1. DOES AESTHETIC BREAST SURGERY LEAVE SCARS?
All surgical incisions leave scars. By utilizing suture techniques and surgical material of good quality, we try to achieve the most discreet scar as possible. Unfortunately, the scar quality does not depend solely on these factors. Each person's genetic characteristics and type of skin also play an important role in this result. Some people have the tendency to develop hypertrophied or keloid scars. Today, this problem can be easily solved with radiotherapy (beta therapy) treatment during the immediate post -op period.

If this tendency is only lately diagnosed, a second surgical time will probably be necessary (exeresis of the scars) under local anesthesia, when we will be able to carry out beta therapy.

For further information about scar evolution, there follows some information about the several phases of the scar healing process.

a. Immediate period: it lasts as far as the 30 th day and the scar shows already an excellent and hardly visible aspect. Some cases present discreet reaction to the stitches and to dressing.

b. Mediate period: it lasts as far as the 30 th day until the 12 th month. During this period, the scar naturally thickens and goes through a change in its color, turning darker (from red to brown) but little by little it becomes clearer. This period is the less favorable of the scar evolution and it is what worries the patients the most. As we cannot accelerate the natural healing process, we recommend that the patients should not be worried about this since, in a later period, the scar remains will surely diminish.

c. Late period: it lasts from the 12 th to the 18 th month. During this period the scar turns clearer and less consistent and reaches its definitive aspect. Any assessment of the final surgery result concerning the scar should be done after this period.


2-  WHERE ARE THE SCARS LOCATED?
The scars location may vary according to the technique utilized. Generally, there is an inverted “T” scar on the lower area of the breast. Another one, which is hardly seen because of the color transition between the areolas and the regular skin. As time passes, (see the previous item), the scars become rather disguised and, in some cases may even become invisible.


3. I HEARD SOME PATIENTS END UP WITH VERY VISIBLE SCARS.
This happens when the patient has the tendency to develop hypertrophied and keloidean scars. But it can be treated with radiotherapy, as it was previously explained in question 1.

4.CAN HYPERTROPHIED SCARS BE CORRECTED?
We have various both clinical and surgical resources available which allow us to treat non-aesthetic scar at a proper time. However, we should not regard the mediate period of the normal scar healing process (from the 30 th to the 12 th month) as a scar complication. You should ask us for clarification about any doubt you may have on your scar evolution.


5. HOW WILL MY NEW BREASTS LOOK CONCERNING SIZE AND CONSISTENCY?
This surgery can reduce the volume of the breast. Besides, both its consistency and shape can also be improved. If the case requires both reduction of the volume and a lifting up, we can choose among various possibilities of volume but the planning of the new breast will be done according to the original breast's workability.

a. Immediate period: It lasts as far as the 30 th day. During this period, although the breasts already present a rather natural aspect, the shape still has not reached its desirable result. This definitive form will only appear after the rotation movement of the breast and after the edema decreases.

b. Mediate period: it lasts as far as the 30 th day until the 3 rd month. During this period, the breasts develop towards the definitive form, which will only be reached after the 3 rd month. Certain insensitiveness on the nipples and some degree of swelling are common during this period. The shape is still far from the definitive one. Although the patients already feel very happy during this period, we usually tell them that the result will get even better during the late period.

c. Late period: it lasts from the 3 rd to the 12 th month. During this period, the breast reaches its definitive aspect (scar, shape, consistency, volume, sensitiveness, etc.) It is during this period that we generally take the post-op photos to compare with pre-op ones. The breast skin elasticity as well as the volume reached will be rather relevant to the final operation result. The balance between both of them varies from case to case.


6. WHEN WILL I BE ABLE TO SEE THE FINAL RESULT?
Although the immediate result is of very good quality, only during the late period will the breasts reach their final shape (see previous item).


7. IF I BECOME PREGNANT IN THE FUTURE, WILL I CAUSE ANY DAMAGE TO THE RESULTS?
Generally, no. But we recommend a time interval of one year between surgery and pregnancy and a strict weight control in order to maintain surgery results. Very hypertrophied breasts usually have little lactation. Surgery does not interfere in lactation.


8. DOES THE post op period cause pain?
No. This post-op is painless as long as you follow medical instructions during the first days, mainly concerning arms movement.


9. IS THIS OPERATION DANGEROUS?
Rarely does mammaplasty present serious complications. This is so maybe because the patient is conveniently prepared for the surgery and we also ponder on the convenience of simultaneously associating mammaplasty with other surgeries. There are risks inherent to any surgical procedure, which we try to minimize with pre and post op cares.


10. what kind of anesthesia will BE UTILIZED?
General, peridural or associated. According to the anesthetist's judgment.


11. HOW LONG DOES SURGERY TAKE?
It depends on each type of breast, but it is generally around 3 hours.


12. HOW LONG DOES HOSPITALIZATION TAKE?
Local anesthesia: 12 hours
General anesthesia: 24 hours.


13. ARE DRESSINGS USED?
Yes. Dressings with surgical tape and a bra for 15-30 days. These dressings are changed on a regular basis by the medical team.


14. WHEN ARE THE STITCHES REMOVED?
They are removed around the 8 th -15 th day and no trouble is involved.


15. WHEN I BE ABLE TO TAKE A COMPLETE SHOWER?
Generally, after two or three days. Some cases may require special care on the operated area and we recommend it should not get wet for 8 days. Follow medical instructions.


16. HOW IS POST-OP EVOLUTION?
During the first week the mamma is swollen and may cause some aching sensation. The arms and trunk movement will suffer natural restriction due to this little discomfort. Little by little, the movements return to normality. You should ask our clinical team for clarification. You recommend that you follow the instructions below:

a) No sun direct exposure before 45-60 days; b) do not practice any physical exercise, sports or any activity which may cause traumatism on the operated area before 45-60 days; c) do not drive until your doctor allows you to. This will vary from case to case, depending on the make of the car, etc. Remember you will only reach the definitive result in the second month of the post-op period. It is impossible to reach the desirable result before the body naturally responds to the surgical trauma.


17. WHEN WILL I BE ABLE TO RESTART MY PHYSICAL ACTIVITIES (GYMNASTICS, ETC.)
Generally after 45 days but at a progressive rhythm.


18. ULTIMATELY WILL I GET A DEFINITIVE RESULT WITH A SINGLE SURGICAL PROCEDIRE?
Generally, yes. Our aim is that the patient achieves the ideal shape in the most natural in aesthetic manner as possible. Some intercurrence may turn necessary a second surgical time. So the result can be better. This rarely happens but when necessary, it is done under local anesthesia, in a comfortable manner.