuvers can minimize scarring. These include massage, topical creams, and silastic. If you’re considering this procedure it’s important to understand the potential for scarring and its irreversible nature. The majority of patients have excellent results, but occasionally patients are unhappy with scarring and request scar revision. 

Pain Management Following Mommy Makeover Surgery

The mommy makeover is one of the largest procedures performed in cosmetic surgery. This procedure has several components. These include breast augmentation, breast lift, abdominoplasty, and liposuction of the hips and thighs. The exact procedure performed in any particular case is dependent upon the specific needs of the individual patient.

Pain tolerance varies from patient to patient and is dependent upon a variety of factors. The vast majority of patients who have mommy makeover surgery describe their pain

as moderate. This pain is especially noticeable in the first 24 hours following surgery, but improves rapidly over the next week.

Patients are given narcotic pain relievers in the immediate postoperative period and switched to Tylenol 5 to 7 days postoperatively. It’s not unusual for patients to have pain, which is related to muscle spasm following this procedure. When this situation arises, muscle relaxants are extremely helpful as well.

If you’re concerned about postoperative pain management, it’s important to discuss this issue with your plastic surgeon. Your surgeon should be able to develop a plan that addresses your concerns. 

When to start basic cardio exercises after breast augmentation

Recovery varies from patient to patient following breast augmentation surgery. We generally recommend that patients avoid strenuous activities including running for at least six weeks following surgery.

Running in the immediate post-operative period has the potential to cause the breast to bottom out. The constant bouncing of the implants within a freshly formed breast pocket can cause the pocket to expand inferiorly. Capsule formation acts to stabilize the implant pocket, but may take weeks to occur. In some cases, two weeks may be adequate, while longer periods may be necessary in other cases.

Physics suggest that larger implants would be more likely to stretch the pocket and skin, while compressive support bras would minimize the phenomena.

Early resumption of strenuous activities such as weight lifting may be associated with post-operative bleeding and hematoma formation as well. For this reason, these activities should also be avoided.

In some cases, low impact cardio exercise such as elliptical, spinning and stair stepping exercises may be resumed as early as two weeks following surgery.

It’s very hard for women who exercise regularly to give up their work out routines. For these patients, it almost represents an addiction. If you’re considering an early return to strenuous exercise, it’s important that you discuss the issue with your plastic surgeon before proceeding. Your surgeon will have important information regarding your situation and when it’s safe to resume all activities.