Breast Augmentation after Spinal Fusion? How long to wait?

Question

Hi docs, I am a 32F. 5"4 and 115 lbs. After a serious scooter, accident 2 1/2 years we finally found out that the problem was my L5 S1 and I had a minimally invasive fusion from the back. As a present, my fiancé will be gifting me my lovely breast augmentation :) . I got it done by one of the best doctors at HSS and NYC so I'm l& am feeling very good given only 4 weeks. How long should I wait for BA? I was told 3 to 6 months. Postop is OK. I will also consult with my surgeon of course

Robert M. Tornambe, MD · Answer

Congratulations on your speedy recovery! It is best to be conservative with regard to breast augmentation after your back surgery. While your orthopedic surgeon should have final say as to when would be the most appropriate time to have the breast surgery, I would ponder that at least six months should pass to allow the fusion to be either complete or very close to complete before pressing on with another elective surgery. When cleared, come see me or another board-certified plastic surgeon in our area to explore the best options for you. Best of luck.

Jeffrey Lisiecki, MD · Answer

The main question is around if you have any activity restrictions after your spine surgery, if your spine surgeon would be OK with you having another operation where you are moved on and off the table, and if there is any PT required after your spine surgery that you may not be able to participate in if you have a breast augmentation.  I don't anticipate any of this would be an issue 3+ months after a minimally invasive fusion, but this should be a discussion between your spine surgeon and your plastic surgeon!

Stefan Mark Szczerba, MD · Answer

Hi there!  I would definitely wait 3-6 months... let your body heal and make sure there are no issues-then go for it!  Best Wishes!!

Daniel Barrett, MD · Answer

Dear Dls1213,
you should be fully healed prior to another elective procedure. Most surgeons would recommend you to wait at least 6 months prior to another procedure. If you are considering surgery, I would suggest you consult a board-certified plastic surgeon. Only after a thorough examination, you will get more information and recommendations.
Daniel Barrett, MDCertified, American Board of Plastic SurgeryMember, American Society of Plastic SurgeryMember, American Society of Aesthetic Plastic Surgery

Connie Hiers, MD, FACS · Answer

You will need clearance from your first procedure before doing the second. A minimum of 3 months is needed, but it could be up to 6. You don't want to risk infection in either surgical site.

Camille Cash, MD · Answer

Your surgeon is the best one to answer this as she/he is most familiar with your case and how you've been progressing through recovery.  If you plan on about six months between procedures you should be ready barring anything unforeseen.

Kenneth R. Francis, MD, FACS · Answer

Dear Dls1213,
I would recommend at least a 6 month waiting period.  Of course, you should consult with your spine surgeon before hand.  Good luck!

Mats Hagstrom, MD (license on probation) · Answer

I suggest you ask your spine surgeon what the limitations are after your spine surgery.
Unless the restriction include not laying on your back for a few hours, as you no reason why you need to wait for your breast augmentation.
Breast augmentation outcomes are based on three variables.
The first is the patient candidacy for the procedure in the first place.
Not everybody seeking breast augmentation is an ideal candidate for the procedure and you need to understand your own candidacy in order to understand what the procedure can or cannot accomplish.
 The second variable is implant selection in regards to size shape and type.
Plastic surgeon will have their own way of guiding patients through the implant selection process.
Some plastic surgeons do this better than others.
The third variable is the surgeons ability to put the implant in the correct atomic location.
 Whenever patients have problems or are unhappy with the outcome of breast augmentation surgery, we can almost always attribute the problem to one or more of the above three variables.
Choosing excessively large implants will consistently increase the chance of undesirable, side effects, complications and increase the need for revision surgery.
 Provider selection is probably the most important variable and the one where patients have the most impact or control.
I generally recommend having multiple in person consultations before selecting a provider. 
Bring pictures of your body to use as reference during the consultation, taking the same way plastic surgeons take before and after pictures.
During each consultation, ask each provider to open up their portfolio and show you as many before and after pictures as possible of previous patients who had similar body characteristics to your own.
 This means breast that appearance with similar position on the chest wall, similar degree of divergence, similar size, similar degree of ptosis etc. 
Take careful notes during each consultation and use your notes to help you select the right provider for your needs.
There is a lot of information to cover during a consultation for breast augmentation, including the implication of having implants and having a clear understanding between the difference of saline and silicon implants especially long-term, and after implant failure.
Avoid virtual consultation and always rely exclusively on in person consultations.
The biggest mistake I see patients make is having only one consultation and then scheduling surgery.
Having only one consultation, more or less eliminates the ability to choose a better provider.
Being certified in plastic surgery with year of experience and an overall good reputation does not mean that somebody is mastered single plastic surgery procedure.
There’s more variation in regards to skill and experience with these providers than patients are typically aware of.
I cannot emphasize enough, the importance of provider selection and having multiple consultations before choosing your provider.
Famous plastic surgeons are not necessarily better and this is especially true for those who have strong tendencies towards self promotion.
Best,
Mats Hagstrom MD

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