1I had surgery 2 months ago for gynecomastia and right now my chest is swollen, full of lymph. Is it possible to insert a drain to make it deflate?
Gynecomastia, if treated with a liposculpture, sometimes involves swelling that can last for a few months but will resolve spontaneously. Unfortunately it is not a spill or an accumulation of visible liquid that could then be drained but a blockage of the micro lymphatic circulation. Compression girdles to be worn day and night and possibly lymph draining massages can help.
2If one has surgery in a private clinic, what should one look for? What must not be missing in the operating room? What do I need to ensure is present in case of unforeseen events or emergencies?
In Italy there is very strict legislation on the granting of authorizations to private health facilities. With regard to plastic surgery (and not aesthetic medicine) the minimum suitable structures are classified as Extra-Hospital Surgery Structures must have all the credentials be able to carry out all interventions both under local or general anesthesia, in daily hospitalization. These facilities must have, among other things, an agreement with a public hospital in the event of the need to transfer a patient with a complication or that requires hospitalization for longer than one day.
In addition to this type of clinic, there are other private entities of greater complexity such as Day Surgery facilities or Clinics with ordinary hospitalization. To answer the question, the patient does not have to check anything in particular but should simply verify that the clinic is of one of the aforementioned. In fact, there are state entities in charge (ASL and NAS) that carry out frequent and rigorous checks on all the necessary requirements.
3If a periprosthetic fluid flap is found on the breast upon ultrasound examination, does this mean that the prosthesis is broken?
Absolutely no. Finding a fluid flap around the prosthesis is extremely frequent and in most cases completely normal. A covering of connective tissue called CAPSULE forms around each prosthesis. Thin fluid layers of serum often form between the capsule and the prosthesis, which are completely harmless. This finding is more frequent with smooth prostheses and less with textured ones.
4After having breast augmentation I had an ultrasound and in the report it says bilateral presence of deep and multiple radial folds. What are those? Do I need to worry ?
In the absence of any type of disorder (eg stiff breasts, pain) or cosmetic defect, this report does not indicate anything worrying and is indeed a rather frequent finding. The silicone gel prothesis used in breast augmentation are not rigid "stones" but soft devices that can slightly change shape depending on the position one assumes. Instrumental examinations (especially Eco) often show folds on the profiles of the prostheses that are absolutely normal. Therefore, in the absence of other problems, there is no need to worry. The fact that the report indicates this from both sides is further reassuring. Otherwise it is good to contact your surgeon for a visit and possibly perform further tests (usually an MRI).
5I have had a submuscular breast augmentation, after how long can I have sexual intercourse without having problems with scarring and manipulation? And without revealing that I had surgery?
The recovery time after breast augmentation, regardless of the prosthesis housing plane, is about 1 month. This means that after this time the prostheses are usually stable and "fixed" in the right position, the wounds have long since healed and the scars are very resistant. Any residual discomfort after surgery has generally now disappeared. In these terms, it is more complicated. The scar can stay red for up to 6 months or more and during this time it is quite visible. In addition, the breasts in the first few months have a somewhat stiff consistency which takes some time to become loosen.
6What is capsular contracture?
The biological tissue that normally forms around each body implant is identified as a capsule. There is nothing strange or pathological about this. In some cases, attributable to about 1% of operated patients, this membrane tends to increase its thickness and become symptomatic. It can result in discomfort, stiffness and tension to touch with varying degrees of importance. This situation can first of all be prevented by using all possible measures to reduce the risk of peri-prosthetic collections of liquid (serum) or blood such as using drains for 24h after the operation . Last but not least, the use of first choice and absolute quality prostheses is essential (Allergan® or Mentor® are the most valid brands).
7Is it possible to carry out diagnostic breast tests with breast implants?
Absolutely yes. It will only be necessary to inform the radiologist or technician of the presence of the prostheses so that they can take the necessary precautions.
8How long do the protheses last?
Prostheses conceptually have an unlimited duration, being made of a material that is far more durable than human life itself. However, it may be necessary to resort to a replacement for various reasons (like peri-operative complications), for personal preference (to increase the size ) or because many years have passed (even more than 10) and the prosthesis no longer fits the aesthetic parameters of a body that has aged in the meantime. I generally advise patients to perform an MRI every 2 years after the first 10 years after surgery.
9Is sun exposure with prostheses contraindicated?
Yes. For the first post-operative month, the operated skin must not be exposed to UV rays. Beyond the first month and with adequate sun protection, exposure can gradually be resume
10Do breast implants prevent breastfeeding?
No. Breastfeeding is not affected. In some cases, it may be more likely to develop mastitis, which is pharmacologically manageable.
11Is the sensitivity of the nipples altered?
It depends on the type of intervention and the incision that is made. Usually it is not affected by incisions on the mammary sulcus, while it can be affected by incisions on the areolar perimeter.
12Is smoking a contraindication to surgery?
Generally yes. It is necessary to drastically reduce one's habits before the intervention. At least 4 weeks before and 2 after. Smoking reduces the vascularization and perfusion of the small capillaries, increasing the risk of infection and poor healing.
13Will I be able to wear all types of bra?
Personally, I give very precise references to my patients, who wear the post-operative bra (provided by me) for the first month and then I discourage the use of bras with underwire and even more with push-ups for at least 4 months. After this period, I always discourage the use of "bound" bras in favor of softer and more snug ones. The new breast, in fact, must not be supported in a drastic way but only wrapped and contained. Underwire bras can be worn occasionally.
14Are mastopexy scars very visible?
Although it is the breast surgery that involves the most extensive surgical wounds on the breast, they turn out to be hardly visible after a few months. Except for the exceptions in which there is a tendency to hypertrophy on the part of the skin of the predisposed patient, the vast majority of wounds turn out to be far less visible over time than the imprints left by the embroidery of the bras!