Should I be scared to go under the knife?

Question

I am having a breast augmentation in a month and the nerves are kicking in. You'd think I'd be more nervous about how my boobs will turn out, but no, I'm more scared to go under the knife! Will I never wake up? Will I feel them cutting me open? Are there things I can do as a patient to make sure I avoid any complications? I heard of removing nail polish before to make sure the surgeon/nurse can see the circulation in your nail beds. Is there anything else I can do? Is this a common worry among patients?

Martin Jugenburg, MD · Answer

It is completely normal
to feel scared and anxious.

You see, we are naturally scared of
things we do not know or things we do not understand. In order to overcome
fear, you must educate yourself as much as possible about the surgical process.

For example, you asked whether you will
feel them cutting you open…the answer is no because you will most likely be
under general anesthesia where you are made unconscious. Even the incision surgeons
will make will be small and it will be a blood-less dissection due to
electrical cauterization – which uses heat to close blood vessels. When there
is less bleeding, there will be less pain when you wake up.

The source of all this anxiety could be
reading through tonnes of reviews of breast augmentation. Of course, if you
read negative reviews, you are more likely to become anxious, but if you read
more positive reviews, you are more likely to become excited about the surgery.

You have to realize that one patient is
not like another, so taking those negative reviews and applying it your own
case is pointless. In fact, even the breasts in the same individual are never
entirely the same which is why we may see that certain complications occur only
in one breast and not the other.

Please know that compared to the number
of people who get BBAs each year (over 300,000) compared to the number of
negative reviews you read, you will realize 2 things, 1) those with negative
results are more likely to share their story, 2) compared to positive results,
the likelihood of negative results is highly uncommon.

So I urge you to look into the likelihood
of the complications that are scaring you.

In fact, if you were to look at the list of complications to
any surgery, or number of side effects to any drug, you would be more likely to
reject the surgery or drug. The point to understand is not that there are many
risks, but rather the rate of occurrence (i.e., incidence rate of the
complications)

For example, infection is a very dangerous complication that
could destroy BBA results, but the chance of infection following breast
augmentation is 1% which means that there is 99% chance you will not get an
infection. See how if you change the point of reference, things look much
better. This is because of the psychological effect our body has to negative
information.

Another example - many patients read blogs from others about
how they are terrified of general anesthesia and start worrying excessively.
They will read things such as, “oh, what if I wake up during surgery…oh what if
I do not wake up at all?” These are worrisome questions for sure, but again,
they are also highly unlikely situations as you will be supervised during
surgery by a board-certified anesthesiologist and the whole surgical team.

Nevertheless, I would
like to list the things you can do to prepare for the surgery and to help with
recovery.

Note, I am
listing things to make recovery easier and they do not serve as instructions
for recovery (i.e., after surgery, you have to avoid intensive exercise for 6
weeks, you may have to take antibiotics, do breast massages, wear sports bras,
etc.)

Firstly, if you smoke, then please stop smoking – 1 month
before surgery. Smoking a cigarette within the month of the surgery can double
your risk of infection. Smoking will also cause delayed wound healing, so it is
important to cease smoking for 1 month after surgery as well.If you have children, then have someone ready to take care
of them for at least a week.If you have a dog, have someone to walk the dog at least for
2 weeks. Please arrange for someone to drive you to and from surgery
and accompany you for 24 hours right after surgery – most patients bring ask a
friend to help.You do not want to have a lot of work waiting for you after
surgery, so do them beforeCook extra food ahead of time, or you can simply order food
if you are not recovering at homeYou may start a healthier diet and engage in physical
exercise, and avoid alcohol few days prior to surgery.Make sure to inform your surgeon of all your medications –
natural and pharmaceuticalYou may have to stop some
medications like aspirin and ibuprofen as then can increase bleeding.The night before you will stop eating or
drinking anything. In the morning, you can brush your teeth while
avoiding swallowing water.You will also need to take shower and
wash the areas where surgery will take place using antimicrobial soapYou cannot wear any makeup, or put any
moisturizer/lotion or deodorant. As you already know, you will also have
to remove nail polish from one fingernail and toenail so that anesthesia person
can monitor your blood circulation during surgery.Bring loose-fitting clothes that open in the
front and comfortable flat shoes that slip on – you will need such clothes
while you recover for the 1st week.

Hope this helps!

David C. Yao, MD, FACS · Answer

Thank you for sharing. This is a common feeling with many patients. You have many questions and concerns. Rest assured that breast augmentation is a common procedure that has a high satisfaction rate and result rate! Talk with your PS and anesthesiologist about your concerns. They will be able to guide you and allay any concerns! Best wishes!

Jerome Edelstein, MD · Answer

Hello,It is common for patients to be nervous about all the things you are before surgery. For the most part, your Plastic Surgeon should be the one to address all these concerns with you, provide answers and ensure that you have the instructions you need before surgery. Be sure that you choose a board certified Plastic Surgeon with plenty of experience. The facility, staff and safety protocols in place are important for you to ask about. Please see attached link for a list of questions you can ask when planning your surgery.All the best

Larry S. Nichter, MD, MS, FACS · Answer

I have attached a document containing the pre-op instructions I give all my patients.I hope this helps calm your nerves. Always insist on a board certified surgeon.\Good luck!

Richard J. Brown, MD · Answer

Thank you for this question. Really. It is so common and I am happy to answer this for you. Having had surgery 3 times myself and I am a surgeon, I still get nervous every single time. I am healthy and I know I am going to be ok, but it still is scary in this day and age where the media sensationalizes everything. The bottom line is you will not feel anything during surgery. You will be out. That talk about people remembering does not happen with general anesthesia. It really does not. If you are going to a board certified surgeon who will be using a board certified anesthesiologist you should do just fine. If you are a young healthy person you have a better chance of being injured in a car accident then from having this elective surgery. The fear is normal and everyone has it. It is surgery, and there is not a chance of zero risk, but your risk is likely very, very, very miniscule. I do not know your health so I am basing this on the fact that you are otherwise very healthy. Best of luck, you will do great!Sincerely,DrRickAZ

Should I be scared to go under the knife?

Answers (9)