Breast shaping surgery consists of a set of procedures and techniques aimed at improving the shape, symmetry, and scarring of the reconstructed breasts after the initial surgeries are complete. These procedures are individualized for each patient based on conversations with the patients and the plastic surgeon’s assessment of the patient’s needs and desires.
Dr. Jeremy Williams and Dr. Christopher Williams at The Breast Center Park Meadows Cosmetic Surgery will ultimately help you decide if additional contouring or scar revision procedures will help with the overall aesthetic outcome of the reconstruction.
These breast shaping surgeries are usually the second stage of an Autologous Breast Reconstruction, when a woman’s own tissue is used to recreate the breast mounds after a mastectomy. When a tissue expander is used in an implant-based breast reconstruction, we also perform these same breast shaping surgeries to help smooth the contour lines of your breast.
For more information about these and other reconstructive procedures, please call 720-457-4461 to schedule your initial consultation.
Ensuring Natural Results
Although there is a saying, “breasts are sisters, not twins,” we try to make the sisters match as closely as possible. Breast shaping surgery also includes “matching procedures” for the non-cancer breast in women who choose to undergo a unilateral (one-sided) breast reconstruction.
During the second or third stage, our surgeons will perform some additional shaping to help make adjustments to the reconstructed breast or the non-cancer breast in an effort to make the two breasts more symmetrical. These adjustments can include:
During these revision surgeries, whether unilateral or bilateral, fat grafting can be used to help soften the edges around the implant, if needed, and can also fill contour defects which may appear during the settling process.
When fat grafting is used for breast shaping surgeries, the patient’s own fat is harvested by liposuction techniques from donor areas such as the abdomen, flanks, and thighs, then the fat is transferred to the breast area to gain a smoother, shapelier contour. Fat grafting is normally an outpatient procedure, and often takes place at our state-licensed, The Joint Commission-accredited Park Meadows Outpatient Surgery.
Our surgeons can perform additional shaping to the breast and at the same time recreate they nipple. If no additional shaping is needed, Nipple Reconstruction can be performed alone under a local anesthetic at Park Meadows Outpatient Surgery. Three or four months after the nipple has been reconstructed, pigmentation is placed around the nipple to reconstruct the areola and the reconstruction process is then complete.
Types of Anesthesia for Surgery
At The Breast Center Park Meadows Cosmetic Surgery, you will have your surgical procedure performed in one of the only dedicated cosmetic surgery centers in Colorado that is both fully state licensed and The Joint Commission-accredited. We are proud to care for your anesthesia needs with one of our board certified anesthesiologists from South Denver Anesthesia.
Our board certified anesthesiologists will be with you from beginning to end insuring your comfort during the surgical procedure. Anesthesia choices include intravenous sedation and general anesthesia. Your doctor and anesthesiologist will recommend the best choice for you.
Preparing for Surgery
At least 1 month prior to surgery
Stop smoking at least 1 month prior to your procedure. Smoking reduces circulation to the skin, impedes healing, and can lead to serious postoperative complications.
2 weeks prior to surgery
Stop all medications that can thin the blood 1-2 weeks prior to surgery. These include drugs such as Aspirin, Coumadin, Lovenox, Ibuprofen, Vitamin E, and multiple herbal preparations. These medications may cause bleeding during and after surgery. Please see the warning about blood thinning medications on our website for a list of drugs that must be stopped.
1 week prior to surgery
Report any sign of a cold or infection that appear the week prior to your surgery. You may need to postpone your procedure to avoid unnecessary complications. Make sure you fill all of your prescriptions provided to you by our doctors prior to your surgery day; this will make the transition from the surgery center to your home as smooth as possible.
The day before surgery
Do not eat or drink anything after midnight before your surgery. This includes water, ice, or hard candy. The only exception is that you may take your blood pressure or heart medication with a sip of water the morning of surgery.
The day of surgery
What to Expect on the Day of Surgery
When you arrive, you will be escorted to a preoperative evaluation area where you will be asked to change into a gown and will be given foot covers. Your surgeon and the anesthesiologist will meet with you before you enter the operating room suite. During this time, the surgical consent form will be reviewed with you in detail and special markings may be made on your skin at the surgical site. You will have the opportunity to ask any last minute questions.
Once in the operating room, you will be transferred to our padded operating room table. A nurse will start an intravenous drip in your arm and connect you to monitoring devices. The anesthesiologist will give you medication through your intravenous drip to make you feel drowsy.
When your surgery is completed and your dressings are in place, you will be moved to the recovery room. During this period a recovery room nurse will assure your comfort and continue to monitor you closely.
Your stay in the recovery room will last approximately 1 to 1 1/2 hours. Most patients are fully awake within 30 to 60 minutes after their surgery, but they may not remember much about their time in the recovery room due to some of the anesthesia medication. Once you are ready for discharge, a postoperative appointment will be scheduled and your discharge instructions will be reviewed.
You must have a responsible adult drive you home from the surgery center. This individual should have your prescription filled at the hospital pharmacy prior to taking you home. A responsible adult must stay with you the first night after your surgery because you have been sedated.
Post-Operative and Home Care Instructions for Revision of Reconstructed Breast with Fat Grafting Surgery
Start with clear liquids and toast or crackers. If those are well tolerated, progress to a regular diet.
Keep your dressings clean, dry, and intact for the first week. Your surgeon will take down your dressing at your 1-week follow-up visit. If your dressings get wet while showering, pat them dry. If the dressings fall off, replace with dry gauze.
You will have an abdominal binder to wear for approximately 3 to 4 weeks following your surgery. This garment is used to compress the areas of liposuction to promote healing and reduce swelling. It is important to wear this compression garment until your doctor tells you it is no longer needed. If desired, you may switch to a control-top garment (Spanx) for prolonged wear.
You may shower and wash your hair 48 hours after surgery. You may get your incisions wet, but do not direct the water spray at your incision site. Pat dressings dry. Do not submerge the incision in a bath or swimming pool or hot tub for the first 4 to 6 weeks.
Take pain medication as needed for up to 4 weeks in moderation and at night if needed. While you are taking pain medicine, you are encouraged to follow a high fiber diet or take a stool softener such as Colace (available over the counter), as pain medications tend to cause constipation. Do not take Motrin/Ibuprofen or Aspirin products for 1 week after surgery. Ask your surgeon when you may resume your blood thinning medications. All other prescription medications may be resumed immediately, as discussed with your physician. Take your full course of antibiotics if prescribed by your surgeon.
You may walk and climb stairs immediately following surgery. After 2 weeks you may resume moderate activity such as brisk walking. During the first 3 weeks, do not lift anything heavier than a gallon of milk. After 6 weeks you may resume more strenuous aerobic work and lifting activities.
No driving for 48 hours after your procedure or while taking pain medicine.
Smoking, Alcohol, and Cannabis:
Do not smoke for the first several weeks after surgery as it impedes wound healing and can lead to serious wound complications. Alcohol consumption and smoking of any kind is dangerous while taking pain medicine. It has a tendency to worsen bleeding. If you use cannabis/marijuana, please discuss with your physician.
Your first follow-up visit will be approximately 1 week after surgery. Your surgeon will then see you at appropriate intervals after this to monitor your progress.
Depending on your career and your rate of healing, you should be able to return to work within 1 to 2 weeks of surgery. Your surgeon will be able to give you a better estimate depending on your physical and professional profile.
Call your surgeon immediately if you experience any of the following: excessive pain, rapidly expanding swelling under the skin, bleeding, redness at the incision site or pus drainage from incision, spreading bright pink discoloration, or fever over 101.5° F.
Call 911 if you are experiencing a life-threatening emergency. Such symptoms include severe shortage of breath, chest palpitations, sudden or sever chest pain, or other life-threatening concerns.