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Michael A. Bogdan, M.D., FACS
- Suite 170
410 N. Carroll Avenue
Southlake, TX 76092 - Tel: Click for phone number
- Fax: 817-442-1247
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- www.drmichaelbogdan.com
Answered Questions
Q:
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How soon after having breast reduction surgery is it safe to travel out of state. I will be having breast reduction surgery around the 28th of March, give or take a week. I need to travel out of state April 16th. Is this too soon after the surgery to be travelling?
A:
It is reasonable to plan a trip out of state 2 weeks after breast reduction surgery, but you should allow for flexibility. Assuming you have a normal recovery, you will be fine to travel. Delayed healing is always a possibility after surgery, and if this were to occur, you may want to adjust your travel plans. If you are having some type of healing delay, it will be evident within the first week after surgery and then you can adjust your travel plans accordingly.
Q:
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Is it wise for your health/safety and pain/recovery point of view to have a tummy tuck (with liposuction) and a breast lift with slight enhancement all in the same procedure? If this was done, how long would I have to wait before getting back to taking care of my two children, ages 7 and 11 years old. Also, how long before I can go back to driving?
A:
If you are a good surgical candidate (medically healthy, height and weight proportionate), then a mommy makeover procedure such as you describe is safe and makes sense. With any surgery, there are risks such as bleeding, infection, scar, blood clots, etc. For elective surgery such as this, I advise patients to choose procedural combinations that can be performed in six hours or less to reduce the chance of blood clots. From the standpoint of maximizing the results of your breast lift and augmentation (perky results with good scars), I'd recommend staging that combination of procedures, first performing the lift during the full makeover, and later performing the augmentation. The recovery period is dictated by the tummy tuck component. You should plan a "forced" vacation for 2 weeks where you have no responsibilities, after which you can safely plan to take care of your kids. Driving is OK somewhere between 10 to 14 days after surgery (you need to feel good enough to be able to make sudden turns or jam on the breaks without hesitation, and be off any prescription medications for 48 hours). Every surgeon has slight variations in their recommendations, so be sure to discuss these issues with your doctor.
Q:
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I recently underwent breast augmentation (silicone, undermuscle, crease incision) and was told by my physician not to massage the breasts. Yet I hear from many other patients that they were encouraged to massage the breasts at various stages post-op to help soften the implants and decrease the risk of capsular contracture. I am very concerned about the latter. What is your opinion about the safety of breast massage?
A:
You should definitely follow the instructions of your surgeon. Implant massage is a very specific intervention suitable for smooth implants that should only be performed if you doctor recommends it. The exercises are not appropriate for textured implants, and should not be performed. If you have textured implants and you displace them soon after surgery while there is a seroma, they may "fix" in the wrong position. (The only way to correct this would be a return to the operating room.) Always follow the advice of your surgeon, and do not self-diagnose and self-treat.
Q:
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In most cases is 21 months enough time to wait to have minor revisions done on a rhinoplasty?
A:
Yes. In general, you will need to wait one year after a rhinoplasty operation for the majority of swelling to resolve and scar contracture to occur before you can reliably assess the result and decide if a revision is indicated. There is on-going healing and edema resolution that will still take months to years to finish, but at 21 months you should be stable enough to make decisions regarding the risks vs benefits of revision surgery.
Q:
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If a woman was a cup size DD and had 454cc removed from each breast, what cup size would she be after the reduction was completed?
A:
There is no science behind breast size - the companies that make bras are not uniform in their sizing issues, and therefore shopping for bras is not straightforward. (If you find a bra that fits perfectly in one brand, you cannot just use the same number/letter combination to buy a bra from a different company. You will need to try on their bras until you find one which fits well, and it will likely have a slightly different size.) Also, it is not just a fixed volume that constitutes a “DD” size. Take this example: One woman is 5’2”, 130lbs, 32 DD, and the other is 5’9”, 190lbs, 40DD. Both have DD size breasts, but the second woman has much more breast volume than the first, as sizes depend on proportions to the chest (the number) as well as the body frame. Because of these issues, your question does not have a direct answer. You could be size A thru D depending on your height, weight, and chest circumference.
The fact that you are asking the question suggests that you had an insurance-based breast reduction, and are not happy with the resultant breast size. Insurance companies often require a reduction volume of approximately 500gm per side before they are willing to cover the cost of the operation. This is a discrete way to clarify if the operation is mostly a breast-lift (not covered) or a “real” breast reduction (covered). Insurance companies cover the operation to help alleviate symptoms (neck pain, bra strap grooving) that are related to breast weight, hence they can justifiably use a weight guideline to decide if the operation should be covered. Some women do quite well with insurance breast reductions (ie: large women with large breasts will end up with proportionate breasts that they are happy with), but some smaller framed women who have the “insurance standard” 500gm reduction per side may end up with breasts smaller than they desire. A small framed women with droopy DD breasts might only need 150 to 300gm removed per side if she desires a breast lift that results in proportionate C sized breasts - and this will not be covered by insurance.