Regardless of implant type (round or teardrop, smooth or textured, saline or silicone), assuming your surgeon uses careful technique, precise dissection, and meticulous hemostasis, and assuming you have normal healing capabilities, follow instructions, and minimize activities that might cause bleeding, pretty much all patients heal the same.There is no "Quick Recovery," "Overnight Augmentation," "24-hour no-pain-super-duper breast implant job," etc. These are just names designed to impress or make you think there is something special going on. If the alternative is poor training in a non-plastic surgery field ("cosmetic surgeon"), lack of experience, sloppy or rapid surgery, blunt and bloody dissection, and an Ace elastic bandage or snug surgical bra to reduce bruising and bleeding instead of meticulous hemostasis, then recovery may indeed by more painful, marked by more swelling, bruising, and higher risk of re-operation or capsular contracture, and slow return to everyday activities. If your surgeon is an ABPS-certified plastic surgeon with hospital credentials (even if s/he operates in their own surgical facility--is it AAAASF accredited?), then you are on the right track, but there still may be concerns about anesthesia.Most hospital and free-standing hospital-owned surgicenters staff their operating rooms with hospital anesthesia personnel, and most of them use inhalation anesthetics and nitrous oxide, very safe, but with a 7-28% risk of PONV (post-operative nausea and vomiting). Surgical facilities that utilize TIVA (total IV anesthesia) do not have as much associated PONV issues, since there is no gassy smell or nitrous dilation of middle ear spaces, sinuses, and gut leading to the higher PONV rates seen with inhalation anesthesia. Our accredited office surgical facility has used TIVA for well over a decade, with PONV rates of 2-4% overall, including major and long cases such as lower body lifts.Breast augmentation is an operation that can be skillfully and carefully performed in around an hour without haste or sloppiness, and most patients have no problems with either kind of anesthesia. But even a short TIVA is better than short inhalation anesthesia, IMHO.For pain control, some surgeons prescribe narcotics only, whereas others will utilize muscle relaxants, anti-inflammatory medications, long-acting AND extended-release local anesthetics, as well as IV steroids to reduce nausea and stabilize cellular membranes (reduces swelling and any pain associated with this), icebags to the protected breast skin, and of course narcotics if needed.SO, as you can see, there are surgeons who may spend more time and effort on marketing and trademarking "snappy" names for their breast augmentation procedures, but most of us spend our time and efforts at covering all of the details mentioned above. There IS a difference, so I hope you chose your surgeon wisely! For more information, click on the web reference link below for my Comprehensive Guide to Breast Augmentation. Best wishes! Dr. Tholen
