Q-A from clee's blog

Q: Pain 23 days post op. Should I go back to see my PS?

Submitted by Q-A from clee on Tue, 06/21/2016 - 12:38

I'm Still feeling pain in the lower side section of my breast 23 days post up. It's actually keeping me up at night now as it is quite uncomfortable. I'm trying to to do too much but I have a baby and so at times I have to lift her. Should I go back to see my PS?

A: Duration of pain and discomfort variable among patients

The magnitude of the symptoms you describe are more than I would expect at 23 days following surgery.  While this may still be within your normal healing response, it would be best to have your surgeon provide reassurance that all is well by scheduling a visit with him/her. 

Q: I have a curved nose (similar to attached picture), and blocked nostril. Any suggestions?

Submitted by Q-A from clee on Thu, 06/09/2016 - 17:39

please guide me what should i do my nose was broken when i was 12 years, and size of my nose is increasing, mostly one of my nostrils blocks, either left or either right one.that's why i have to take breath from just one nostril and most of the time i have runny nose and excessive sneezing,now,

A: Septal deflection with asymmetry can be difficult but amenable to improvement

Thank you for the photo and question.  Your photo shows a substantial deflection of the septum leading to the severe nasal asymmetry and may be the cause of your symptoms.  A more detailed review of your history and examination is necessary before one can conclude whether this has arisen from previous trauma.  Most patients with asymmetries presenting in my practice are developmental and not the result of an extrinsic event.  

Nonsurgical injectables have no role for this type of nasal anomaly.  Surgical straightening of a severe septal deflection is a technical challenge with full correction often not possible. Nevertheless vast improvement can be anticipated with a good surgical plan and meticulous technique.  I recommend you seek out a reputable nasal surgeon in your community to review you options. 

Q: How to improve breast sensitivity, stop numbness in the nipple and make the area below it feel touch and changes in temperature?

Submitted by Q-A from clee on Thu, 06/09/2016 - 11:43

I went for a breast augmentation -2011(implants over the pectoral muscle/inframammary incision. I felt numbness under the nipple area and loss of sensitivity. After 1 year, no changes. I decided in 2015 to have the implants removed, but the surgeon ended up putting a smaller one not to make big scars or have a saggy breast. my scar is bigger now. I am looking on how to improve sensitivity (stop numbness in the nipple and area below it to feel the touch and changes in temperature.

A: Loss of sensation not likely to improve 5 years following breast augmentation

The nerves giving sensory innervation travel on the external (lateral) border of the breast.  These nerves are not easily seen and often suffer a stretch injury during breast augmentation from the pocket dissection and implant placement.  In the vast majority of patients, the nerves are intact but "stunned" (medically termed neuropraxia) and sensation returns to normal.  This sensation usually returns within 3 months but may require up to 18 months.  Persisting loss of sensation beyond 18 months suggests that the nerves have sustained a greater degree of injury with resulting permanent residual sensory loss.  Regrettably, implant downsizing / removal  are unlikely to alter the state of the nerve damage after your primary breast augmentation.  It would be worthwhile to discuss this prognosis in greater detail with your plastic surgeon.  Wishing you well.

Q: I Am 5'0, 125 Pounds is 440 in One Breast & 480 in Another Too Big for my Petite Frame?

Submitted by Q-A from clee on Wed, 06/22/2011 - 11:57

Met w/a surgeon today. I am 5'0, 125 pounds, chest width 34, hips 36.5, waist 30. Told him I liked the 400-450 implants after trying them on. At first he thought that would be too big for me. Then he changed his mind & recommended 440 in one & 480 in another due to one breast being larger than the other with a high profile implant (saline). Do you think I will look to big on a petite frame...should I go smaller?

A: Might be large for your stature

There is a great deal of subjectivity to the desirable sizing of breast implants in augmentation mammoplasty. One good rule of thumb is to choose implant dimensions not to exceed the base width of your natural breasts. This will prevent your augmented outer edge of the breast from bulging outward toward the inner aspect of your arm. I would recommend you review with your surgeon the implant footprint dimensions against your breast base dimensions so that the breast base width is not exceeded.

Q: Breast Reconstruction Options?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:45

I have been diagnosed with intermediate DCSI. My surgeon has performed a lumpectomy and the margins are not clear. Currently, it is considered 3.5 centimeters and was told I would need the 6-week radiation treatment rather than the 1-week because of the size. I would rather not do another lumpectomy at this time and do a mastectomy to be safe. I'm a heavy woman and am currently a DD. What is the best reconstruction option?

A: Mastectomy with sparing of skin and immediate reconstruction

Mastectomy with sparing of skin and immediate reconstruction is a good option as it avoids radiation and recurrence. Whether to spare the nipple, use your own tissue, or implant has much to do with your body habitus and aesthetic desires. DD sized breasts rarely have the nipple in a normal position and likely will require reduction in your breast skin envelope to yield an aesthetic breast reconstruction. It would be best to meet with an experience breast plastic surgeon to review the options, risks, and photos of the various surgeries.

Q: My Gynecomastia Surgery Was Not Completed on my Right Hand Side.

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:30

When I asked the Dr. at pre-op the amount of removal he said, "A lean guy like yourself, we can get pretty much get all of it" Area 1: Lipo was done on the very lower chest area of the left side. Skipped on the right. Area 2: Glandular tissue excised on the left side of the right areola. Skipped on the right. Area 3: Skipped and not as important to me. The surgery has made me more a-symmetrical. There is still irritation and tenderness just as before. What are my options?

A: More details and examination needed to advise

More details and physical examination necessary before useful advice can be offered. Specifically, preoperative photos, volume of tissue removed (by lipo and excision), duration of time since surgery would be helpful. Going on your photo alone without details as above would lead me to think that you have a good result.

Q: How long after "Popping" the Implant with Needle Should You Wait to Get Explant?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:20

I want to get my D cup size 10 year old implants removed as soon as possible. I was unhappy from day one but have been afraid to do it. I'm now psychologically prepared for the surgery and for what I'm going to look like after and it's well worth it to me. My question is - I plan to have them "popped" in a couple weeks in-office. After they are deflated with the needle, how long should I wait to get the actual implants removed? I don't know if I want a lift or not.

A: Popping them before surgery brings on more risk

Popping them before surgery brings on more risk. Proceeding straight to surgery for removal is preferable. If there is a desire to minimize the scar, the implant can be deflated under direct vision at the time of explanation.

Q: Took Aspirin Week Before Tummy Tuck. Do I Need to Cancel Surgery?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:14

A: Decision to be taken with your surgeon

If you are otherwise healthy and did not take other medications, the cessation of aspirin one week prior to surgery is likely sufficient. However, this is a decision you should take together with your surgeon.

Q: Is It Safe To Put Implants In After Radiation?

Submitted by Q-A from clee on Tue, 06/21/2011 - 23:01

I was diagnosed with breast cancer in May 2010 at the age of 33. I since have undergone a bi-lateral mastectomy...chemo and radiation. I am scheduled to begin reconstruction in Sept 2011. Due to the radiation on my right side would it be safer to do a DIEP procedure which is what my surgeon wants to do or can I just go with implants which is what I would like to do? Ive been checking up on it and have found alot of sights which say not to put implants in radiated skin

A: Bilateral DIEP is a good choice

So sorry for what you are going through. Radiated tissue generally reduces the quality of the soft tissues and increases the complication rate of implant reconstruction. An experienced surgeon in microsurgery and DIEP flap is recommended. There are substantial risks with DIEP's. However, preserving the abdominal muscularity in patients with bilateral breasts to reconstruct is worthwhile to reduce the risk with abdominal wall weakness. Wishing you the best of outcomes.