BREAST SURGERY

1. BREAST AUGMENTATION (Augmentation Mammaplasty, Breast Implants)

This surgery is designed to increase the size of the breasts through the use of implants and is a cosmetic procedure aimed at helping women whose breasts are small or have lost definition following child-rearing, to improve their appearance and self confidence.  This operation is also carried out on many in the transgender community who wish to project a more feminine image.

PRE-OPERATIVE CONSULTATION

Doctor Sanguan insists on straightforward communication between himself and a prospective client in order to avoid most of the problems regarding the outcome. If he believes that the person is not a good candidate for Breast Augmentation, perhaps because the breasts have lost too much definition and firmness, he may recommend that the surgery should not go ahead. In this way, disappointment over the final results can be avoided.
If it is decided that the client will benefit from the procedure, details including size, location and type (Saline or Silicone) of implant, profile, shape, and incision location will be discussed and agreed upon.
As is the case with any major operation there will always be a risk of complications. These risks are significantly reduced when the operation is undertaken by an experienced surgeon, and Doctor Sanguan has performed more than 1000 over the last decade. However, he will ensure, during the consultation, that all prospective clients are made aware of possible, if unlikely, complications, such as infection in the implant pocket, bleeding and blood collection in the breast, fluid collection around the implants and capsular contracture (hardening and possible movement of the implant).

SURGERY SCHEDULE DETAILS 

Patients will be picked up from their place of residence and admitted to Phuket International Hospital on the day of surgery. Chest X-rays and routine blood counts will be carried out. Patients are required to refrain from eating or drinking for at least 6 hours prior to surgery, and should also inform the hospital staff of allergic or other health issues.
The surgery is performed under general anesthetic and will take between one and a half and two hours, depending on the location of the incisions, and whether the operation is a fresh or a corrective case.
The incision is approximately 4-6 centimeters and the space for the implant will be created under or over the chest muscle, dependent on the agreement reached during consultation. Prior to insertion of the implants, antibiotic solution is used to irrigate the pockets, and then the implant is squeezed into the correct position. The incisions can then be closed. In the rare event of bleeding and blood collection in the breast, a drain may be used and kept in place for a maximum of two days.

 POST-OPERATIVE CARE

Patients will recuperate at the hospital for one or two nights before returning to their place of residence. They will then be required to return to the hospital five days after surgery for a check up and for the removal of stitches.
Elasticated support bandages are wrapped around the breasts for several days, although if these are not comfortable an unwired sports brassiere can be worn.
 At the second consultation patients will be shown appropriate massage techniques to avoid capsular contracture. This breast massage should be continued regularly for 6 months, 3 times a day, with each massage lasting several minutes a session.
 After a few weeks, the breasts will have recovered sufficiently to allow the wearing of a normal brassiere. However, transgender clients and women whose previous breasts were quite flat are recommended to avoid wearing brassieres in order to allow the implants to drop and stretch the skin faster.

In many cases, the new breasts will not look natural immediately because the skin over the breasts and implants has never been stretched before. However after a few weeks the appearance of the breasts will improve but it may takes a few months before a totally natural look is achieved.

ACTIVITIES

For the first week after the removal of the stitches light activities can be carried out, but patients should refrain from raising their arms above shoulder height.
Driving of vehicles can resume after one week.
After one month, the full range of normal activities can be resumed.

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2. BREAST LIFT (Mastopexy)

Following breast-feeding, or simply as a result of the normal aging process, breasts will sag and lose firmness and shape as the skin loses its natural elasticity. Breast lift surgery is designed to correct this problem, restoring the breasts to their former shapely appearance.
The surgical technique involves removing excess loose skin and relocating the nipples (areolas) to a higher, more natural-looking position. Some glandular tissue may also be removed.
Frequently, this operation is undertaken in conjunction with Breast Implant surgery.

PRE-OPERATIVE CONSULTATION

Doctor Sanguan will discuss the merits of this surgical procedure, and, as with Breast Implant surgery, will explain the possible risks associated. The main concern involves post operation appearance, as some scarring is inevitable, firstly around the areola itself and secondly vertically from areola to the breast fold. Usually, the scarring is inconspicuous, although occasionally hypertrophic or keloid scarring may occur.

SURGERY SCHEDULE DETAILS

Patients will be picked up from their place of residence and admitted to Phuket International Hospital on the day of surgery. Chest X-rays and routine blood counts will be carried out. Patients are required to refrain from eating or drinking for at least 6 hours prior to surgery, and should also inform the hospital staff of allergic or other health issues. The intake of Aspirin or any anticoagulant drug should be stopped at least 2 weeks prior to surgery, and smoking also stopped for 2 weeks, as this can lead to vascular impairing to the skin and nipple flap.
Usually Breast Lift surgery is carried out under general anesthetic, although if the breasts are not large and still reasonably firm, “twilight” anesthetic (whereby the patient is sedated, but not unconscious) may be used.
The procedure takes between 3 and 4 hours.

POST-OPERATIVE CARE

Usually patients will remain in hospital for one night after which they will be able to return to their place of residence. Breasts will be bandaged, and patients need to refrain from showering the chest area for a few days. Pain killers and antibiotics will be prescribed.
One week after surgery patients will return to the hospital for the removal of stitches. Assuming there are no complications, patients can then resume their holiday or return home.
Patients should wear a good supporting brassiere regularly during the day.
The breasts will take on a more natural appearance over the first 4 to 6 weeks following the surgery.

ACTIVITIES

Patients should avoid the lifting of heavy items for the first few weeks, but normal exercise and other activities can be resumed after 4 weeks.

FOR EXAMPLES CLICK HERE

3. BREAST REDUCTION (Reduction Mammaplasty)

Many women with large, pendulous breasts (Breast Hypertrophy) may suffer from neck or back pain, irritable rashes or fungal infection in the breast folds, or breathing difficulties. Exercise and sporting activities may also be limited. Breast Reduction surgery can resolve these issues, thus eliminating functional and emotional problems as well as providing cosmetic improvements.
Breast Hypertrophy is caused by an imbalance in hormone production, and is often a genetic condition.
Women seeking Breast Reduction surgery must be over 18, to ensure that their breasts have fully developed, and should not consider this surgery if intending to breast-feed infants at a later date.
It is helpful if, in advance the prospective patient can send photographs, so that Doctor Sanguan can evaluate, and communicate back, the likely surgical procedure. This will also allow him to explain possible resulting problems. For example, if the breasts are very large it may be necessary to detach and realign the nipple and areola complex which would then result in loss of nipple sensation.

PRE-OPERATIVE CONSULTATION

Doctor Sanguan will explain to prospective patients the consequences of this operative procedure to ensure that the disadvantages (for example, inability to breast-feed) as well as the advantages are fully understood.
He will also outline the possible risks that may occur. These include infection of the wound, blood or fluid collection inside the breasts, loss of nipple sensation and necrosis of the skin or areola complex.
It will be explained that some scarring around the aroela and in the breast folds will be inevitable, but that, in most cases, is insignificant in appearance.

SURGERY SCHEDULE DETAILS

Patients will be picked up from their place of residence and admitted to Phuket International Hospital on the day of surgery. Chest X-rays and routine blood counts will be carried out. Patients are required to refrain from eating or drinking for at least 6 hours prior to surgery, and should also inform the hospital staff of allergic or other health issues. . The intake of Aspirin or any anticoagulant drug should be stopped at least 2 weeks prior to surgery, and smoking also stopped for 2 weeks, as this can lead to vascular impairing to the skin and nipple flap.
The surgery will take place under general anesthetic and involves the removal of excess glandular tissue, fat and skin. The operation takes between 4 and 6 hours.
New smaller, lighter and firmer breast contours are reconstructed and the nipples and areola complexes are reduced and relocated to a more natural position. 

POST-OPERATIVE CARE

Patients will remain in hospital for between 2 and 3 days, before transferring to their place of residence. Drain tubes on both breasts will be removed 1-2 after surgery. Breasts will be bandaged, and patients need to refrain from showering the chest area for a few days. Pain killers and antibiotics will be prescribed.
One week after surgery patients will return to the hospital for the removal of stitches. Assuming there are no complications, patients can then resume their holiday or return home.
Patients should wear a good supporting brassiere regularly during the day.
The breasts will take on a more natural appearance over the first 4 to 6 weeks following the surgery.

ACTIVITIES

Patients should avoid the lifting of heavy items for the first few weeks, but normal exercise and other activities can be resumed after 6 weeks.

FOR EXAMPLES CLICK HERE

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