Breast Enlargement & Augmentation - Possible complications & how to avoid them
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Hello! My name is Adrian Richards, and I'm going to be talking today about some of the complications that can occur following breast augmentation enlargement surgery. So it's important to remember that although breast enlargement is a very commonly performed operation, it's generally very safe nowadays in the UK, as with any surgery problems can occur. It's important that you go into surgery being very aware of this. Okay complications can basically be divided into early complications and late complications. So I'm going to start off talking about the early ones which typically occur within 48 hours of the operation. Okay, so the main complication that occurs during that time is bleeding and this is because the surgeon has to divide the blood vessels and create a cavity for the implant to go in. If one of these blood vessels becomes reopened, the vessel will bleed and blood can collect around the implant. You will notice if this happens, it's normally very obvious if it happens and the breast will normally suddenly enlarge and become very firm and uncomfortable. That doesn't cause any long term problems but the difficulty is that you will need to be taken back to the operating theatre and your surgeon will need to find the bleeding blood vessel and cauterize it. So long term no significant problems but it's a nuisance, you will need another anesthetic normally within first 48 hours of surgery. And you need to be very clear with your surgeon that if it does occur, that it will be covered within the package. Okay, after 48 hours the complications that can occur, you normally, at about a week to ten days is infection and this -- you will notice this by generally feeling unwell, a bit fluey, high temperature, and the breast may become swollen and hard. Now you should have antibiotics in operating times. I typically would give you an IV dose of antibiotics just before you have the operation, so a high concentration in your blood during the operation and then two further doses of IV antibiotics after the operation. Now if you do develop any of these symptoms of potential infections, it's very important, you contact your surgeon immediately because the earlier we can treat with IV antibiotics, the more likely we are to be able to resolve the infection. So you probably need to be readmitted and have intravenous antibiotics straight into one of your veins. Now people who do get infections, approximately 50% of patients can keep their implant and the infection will resolve with antibiotics. But the other 50% need the implant removed normally for a period of approximately three months before the implant is reinserted. So how can you reduce the risk of that infection? Well I perform 250 implants a year and I would typically see zero to one infection a year. How can it be reduced? Well as I said before, a very good surgical technique. The second thing is IV antibiotics during the first 24 hours in surgery and the thing I think is very important is that the surgery is performed in the Laminar Air-flow Theatre. This is a special latest type of theater that -- where the air is changed every two minutes. So any potential bugs are flushed out within two minutes and most implant operations, particularly hip operations are performed in Laminar Air-flow theatre. So do ask your surgeon about that. Okay what problems can you get after two weeks, after three weeks? Well, the most common one is capsular contracture. So with the furry, textured implants that we use now, this is much reduced. But typically 3-4% of patients will get some hardening of their implants. No one knows why this occurs. It tends to be occur more in smokers, no one really knows why. How can you reduce the risk of this? Well, the main thing is to have the latest implants and the Allergan type of implants have got the lowest recorded capsular contracture of 2%. So I would advocate that you to think about those. Discuss with your surgeon his capsular contracture rate, if you do get
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