"Rapid Recovery" breast augmentation: is this an ideal method for less trauma and shorter recovery?

Question

I have been hearing many woman remark that their surgeons used this "rapid recovery" or "flash recovery" and that they had great outcomes with less pain and shorter recovery. I also heard it decreases the likelihood of capsular contraction, is that true? I am a type one diabetic so less trauma and quicker healing sounds ideal. No lift needed and 500-550 cc's is that too large for this method? Pros/Cons? Thank you.

Steven Teitelbaum, MD · Answer

I've been teaching this at meetings for over ten years and an augmentation can be done with a return to normal activities within 24 hours, without any special bras, narcotics, or pain pumps.The man who deserves credit for this is John Tebbetts of Dallas.  He published this technique in 2001 and what is shocking is that all surgeons have not yet embraced it.Many surgeons can consistently deliver a 24 hour recovery, but most cannot.  Yet I see some of them advertising that they do.  You need to see proof that they do it.  For instance, I've done it at televised national meetings and I have clips and testimonials on my website saying that i can do it.So the answer is that it is something that you should seek.It can be done with large implants, but I have to warn you strongly against those giant implants.  I published a paper with Dr. Tebbetts describing how large implants such as the 500-550s you mention cause irreversible and significant damage to breasts.  If you don't believe me, ask a surgeon to show you ten year follow-up photos on women with implants that size.  That has never been published and I've never seen that at a meeting.  So i would urge you to reconsider your choice of size.

George Marosan, MD · Answer

Thank you for your question. "Rapid recovery" is not a surgical description, but the end product of careful, meticulous breast augmentation. We all aim at rapid recovery, minimal downtime and minimal discomfort. My personal technique to achieve "rapid recovery" is the following: 1. I inject Botox into the pectoralis major muscle (if submuscular implantation is planned) 2 weeks prior to surgery. 2. Use the tumescent technique infiltration into the breast tissue and under the muscle. This has two effects: a) bloodless surgery and b) 8-12 hours initial pain free recovery. 3. Meticulous cautery dissection using direct visualization with a fiber optic retractor, not touching the rib surface during the pocket dissection and gentle handling of the tissues and zero bleeding.All these steps will lead to rapid recovery and less capsular contractures if the appropriate size implants are chosen for your frame and breasts as well.See a board certified plastic surgeon for an in person consultation/evaluation. Good luck.

Joe Gryskiewicz, MD, FACS · Answer

Hi Girlygrl!!!  
 The quick recovery, etc. is well documented.  We 
specialize in quick-recovery
(flash-recovery, rapid-recovery) breast augmentation, also known as the “no
touch technique.” It is a surgical procedure that uses special instruments and
techniques to minimize tissue damage and avoid touching the ribs. It causes far
less trauma to surrounding tissue than traditional approaches, and it
dramatically reduces pain, suffering, and recovery time. In my published
studies of our own patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24 hours. Quick-recovery
BA is not a “gimmick.” These specialized techniques, which actually speed
recovery and get you back to your daily routine, kids and work, are published
in our plastic surgery journals. Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore these are sound techniques, not marketing hype. So that would be good for you.  There are no studies to show less capsular contraction.  Don't smoke. You are at a slightly higher risk for infection from diabetes.
      Here are a few tips for you because this is perhaps
the hardest decision for a patient to make, as well as the surgeon.  Also see the video attached to my answer.  We spend up to two hours for our BA consults
to be sure there is careful communication. We do a full exam in front of a
full-length mirror taking six exact measurements.    We
put your photos on a large computer screen for imaging, and go over your
“ideal-size” photos. We then save this information to your password protected
“web account.” 
     First and
foremost the implant should fit the dimensions of your breast and tissue cover.
 Balancing the implant to your
over-all body shape and tissue cover is essential.    The main thing is to
have the diameter of the implant fit the diameter of your breast "foot-print".
 Higher profile implants tend to have a smaller diameter.  Higher is really a marketing term, but often
translates into the same volume implant with a narrower base.  Saline implants actually tend to decrease in
diameter as they are inflated!  The average size chosen over our last 7,000 breast implants was
“350cc”.  BUT, 90% of our patients tell us they wish they were
bigger a year after BA.  (We will see you
every year for routine checks at no charge.) It’s like your mind incorporates
the "new you" into your own self-image over a period of time. Cup size estimates can be misleading, but I generally advise patients
that they will experience an increase of approximately one cup size per 200 cc.
 You can try on implants in the office by
placing them into a special bra.  The implant is also flattened somewhat when under
the muscle, so it is a good idea to bump it up a bit. Approximately 1-ounce (25cc) is added to the final volume to account for
flattening of the implant in the partial sub-muscular pocket.  Once you decide on a size you like, then add
on 25cc, because in real life the implant will be flattened slightly by your
tissues.  Multiple measurements need to
be taken to fit an implant to your exact anatomy.  Have your surgeon's
office show you the charts of the implant dimensions for the various profiles
of silicone and saline from the manufacturer.  Then you and your surgeon
can piece together the puzzle by matching your measurements, with your wishes,
versus your tissue cover and the available implants to arrive at
a surgical plan.  Keep in mind
larger implants tend to have more problems over the years.  Since silicone implants wrinkle less than
saline implants, they might be your best bet.
     You can
also approximate this at home by measuring out an equivalent amount of rice
placed into a cutoff foot of old panty-hose, and put this in your bra.  Wear this around the house for a while, and
see what you think.  Implant size must
square with assessments of tissue cover, breast diameter, and chest wall width.
 Multiple measurements of your chest wall
are taken (seven in total).  Implant size
selection has been an issue of much discussion. 
    
Therefore, I use a wide variety of methods, but the implant size is
always established preoperatively.  Also,
patients are advised to bring reference photos demonstrating their ideal size
and shape.  A photo album of patient
pictures is maintained to assist them.  These photos ultimately help in determining
where the implants will be placed, since they can be shifted inside (to provide
more cleavage), to the outside, up or superiorly, and down or inferiorly during
surgery.  In determining the final size
selection, I always place the highest priority on the preoperative measurements
and potential tissue cover.  Finally,
your verbal requests are factored into the analysis. 
     We use
the quick-recovery approach, so click on the web reference link below to have
this explained and you can see the list of Quick-Recovery (Flash-Recovery or
Rapid-Recovery) Breast Augmentation articles from peer-reviewed surgery
journals.  It is a surgical procedure that
uses special instruments and techniques to minimize tissue damage and avoid
touching the ribs. It causes far less trauma to surrounding tissue than
traditional approaches, and it dramatically reduces pain and recovery time. In
published studies of BA patients, 95-percent of women interviewed after the
procedure returned to normal daily activities within 24-hours. Quick-recovery
BA is not a “gimmick.”  These specialized
techniques, which actually speed recovery and get you back to your daily
routine, kids and work, are published in our plastic surgery journals.  Because these PS journals are “peer-reviewed”
and edited, they are the gold-standard in our field as being valid science.
Therefore, these are sound techniques, not marketing hype.  
     Be sure
to see only a board certified plastic surgeon (by ABPS - The American Board of
Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic
Plastic Surgery) and or a member of ASPS (The American Society of Plastic
Surgeons).  Also, ask if the PS has an
established, high volume breast augmentation practice, performing several
hundred breast augmentations each year.  Be sure the PS has been in practice for a
while, about 20-years might be a good gauge. 
Does the PS offer all three incisions? 
Discuss the implant type (gel or saline), shaped "gummy bear"
or non-shaped, smooth or textured, implant pocket (over or under the muscle)
and the "quick-recovery approach." 
Ask to see their before and after photos if you didn’t see any on their
website.  If they are experienced, they should have several 100 breast
implant patients for you to view.  I would also recommend that your doctor
offer you the chance to talk to past patients who would be happy to discuss
their experience with you.  You need to feel comfortable, so make sure the
environment is safe as in an accredited surgery center.  Also, ask a prospective surgeon if he or she
has ever published journal articles in professional peer-reviewed journals,
which they can provide you.      
All the best, “Dr. Joe”

Hetal Fichadia, MD, FACS · Answer

Thanks for your question. Basically, a 'rapid recovery' or 'flash recovery' breast augmentation is a name for a procedure where the surgical technique focuses on using appropriately sized implants, minimizing rough tissue handling, preventing bleeding in the implant pocket, and avoiding blunt dissection (using fingers, etc). These are technical details that all plastic surgeons should be using - whether they advertise 'flash augmentation' or not. In general, breast augmentation should not be a very painful procedure and surgical recovery (including need for narcotic pain medicines, etc) should be within 1-3 days. Of course, there are some restrictions such as avoiding heavy lifting afterwards to ensure that the implant pocket is allowed to heal.

If there are other anatomical features such as tuberous or constricted breasts, need for a breast lift, use of excessively large implants, etc, then the surgery is more involved and the recovery period may be longer. While most patients follow this course of quick recovery with a straightforward breast augmentation, I also tell my patients that everybody heals at a different pace. So, it's important to give your body the time it needs to rest and recover. Without an actual physical examination, it's impossible to know if 500-550 cc implants are too large for you. Be sure to find a qualified plastic surgeon who you can trust. Good luck with this process!!

Curtis Wong, MD · Answer

is more of a marketing issue but there are some intra-operative things, when avoided, can make your recovery much easier.  If your surgeon can guarantee no narcotics post-op and you can go out dancing that night or your procedure is free, then go to that surgeon and if you need narcotics or have a complication, you won't get dinged for more costs.  Plan on taking the first couple of days off of responsibilities and those motivated, will return to work and activities sooner.  My restrictions are no strenuous or bouncy activities.

"Rapid Recovery" breast augmentation: is this an ideal method for less trauma and shorter recovery?

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"Rapid Recovery" breast augmentation: is this an ideal method for less trauma and shorter recovery?

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