What Are My Chances of a Complication After Breast Surgery?

Vacation photo by Dr. Yoho

Breast surgery recovery is relatively predictable, but the most important predictor of an individual’s surgical result is their psychological and physical preparation before the surgery. Their breast shape and size often dictates how good a result can be obtained, and although we can make great improvements in many cases, certain breasts are just very difficult to make perfect. In particular, patients with long, skinny breasts or very droopy breasts require fairly extensive surgery which is significantly less predictable than just inserting an implant. Additionally, we absolutely refuse to put an implant in at the same time as a breast lift is performed. The implant pushes out on the repaired area while the little stitches and the tissue try to heal and hold the breast implant in. This is a recipe for repeat surgeries, and there are a significant number of articles in the medical journals that recommend that breast lifts not be performed at the same time that an implant is inserted. 

The complications that occur with breast surgery include about a five percent rate of hardening or capsular contracture over the life of the implant. If this happens, you need to report back to us as soon as possible, because there are medical ways to treat it. 

Other potential complications include: infection, but this has a very low rate at less than one percent; blood buildup around the implant which might need to be taken out within a few days, and variations in shape and position that may be related to the surgery or it may be related to the shape and size and contours of the pre-existing breast. 

Touchups are just a few percent of what we do, but if we consider the result imperfect and a touchup appropriate, we do breast touchups at no charge. Come in and see us for a free consultation.


Breast wishes,


_________________________
Robert Yoho, M.D.

What to Watch For After Your Breast Surgery

One of Dr. Yoho's children during a beach vacation

First, the surgeon may have taped areas of your breast or given you a special bra or binding to wear after your breast implant. We generally use an elastic dressing which should be removed at 24 hours, and a bra should be applied or the bra which is underneath the elastic should be left on. Checking on the breasts at 24 hours is always desirable, because one of the rare complications of breast implant surgery is blood buildup around the implant, and sometimes this has to be removed within a few days to prevent a breast capsule or hardening.

We always emphasize the following in follow-up visits: First, good support bras are exceedingly important and we really like the Bali Minimizer bra for this. There are some exceptions, so some women need to wear no bra or a bra that doesn’t offer much support for the initial period after the breast surgery.

Secondly, we recommend 800 IU of Vitamin E each day taken orally, which can be purchased at any health food store. This should be taken indefinitely and may significantly decrease the chance of hardening or capsular contracture of the breast. We also believe fish oil is a great boon to decrease inflammation and also decrease the chance of capsular contracture. We recommend a teaspoon of liquid fish oil a day, which is the equivalent of four to five of those large fish oil 1,000 mg pills taken with food, and sometimes we recommend more if the patient is starting to have trouble with a capsule for short periods of time. Note that you can buy this on vitacost.com and we recommend several brands, including Carlson’s or Nordic Naturals or Eskimo brand fish oil, all of which have very little fishy taste.

Breast wishes,

_______________________________

Robert Yoho, M.D.

Does Dr. Yoho Touch Up Other Surgeons’ Cosmetic Surgery?

Dr. Yoho loves to visit Yosemite with his family

We are happy to have a look at problem surgeries. Sometimes patients lose faith in their surgeon due to a surgical complication or sometimes due to inexpert work or personality problems. We are happy to evaluate these people on a case-by-case basis and as long as your attitude is good and you don’t have an unreasonable expectation about your result, we’re happy to help. Note that in some cases it may be tougher to get quite as good a result in the secondary case as if we operated to begin with, because of scarring issues or healing issues and sometimes because of psychological issues. We work hard on surgeries such as “tummy tuck tune-ups,” which involve liposuction of the appropriate areas surrounding a surgery which was originally a tummy tuck. Some people have weight gain after liposuction or tummy tuck, and these cases can be improved a great deal also. We also have the ability to touch up the “pixie ear” of a facelift which has been inexpertly performed. Sometimes this involves a small touch-up facelift, and the general rule of thumb is that waiting at least four to six months after the prior surgery is the best policy. The cases that are even farther from the original surgery than this, that is, several years afterward, sometimes react even better to the touch-up surgery, because the tissues have had time to completely mature. 

The rule of thumb in soft tissue work is that four months is a minimum before a repeat surgery is done in general. However, we believe that healing processes, especially in darker skins, can go out a year or more. In orthopedic surgery, or bone surgery, just as a matter of interest, the healing curve is two years or even longer. Dr. Yoho has experienced this himself with his own adjustment to a foot fracture which is much better at three years than it was at two years.

But in any case, please feel confident to have a free consultation at Dr. Yoho’s office for other surgeons’ work and we’ll see if we can improve things. And we’re happy to give opinions about what we think would be beneficial or how improvement might be best effected.


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Robert Yoho, M.D.