Capsular Contracture Stage One

Stage I capsular contracture is essentially a normally soft breast implant. There are no signs of any breast implant hardening. The breast implant can move comfortably inside the breast implant pocket. Breasts are not painful and not tender to touch. Visible or palpable ripping of the breast implant shell may be present, but they are not an indication of breast implant scar capsular contracture. Excellent communication with your plastic and reconstructive surgeon is paramount before your breast augmentation surgery. Patients must select the appropriate size, style, and shape of implant which most suits their figure and needs. Excessively large implants increase the chance of capsular contracture. Placing the implants under the pectoralis muscle decreases the chance of capsular contracture. Textured breast implants have also been shown to decrease the risk of capsular contracture. Consultation with a plastic and reconstructive surgeon certified by the American Board of Plastic Surgery is the first step in assuring the best outcome. Patients must discuss their ideal breast size and look as well as implant type and location in order to optimize their outcome. Prevention of breast implant capsular contracture is the most important task after breast augmentation surgery. Patients should regularly massage breast implants, as breast massage has been shown to decrease the incidence of breast implant capsular contracture. If patients notice development of any change such as slight firmness at one or both breast implants, they should contact a plastic and reconstructive surgeon as soon as possible for an appointment. Close follow-up appointments with a plastic surgeon are important to treat timely and even prevent post-operative complications. So be sure to return for all of your follow-up appointments! Prophylactic antibiotics are indicated for any dental procedures or tooth cleaning within six months of breast augmentation surgery. Bacteria can travel via bloodstream to the breast implant causing an inflammatory reaction which can be the beginning of capsular contracture. Prevention of capsular contracture begins even prior to your breast augmentation surgery. Your plastic and reconstructive surgeon must discuss your ideal implant size, shape, material, location, and incision before breast augmentation surgery. Breast augmentation methods which reduce capsular contracture include placement of the breast implant under the pectoralis muscle (versus over the muscle), using textured implants (versus smooth implants), limiting handling of the implants and minimizing skin contact prior to breast implant insertion, and irrigation of the implant pocket with antibiotic solutions. Following breast augmentation surgery, regular follow-ups by plastic and reconstructive surgeons are paramount in minimizing complications. To stop a problem at its early stages is of utmost importance. Examination on the day after breast augmentation surgery is recommended. Another examination one week after surgery, followed closely by another follow-up three weeks after your surgery are also important. These early visits serve to minimize the risks of early complications from breast augmentation surgery. Capsular contracture may begin anytime after breast augmentation: from a couple of weeks to decades after breast augmentation. The intervals between plastic surgery office visits essentially double until patients reach the one year after surgery visit. The late follow-up appointments are to diagnose late complications after breast augmentation surgery. After the first post-operative year, patients should continue annual breast examinations by a plastic and reconstructive surgeon to evaluate patients' breasts for any masses, implant rupture, or capsular contracture. If patients are over forty, an annual mammogram is currently recommended to evaluate for breast cancer. If patients wish to have breast implants removed or exchanged, and they have normal breasts with a Stage I capsular contracture, patients' insurance company will not likely cover the expenses of patients' surgery. However, some insurance companies do cover the elective removal of normal breast implants. Insurance companies will never pay to have breast implants replaced. A patient's plastic and reconstructive surgeon can write a letter addressed to the patient's insurance company to request pre-authorization for implant removal surgery. Pre-authorization will improve the chances of insurance companies paying for implant removal surgery. Breast implant capsular contracture may occur anytime after breast augmentation surgery. Prevention of capsular contracture or tight scar formation around breast implants is the main goal in Stage I. Breast massage should begin by the second week after surgery once any pain has minimized. Regular breast massage, annual physical examination by a plastic and reconstructive surgeon, and mammograms after the age of forty are all imperative to excellent breast health.

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Surgery

An act of performing surgery may be called a surgical procedure, operation, or simply surgery. In this context, the verb operates means to perform surgery. The adjective surgical means pertaining to surgery; e.g. surgical instruments or surgical nurse. The patient or subject on which the surgery is performed can be a person or an animal. A surgeon is a person who performs operations on patients. In rare cases, surgeons may operate on themselves. Persons described as surgeons are commonly physicians, but the term is also applied to podiatrists, dentists and veterinarians. A surgery can last from minutes to hours, but is typically not an ongoing or periodic type of treatment. The term surgery can also refer to the place where surgery is performed, or simply the office of a physician, dentist, or veterinarian. At a hospital, modern surgery is often done in an operating theater using surgical instruments, an operating table for the patient, and other equipment. The environment and procedures used in surgery are governed by the principles of aseptic technique: the strict separation of sterile free of microorganisms things from unsterile or contaminated things. All surgical instruments must be sterilized, and an instrument must be replaced or re-sterilized if it becomes contaminated i.e. handled in an unsterile manner, or allowed to touch an unsterile surface. Operating room staff must wear sterile attire scrubs, a scrub cap, a sterile surgical gown, sterile latex or non-latex polymer gloves and a surgical mask, and they must scrub hands and arms with an approved disinfectant agent before each procedure. Prior to surgery, the patient is given a medical examination, certain pre-operative tests, and their physical status is rated according to the AS A physical status classification system. If these results are satisfactory, the patient signs a consent form and is given a surgical clearance. If the procedure is expected to result in significant blood loss, an autologous blood donation may be made some weeks prior to surgery. If the surgery involves the digestive system, the patient may be instructed to perform bowel prep by drinking a solution of polyethylene glycol the night before the procedure. Patients are also instructed to abstain from food or drink to minimize the effect of stomach contents on pre-operative medications and reduce the risk of aspiration if the patient vomits during or after the procedure. In the pre-operative holding area, the patient changes out of his or her street clothes and is asked to confirm the details of his or her surgery. A set of vital signs are recorded, a peripheral IV line is placed, and pre-operative medications are given. When the patient enters the operating room, the skin surface to be operated on, called the operating field, is cleaned and prepared by applying an antiseptic such as chlorhexidine gluconate or povidone-iodine to reduce the possibility of infection. If hair is present at the surgical site, it is clipped off prior to prep application. The patient is assisted by an anesthesiologist or resident to make a specific surgical position, sterile drapes are used to cover all of the patient's body except for the head and the surgical site or at least a wide area surrounding the operating field. The drapes are clipped to a pair of poles near the head of the bed to form an ether screen, which separates the anesthetist/anesthesiologist's working area from the surgical site. Anesthesia is administered to prevent pain from incision, tissue manipulation and suturing. Based on the procedure, anesthesia may be provided locally or as general anesthesia. Spinal anesthesia may be used when the surgical site is too large or deep for a local block, but general anesthesia may not be desirable. With local and spinal anesthesia, the surgical site is anesthetized, but the patient can remain conscious or minimally sedated. In contrast, general anesthesia renders the patient unconscious and paralyzed during surgery. The patient is intubated and is placed on a mechanical ventilator, and anesthesia is produced by a combination of injected and inhaled agents. An incision is made to access the surgical site. Blood vessels may be clamped to prevent bleeding, and retractors may be used to expose the site or keep the incision open. The approach to the surgical site may involve several layers of incision and dissection, as in abdominal surgery, where the incision must traverse skin, subcutaneous tissue, three layers of muscle and then peritoneum. 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