• What’s Done in the Operating Room During My Breast Augmentation?

    saturday-night-fever1

    Generally a huge party that you’re not invited too, since you’re asleep. Lots of dancing and jubilation.

    OK seriously, it’s surgery, so while you’re sleeping, I usually pick what music to listen to during the procedure (I prefer hip hop to opera), but that’s about the extent of the party. Here’s what’s really going on:

    1) Check-in/ Pre-Surgical Work-Up

    2) People in the O.R. – Who are These Masked People?

    3) Going to Sleep – Getting 3 Margaritas in 30 Seconds

    4) Surgery Procedure – Not even Michelangelo Can Compare to the Ego of a Plastic Surgeon Creating Perfect Breasts

    5) Waking Up- It’s Over Before You Know It

    6) Going Home- You’d Better Have a Pain Pump and Some Servants at Home

    Check-in

    Generally, you will be asked to show up a little early for your procedure. There may be some paperwork to fill out, and you will change into a lovely surgical gown that exposes your backside to the world – sorry, I don’t know if those will ever change. You will also probably get an IV placed in your hand or arm area. A nurse will take your vital signs- height, weight, temperature, blood pressure, heart rate, etc. You will also answer a bunch of questions about your medical health, who’s taking you home, if you have any questions about the medicine you will take after surgery, etc.

    Then you’ll wait a little while and try not be nervous. Hopefully there will be a bunch of 2-year-old magazines to read, or perhaps TV will be showing scenes from some natural disaster occurring somewhere in the world. Waiting rooms are awesome. And no, I don’t like to keep my patients waiting in there indefinitely contrary to what most people think.

    Then, you’ll meet your anesthesiologist, who will also talk to you and ask a bunch of medical questions about your health. He or she will probably also ask you to open your mouth and jaw, because this helps determine what kind of breathing apparatus is used during your procedure.

    I will stop in and say “hi”, and may make some drawings on you. These drawings help guide me during your operation, in terms of positioning of your breast implants, where to make the incision, etc.

    People in the OR

    When you’re brought into the OR, there are typically several people in there. You will already know the anesthesiologist. The scrub nurse will be someone near a big table with all of the torture devices, er I mean, surgical instruments. The person bringing you in will be the circulating nurse, a nurse that doesn’t assist during the actual surgery, but rather, makes sure you’re okay and will pass off instruments and get things for the surgical team. And, course, I’ll be there.

    Everyone will be wearing surgical scrubs, a hat, and a mask. During your procedure, everyone operating on you will be completely sterile- gloves, surgical long gown, the works. This is to ensure that nothing that has the potential to carry germs touches your surgical site, which can increase the chance of infection.

    Going to Sleep

    You will be given medicine through your IV to help you go so sleep. Modern anesthetics are super awesome- you go to sleep very quickly, and you wake up smoothly, with little nausea or vomiting.

    In my operating room, sometimes the anesthesiologist will ask you to count from 10 to 1 backwards while giving the IV sedation medicine. Most patients don’t hit the number 3. The medicine is THAT smooth and fast.

    Most patients say that they remember walking into the OR, lying down, and then waking up. Easy, peezy, lemon squeezy.

    In my OR, the anesthesiologists usually use a “BIS monitor,” which measures your brain waves to measure your overall sleepiness. This is a great tool to prevent being awake during surgery. We’ve all seen that terrifying episode of Dateline, right?

    Surgery Procedure

    During the procedure, I will make the surgical incision that you selected, create a pocket for the implant, put in the pain pump, and then put the implants inside. You will be placed in a sitting up position, as well as in the lying down position, to ensure that the positioning of the breast implants are even on both sides. Then, the incisions are closed. A surgical dressing and post-surgery compression bra will be placed on you. You will be gently awakened, and brought to the recovery room to be monitored.

    Waking Up

    The recovery room is the area where you will be spending some time to let the anesthesia medicine wear off, and a recovery room nurse will monitor you and make sure that you’re doing okay. Most patients only need to spend about 30-60 minutes here before being cleared to go home.

    You should not be in that much pain, especially if you have surgery with me. I give local numbing medicine at the beginning of the case, which helps with numbing pain relief right after surgery. Also, you have a pain pump, remember? It’s awesome, I know. Your breast implant pocket will get a consistent and low dose of medicine for the next 3-4 days, and this local numbing medicine starts working at the end of your operation, right before the incisions are closed.

    While you’re waking up, you will be able to answer questions correctly and talk to people, but you will not be able to remember most of these conversations. I ALWAYS talk to my patients right after surgery, but that doesn’t mean that they remember that conversation! The medical term is called “retrograde amnesia.” Don’t worry about embarrassing yourself- you talk normally, you have normal logic, you have normal conversational interaction. However, you simply won’t remember that particular conversation.

    Going Home

    Once you’re more awake and “with it,” you’ll be able to go home. You’ll probably be put into a wheelchair, and a nurse or a medical aide will help you get into your car.

    When you get home, you can chill out. Several of my patients report feeling well enough to go to the movies. If you’re going to be in bed, I recommend that your head and chest be elevated, and a pillow be placed under your knees, to help give you comfort and reduce swelling.

    Take it easy in terms of eating. The anesthesia slows down your GI tract, so you are more prone to nausea than usual. Stick with water, juice, electrolyte drinks, Gatorade, Vitamin Water, and broth-based soups before tackling solid food.

    Hopefully your cabana boy (i.e. husband, boyfriend, partner) will be ready to give you a foot massage, mani AND pedi when you arrive home. Remember, he’ll be wanting to get his hands on your new accessories as soon as possible, so milk it for all it’s worth.

     

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