Breast Augmentation Recovery…how long does it take to get better.

With Spring Break and the summer bathing suit season a few months away I am seeing the usual ‘Spring rush’ for breast augmentation, which is the most common cosmetic operation in the US. Recovery period is a common concern for the patients and so I wanted to go over so generalities about return to work, exercise, swelling etc..

The biggest determinants of recovery are 1) placement location 2) Implant size and 3) your starting point. Implants that are placed below the muscle lead to more recovery than above the muscle. When the muscle is lifted and manipulated it swells and gets sore. Under hurts more than over. Larger implants stretch your tissue out more and so the more stretch the more pain. And the final aspect is how tight your skin is to begin with. If you have had pregnancies and your skin has stretched it will feel much less tight than say an A cup woman who has never been pregnant. Again, more stretching means more discomfort.

So how long will you be sore? Well, assuming you go under the muscle as most people do, the first two or three days post op are the worst. These first few days you will need to use your pain meds and muscle relaxants. These will help a lot and keep you comfortable but the side effect is you will be groggy. You will be mobile and able to do basic day to day things but you will be sore if you try to do too much to soon. Most patients, if they have a  desk job, are able to get back to work within 5-7 days. If you have a job that involves heavier lifting, pushing, pulling etc…you might need several weeks to recover. As far a exercise, you can start some light aerobic stuff at 2 weeks, but start slow. Full bore exercise is probably more likely at the 4-6 week point or longer.

Bras and Bikinis. Do NOT run right out and buy a whole slew of new bras and bikinis! It takes at least 6-8 weeks to even start to see what your final size and shape will be. Go buy some inexpensive bras at first to ‘bridge the gap’ from where you started to your end result. Your surgeon will be able to tell you when you can go shopping based on your exam.

Considering Breast Augmentation? Check out our websites at www.CorbettCosmeticSurgery.com or www.KentuckyBreast.com

Lee Corbett, MD

www.kentuckybreast.com

Split Earlobe repair. What’s this entail?

Split earlobes are fairly common, particularly amongst the women who had their heyday back in the ’80’s when larger, heavier earrings were the style. A second wave is also starting to hit my office with all of the gauging of earlobes. While a gauge deforms the lobe shape more than a common split, the repair process is fundamentally the same.

So what does the repair involve? Well, it’s actually a pretty quick procedure. I do it in the office and use local anesthesia. So the split or gauge area is injected with lidocaine®. The lidocaine stings a little bit but this only lasts a matter of seconds. The area is numb almost immediately. We clean the ear off to sterilize the skin and then the repair is begun. You can’t sew skin to skin, it would separate the minute the sutures were taken out, so I need to cut away the skin that  lines the split or gauge. This literally takes about 20 seconds. Then the earlobe is sutured back together with a very fine stitch. You will have stitches on the front of the earlobe and on the back. Total repair time is usually 10 minutes or less and then you’re on your way!

Sutures come out in one week and you can re-pierce in 3 months.

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

Preparing for your plastic surgery consultation…

I met a very nice patient a few days ago and we had a very different but very fun type of consultation. She was a 40ish lady and wanted to know what could be done about her face. The thing is, she couldn’t really tell me what she didn’t like, she just knew she “looked older” and didn’t like that part. She wanted me to analyze her face and help her figure it out.

Sooooo…off I went and we broke down every aspect of her face from top to bottom. We found a couple of minor issues that were easily addressed with a little Botox® and a couple of syringes of filler and she left the office happy BUT with some homework before her next visit.

Her ‘homework’, and I would recommend this to anyone before their facial aging consultation, was to sit down in front of her makeup mirror and simply make a list of what she saw that she didn’t like. I also asked her to do this with a photo in hand of her when she was in her mid 20’s so she could compare and really see what changes had occurred.

If you can give your plastic surgeon a very specific, detailed list, we can offer a list of “fixes” starting from easiest/least complicated up to surgery and that way you can decide which approach you want to take.

Lee E. Corbett, MD

Corbett Cosmetic Aesthetic Surgery and MediSpa

The misunderstandings about fillers…

About every other day I have someone ask me why so and so looks the way she does or why the celebrity of the day has “lips like that”? What they are questioning is the look you can get when you add a lot of filler, such as Restylane® or Juvederm®, to the lips or cheek areas. Usually it’s the lips.

Well, the thing is, it’s not the filler and it’s not the injector, at least not in my office, it’s the patient who is directing this. When we inject filler what you see is what you get right on the spot. Now in the day or two after you may have swelling or bruising that can slightly alter what the real result is, but that is transient. So the point is, when you see someone with really full lips, that you might think are overly plumped, well, they are that way because she wanted them that way. We don’t make that decision for the patient.

When we inject filler we have the patient there with mirror in hand. We treat and then have her take a look. If she likes what she sees we stop. If she wants more, we add more in small amounts until she is pleased. It’s that simple. So don’t be afraid of filler!  Fillers are GREAT products and are actually the treatment that is growing in popularity by the day. If you only want a mild to moderate correction/enhancement that is entirely possible.

Fillers are your friend!

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

Scar revisions…are they worth it?

As a Plastic Surgeon I get a lot of requests to check patients to see if they are a candidate for scar revision surgery. A lot of times the answer is a quick, easy “Yes” but not always. And when I tell the patient that I can’t help they are usually fairly unhappy so I want to go over what I, as a plastic surgeon, am thinking when I see a scar.

First, I want to know how old it is. It takes at the very least 6 months to get a good idea of what a scar may turn out like. A lot of times what looks pretty bad at a month or two ends up looking quite good by the 9-12 month point. 1 year is the usual point where I will consider a surgical revision.

Secondly, I want to know the circumstances that left the scar. If the scar resulted from a traumatic laceration I am more willing to consider revision. Traumatic lacerations are usually dirty wounds that involve a crush component to the wound edges. This is not very favorable and can leave a worse scar. If on the other hand, the scar resulted from a surgical procedure I am not quite as willing to take a revision on because the wound was already repaired by a trained surgeon under ideal circumstances.

Third, the location of the scar is important. Any scar over a joint, on the upper back, or the upper mid chest is not going to heal well no matter who sewed the cut up the first time. These areas are just very unfavorable. So location in important.

Your biology is important. If you have a keloid scar or a hypertrophic scar, well these are errors in wound healing that tend to be genetic. There are some things we can try to defeat these problems but unfortunately, especially with keloids, your genes win and the scar returns. Bottom line is some people just don’t heal as well as others and there is nothing I can do to change that.

Finally, if you have a scar and want it completely gone, well that is impossible. It ranks right up there with getting rid of stretch marks. Sounds good but it isn’t gonna happen.

So if you have a scar and your surgeon tells you “I can’t help” there are a lot of good reasons and probably a lot of experiences behind that statement.

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa

What are fillers and what can they do for me?

Basically, Fillers are injectable treatments that we use to help restore facial volume. If you are in your mid 30’s or above age wise, and you are at a normal weight, you are probably noticing that your face looks a bit thinner each year. A full face is associated with youth. Look at the Victoria Secret supermodels that are plastered everywhere, they are all about 6’0″ tall and 120 lbs but they all have these beautiful round, full faces. That’s because they are all in their teens and 20’s.

So, we use filler to help restore the volume to your face to help you look younger. Now, today’s fillers are an evolution from the Collagen injections of days gone by. The problem with collagen was that some people were allergic to it so you had to skin test them, then wait several days or weeks, then inject, but you had to over inject them because some was going to go away almost immediately so you never really knew what your result would be, and in the end the stuff went away in 3 months or so. And it was expensive. Bad combo.

Today’s most commonly used fillers are made of Hyaluronic Acid (HA). The two most common trade names for these fillers are Juvederm® and Restylane® which you can find in almost any plastic surgeons offices. These are FDA approved products to help fill deeper facial lines and restore facial volume. HA is what is known as a GAG, a gylcosaminoglycan and is already found throughout the body in your connective tissues. So it is already a part of your person and very safe to use. The companies that produce these products all of varying claims of their longevity but what we see is that most people seem to get about 15 to 18 months out of these fillers. The HA fillers are reversible as well so if the patient does not like the result they produce the product can be dissolved. We love them and their popularity amongst our patients and nationally increases every year.

There are more sophiticated fillers like Radiesse and Scuptra. These last much longer, are irreversible and tend to be more expensive. These products are typically used for patients who have had the HA products a couple of times, know they like the results, and want a longer lasting product.

If you have filler questions contact us and schedule a consultation via e mail at lyzah@corbettcosmeticsurgery.com or 502.721.0330.

Lee Corbett, MD

Medical Director Corbett Cosmetic Aesthetic Surgery and MediSpa.

Post Operative Swelling: When does it go away?

I was on Real Self answering more patient questions today and I am amazed by the number of questions that come in about swelling. Many of these patients have had surgery in the last week or two and are concerned because there is still swelling.

Any time you have surgery, particularly surgery on soft tissues (breasts, tummies, fat) , swelling is an expected normal reaction. There isn’t an operation in plastic surgery where you will see your final results in the first week or two. It just doesn’t work that way. It will usually take at least 4 to 6 weeks for most of the swelling to go away but it can also take between 3 to 6 months depending on what was done. Liposuction for instance will leave you swollen for 3 to 6 months. Now Smart Lipo laser lipo may leave you less swollen than traditional lipo, and you may swell less than your cousin, but everyone swells no matter the technique or the person. That’s just the way the human body heals.

So, if you are reading this and you are swollen post op you are probably healing completely normally. But, and this is the other thing I don’t get, if you are worried, call your doctor! Why turn to the internet for answers? You’ve researched and interviewed your surgeon and ultimately trusted them enough to let them operate on you. Listen to what they have to say.

3 to 6 months. That is normal.

Lee E. Corbett, MD

Board Certified Plastic Surgeon

The 3 P’s of Medi-Spa safety

The idea and a lot of the content of this blog comes directly from the ASPS website blog but it is really informative and so I thought I would copy it and add some additional thoughts. MediSpa treatments are a group of minimally invasive things that usually involve an injection. What we are talking about here are things like Dysport, Botox, Juvederm, Restylane, Perlane, Sculptra, Radiesse, chemical peels and lighter laser/IPL treatments. So what are the 3 P’s? Product, Place, and Practitioner.

Product: Know what product your MediSpa is using. If you haven’t heard of a particular product or heard of it being used in the manner being proposed ask some questions. A great example of this is the Botox and Dysport debate. Botox is used to smooth wrinkles around the eyes and forehead. It is the market leader and everyone knows it by name. Well, Dysport is effectively the same product. But, it is produced by a British company and doesn’t have the same name recognition. So here is an example of something you might not have heard of that is perfectly acceptable. The other end of the spectrum would be something like liquid silicone injections. These are bad. These are the plastic surgery horror stories that you can google. Research your products! Know what is being injected. If it isn’t FDA approved to be injected say “NO!”.

Place: I’ll be the first to admit I have injected close friends with Botox and Dysport in my kitchen. Very close friends. But if you are considering injectables, be it toxins or fillers, be safe with your choice. These are medical procedures. They need to be done in the proper environment. Injectables in hair and nail salons just isn’t a great idea. Honestly the chances of immediate problems with an injection is remote, but if, just if, something unexpected occurs, you want to be in the proper venue. Finally, let me comment on the “Botox Parties”. I know plastic surgeons and derms do these but I disagree. Injecting a group of women in someone’s home when there is alcohol involved just isn’t a great idea.

Practitioner: Who are you letting put that needle in your face?? Are they trained? Who oversees them? You need to know this. In a lot of offices the Plastic Surgeon does all of his own injections. That’s ok. A lot have a nurse or a nurse practitioner do their injections. For instance in my office, I do some toxin injections, but my RN, Lyzah, does most of them. But, before she injected anyone, she was trained by me and then 3 company approved trainers for the products. Then she injected me and all of my staff. Then she injected patients with me literally looking over her shoulder. Now she has injected 1000’s of patients and I have yet to see anyone with a problem. So a properly trained non MD injector is perfectly acceptable. But if you encounter an Aesthetician or LPN or Medical Assistant injector, I would be wary.

Lee E Corbett, MD

Board Certified Plastic Surgeon