Logo Roy Kim, MD
San Francisco Plastic Surgery

call us at 415.362.1846

220 Montgomery Street, suite 348
San Francisco CA - 94104

What is the Recovery Process After Breast Reduction?

9
Dec

LOS ANGELES, CA - AUGUST 23: Actress Drew Barrymore arrives at the premiere of Warner Bros. 'Going The Distance' held at Grauman's Chinese Theatre on August 23, 2010 in Los Angeles, California. (Photo by Jason Merritt/Getty Images)

Breast Reduction is a surgical procedure to reduce the size of very large breasts. Very large breasts, or macromastia, may cause neck, back, and shoulder pain. Reducing the volume yet enhancing the appearance of your breasts is possible with surgery. Recovery after surgery is surprisingly short and not too painful.

Breast Reduction surgery is typically done on an out-patient basis. The procedure takes about 2-4 hours, depending on your individual situation and amount of surgery required. Your recovery depends on the amount of breast tissue that needs to be removed, the amount of tightening performed, and the actual procedure being done, as well as your individual pain tolerance.

The 2 major surgical ways to reduce breast reduction include an “upside down T incision” (inferior pedicle breast reduction), and a “lollipop” incision (vertical limb or vertical mastopexy breast reduction). Your type of surgical approach and incision depends on your breasts, the amount of breast reduction needed, and surgeon preference. There is an increased preference for the “lollipop” incision over the past several years, since it has a slightly less noticeable scar length.

The recovery after breast reduction takes several weeks to months after your procedure. Most of the healing occurs and swelling disappears within the first month or two after your operation, but it takes a total of 6-12 months for all of the healing to complete. It will also take several months for your breasts to “drop” and look more natural, as opposed to the swollen appearance they have right after surgery. Every patient is different, and communicating closely with your plastic surgeon is the best way to have realistic expectations about recovery after your breast reduction.

Your breasts will be swollen and possibly bruised right after surgery. Compression in a surgical bra, icing, rest, and elevation of your chest will all help to lower the amount of swelling and pain you have right after surgery.

Using a pain pump right after surgery will also decreased your pain during your recovery after breast reduction surgery. Pain medicine can be delivered directly into you breast tissue, which gives you a large amount of pain relief directly to the areas of surgery. This usually translates into less pain medication usage after surgery as well.

May patients can start using anti-inflammatories that are not prescription strength several days after surgery. Everyone has a different pain tolerance, so your recovery after surgery may differ.

Most patients in my practice return to office work within 1 week of surgery. Light exercise is possible right after surgery. Vigorous exercise may take 2-4 weeks after breast reduction surgery, because of the need to wait for the skin incisions to fully heal.

Most of my patients will only need antibiotics for several days after surgery to prevent infection. It is not common to need antibiotics for greater than 5 days after a breast reduction surgery in my practice.

You are placed in a surgical compression bra right after your breast reduction procedure. You should wear this type of bra, or a sports bra, for several weeks after surgery to allow the swelling in your breasts to reduce, as well as to maintain an overall aesthetic shape. Your plastic surgeon will generally go over with you when it’s safe to resume wearing a regular bra.

 

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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What Causes Breast Implant Rippling, and How Can I Avoid it?

8
Dec

Young Shar-pei

Rippling or wrinkling occurs when the edge of your breast implant can be seen or felt underneath your skin after your surgery is completed. There are several ways to reduce this rare complication, and your choices before your breast augmentation procedure may affect your long-term aesthetic results.

Choosing silicone breast implants over saline breast implants is a crucial choice to reduce rippling. Because the of the nature of the filler material of silicone gel versus saline solution, a silicone breast implant will have a lower risk of wrinkling than a saline breast implant.

Placing your breast implant under the muscle will also reduce your risk of feeling the edge of your breast implant. The more “stuff” covering your implant, such as skin, breast tissue, and muscle, will lower the chance of feeling the edge of your implant after your breast augmentation.

Patients who are very thin may be at increased risk of rippling. Even thought a silicone breast implant may be under the muscle, if you have little body fat, you may be able to feel or see the edge of your breast implant. You may find this more noticeable when you are standing up, and then you lean over and feel the side of your breasts.

If you notice breast implant edges, you may find it more noticeable on the sides of your breasts. This is because there is little to no muscles on the sides, near the underarm area. The pectoralis muscle that covers your breast implant is thicker and more prominent over the top, middle, and bottom sections of your breasts, and not very thick on the sides.

Choosing silicone breast implants under the muscle before your breast augmentation procedure is the most direct way to reduce the risk of breast implant wrinkling or rippling. If you have saline implants, or have them placed above the muscle, or both, then you may wish to have the breast implant or position changed to reduce the ability to feel the edge of your implants.

 

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Remember Pearl Harbor

7
Dec

. . . we here highly resolve that these dead shall not have died in vain . . . Remember Dec. 7th! Color poster by Allen Saalberg, (Edisto Images)

Survivors of the attack on Pearl Harbor render honors to a joint service color guard during a joint U.S. Navy/National Park Service ceremony in Pearl Harbor, Hawaii, Dec. 7, 2008, to commemorate the 67th anniversary of the attack on Pearl Harbor. The theme of this year's historic commemoration, Pacific War Memories: The Heroic Response to Pearl Harbor, emphasized the brave efforts of those who fought at sea, on land and in the air to turn the tide in the Pacific. More than 2,000 distinguished guests and the general public joined U.S. service members, Pearl Harbor survivors and their families and friends for the annual observance. (U.S. Navy photo by Mass Communication Specialist 2nd Class Michael A. Lantron/Released) (Edisto Images)

US Flag flying off the back of the USS Arizona in Pearl Harbor, Oahu, Hawaii, USA

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What is the Best Anti-Bruising Cream After a Facelift?

6
Dec

Bruised pear with band-aid on red background

After your facelift, you will probably want to minimize swelling and bruising after your procedure. To heal faster and reduce bruising as much as possible, there are several  creams which may help reduce bruising.

The best herbal cream to reduce bruising, in my opinion, is some type of Arnica cream. Arnica is a type of sunflower that has been used to reduce bruising, sprains, and muscle inflammation. In cream or lotion form, it may help with to reduce bruising and swelling.

Another herbal medicine based on Echinacea may also help in reducing bruises. This herb is derived from a type of daisy, and has been used because it is thought to induce white blood cells towards the area of injury and help prevent infection. This may also reduce bruising, since white blood cells will help to mobilize fluid and help with healing.

A big medicine or cream NOT to take after your facelift is anything in the aspirin family. Aspirin is a wonderful anti-inflammatory, but unfortunately works by thinning your blood slightly. This is a potential problem after surgery, because you want your body to heal and not have excessive bleeding after your procedure. Aspirin, ibuprofen, and any other medicine is generally not recommended before or after a facelift- talk to your plastic surgeon about his or her preferences.

 

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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What We're Listening To- All Day by Girl Talk

5
Dec

Occasionally everyone in the operating room starts busting a move in-between cases. We've all been shaking to the latest oeuvre by Girl Talk, the album All Day. It's an epic mash-up. Plus, he's from my home town, the birthplace of Iron City Beer- Pittsburgh, PA!

Warning- not suitable for young children.

Download the album for free here-

http://illegal-art.net/allday/

Tour Dates here-

http://illegal-art.net/shop/#news49

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Are Limited Surgical Liposuction Alternatives Effective?

2
Dec

Fitness detail

There are several limited incision and minimally invasive liposuction alternatives on the market. Some of my patients have asked me if they are effective or not. The alternatives to surgical liposuction do work to remove fat, but in generally, they may not be for everyone, and will not result in as much fat loss as traditional liposuction.

Some alternatives to traditional liposuction include use of a laser. Generally, an incision still needs to be made, and a plastic catheter is placed underneath the skin and into the area of fat. The laser is then activated, which melts the fat. The fat still needs to be removed with traditional liposuction.

There is a different technique that uses cold to “freeze” the fat externally, and your body absorbs the fat and excretes it. This method relies on clamping the fat, and then applying the cryo-device. The problem with this technique is that the clamp can’t actually clamp all areas, the skin and fat under the clamps may have a dimple after the device is applied, and not much fat can actually be removed.

Liposuction requires a small incision to access the skin, and then either suction or ultrasound or both are needed to melt and/ or remove the fat. This can remove the most amount of fat and give you the best contour possible, but it may require general anesthesia, more swelling, and a longer recovery time. However, traditional liposuction still remains the gold standard of body contouring and fat loss.

There are other technologies on the horizon. The one I closely follow is use of an external ultrasound device that melts fat, and your body excretes the dissolved fat. This technology has the advantage of no incisions, true fat loss, even contour, and no down time. The problem with this technology is that it will still not remove as much fat as traditional liposuction. This device exists in Europe and Asia, but is not in the US, and is still awaiting FDA approval.

 

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Happy Thanksgiving!

25
Nov

Food-laden table for traditional holiday meal

Fun Facts About Thanksgiving

- Benjamin Franklin wanted the turkey to be the national bird of the USA, not the Bald Eagle

- The first celebration of Thanksgiving was 1621

- more info can be found here- http://en.wikipedia.org/wiki/Thanksgiving_%28United_States%29

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How Important Is It To Wear a Compression Garment After Liposuction?

17
Nov

10th May 1950:  A model shows off an Aurore tulle brassiere and girdle at a fashion display of corsetry, underwear and nightwear at the Park Lane Hotel in London.  (Photo by Topical Press Agency/Getty Images)

After liposuction, your skin is technically a little loose, and will require some time to tighten up and fuse to the underlying soft tissue underneath. This is why you will probably wake up with a compression garment after your liposuction procedure.

This garment is usually quite snug, and helps to reduce swelling and allow your skin to tighten quickly the next several weeks after your procedure. The compression garment is crucial after your liposuction procedure, and comes in different shapes and sizes to compress your abdomen, arms, thighs, neck, or any area where you had liposuction.

You will also notice that wearing a compression garment right after your procedure will help support your body when moving. This is more noticeable with the abdomen area, but you will still notice it in the arm and thigh areas.

Most plastic surgeons recommend wearing some type of compression garment for 1-4 weeks after surgery, and some advocate wearing a 2nd, slightly less snug garment, after the initial healing phase. The length of time depends on your body areas of liposuction, how much fat will need to be removed, and your overall healing time.

 

Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Have you ever had liposuction? Or do you have any suggestions on wearing your compression garment after surgery? Please feel free to leave a comment or question below.

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7 Ways To Get Rid of Crow's Feet

16
Nov

Close-up of a senior woman in thought

Crow’s Feet occurs when you have fine wrinkles around the corners of your eyes. When you smile or close your eyes tightly, you may be able to see wrinkles form, which are also known as crow’s feet. There are several ways to avoid them and postpone their appearance, and several ways to actually eliminate them.

Sun exposure increases your chances of developing crow’s feet, so avoid the sun or use sunscreen or both. Helpful hints regarding sunscreen include using fresh, non-expired sunscreen, applying it frequently, and applying enough of it to your face.

A healthy lifestyle is key to avoiding skin laxity and wrinkles in general. Avoiding excessive drinking, eat healthy foods that can support collagen and skin health, and hydrate frequently to help keep your wrinkles at bay.

Don’t smoke- smoking causes more wrinkles, period. The blood vessels to your skin become smaller, and your skin’s ability to repair itself may become impaired with time.

Excellent skin care, especially prescription skin care, will help with regeneration of your collagen and enhance your skin’s ability to have fewer wrinkles. Exfoliating agents, such as Retin-A or chemical peel, will also help to reduce crow’s feet.

Botox is one of the best procedures for elimination of crow’s feet. Botox is an injectable that temporarily paralyzes muscle. If Botox is injected into the muscles that cause the wrinkles around your eyes, then your crow’s feet should disappear.

Skin resurfacing, such as with a laser resurfacing procedure, will be stronger and more effective than just daily skin care. You will probably have to take some time off of work, but a facial resurfacing will help tremendously with your overall facial skin tone and reducing the fine wrinkles you may see.

Surgery is a last resort, but a facelift modification is possible to reduce the crow’s feet. Using either a facelift approach or an eyebrow lift approach, the skin can be separated from the underlying muscles that cause crow’s feet.

 

 Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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Why is My Surgery so Early in the Morning?

15
Nov

Alarm Clock Waking Teen Girl

As you probably suspect, one of the biggest reasons why I went into Plastic Surgery is to become a sadist. Not only can I inflict pain with surgery, but I can also make my patients wake up at a painfully early hour to completely disrupt circadian rhythms and generate even more torment.

On a more serious note, the reason why surgery is scheduled so early in the morning is because we’re actually quite compassionate. Generally speaking, you will need to have an empty stomach for about 6-8 hours before your procedure. This ensures that your stomach is empty of any contents for general anesthesia. This way, if you get nauseated after surgery, you can try to throw up, but nothing will come out. With no stomach contents, you won’t accidentally swallow stuff into your windpipe, or lungs.

Aspiration pneumonia is a serious complication for any surgical procedure requiring sedation or general anesthesia. If you have dry heaves, as opposed to actual stuff or vomit in your stomach, then the changes of you having anything going into your lungs is much lower. As surgeons, we take this risk so seriously that we ask patients not to eat or drink 6-8 hours before any surgery requiring some sleep or sedation medicine.

If you have your operation at 730 AM, that means that you probably have had nothing to eat or drink- you’ve been sleeping at night. If we operated at 300 PM, then you would not be allowed to eat or drink after 700 – 900 AM, and you’d be wide awake during your entire fast. You would probably be grumpy and hypoglycemic, and you would not have the advantage of being asleep during this non-eating and drinking period.

So, be thankful for your early morning surgery start time!

 

 Should you desire more information about my available services, or want to schedule an appointment, please contact my Patient Care Coordinator at info@drkim.com, or call our office at 415-362-1846.

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  • American Board of Plastic Surgery
  • American Aesthetic Society of Plastic Surgery
  • American Society of Plastic Surgeons
  • Real Self