38 March 2016 March 2016 39 Expert guide: Aesthetics & Cosmetology 2016 Preparation for the Surgery Depending on the age and family background of the patient, the Plastic Surgeon will request a mammography before the surgery. He will also give specific instructions on how to prepare you for the surgery’s day, including provisions regarding the type of food, drinks, tobacco con-sumption, and the intake of some vitamins and specific medicine, or not. If the patient develops a flu or skin infection, the surgery would need to be rescheduled.If you smoke, it is particularly important for you to stop smoking at least 2 weeks or more before and after the surgery. Tobacco inhibits and blocks healing of the wounds. Follow the instructions carefully because they will help you experience a better evolution of your sur-gery.Be sure to count on a family member or on a companion for your return home after the sur-gery.Where can the surgery take place? Augmentation Mammoplasty can be performed at a hospital or at an outpatient centre.Types of Anesthesia Augmentation Mammoplasty is usually per-formed under general anesthesia but it can also be performed under local anesthesia or intravenous sedation, depending on the scope of the surgery and, of course, on the patient’s and medical doctor’s preference and tolerance. With the use of local anesthesia, the patient is surgical procedures, but to perform individual surgeries to avoid lengthy surgeries. The meth-od and the surgical technique to insert and place the mammary implant will depend on the patient’s anatomy and on the Surgeon’s criteria and recommendation. The incision can be done on the submammary fold (where the breast and the chest meet), around the areola and at the level of the underarm.The incisions are made at an almost unnotice-able location on the submammary fold around the areola and at the level of the underarm. Through the incision, the tissue of the mam-mary gland is lifted thus creating a “pocket” or space that can be placed before the pecto-ral muscle, i.e., behind the mammary gland or also behind the pectoral muscle. The implant is placed in the centre in relation with the areola and the nipple. The mammary implant is placed directly under the tissue of the mammary gland or behind the pectoral muscle. Some researches show that placing the im-plant behind the muscle may reduce the capsu-lar contracture. Also, this location behind the muscle interferes in a minor degree with the performance of the mammography than when the implant is placed directly behind the mam-mary gland. Incisions are closed with fine non-visible suture under the skin. Then, the post op. treatment is done with gauzes and bandages to help immobilize the breast. After the surgery, the breasts look high and projected, firm and natural to the body contour. The scar of the in-cision vanishes with time. After the Surgery, the Post Op. Treatment After the surgery, the medical doctor uses an elastic bandage or a post op. bra on the patient’s conscious during the surgery but sedated and relaxed without feeling pain. Cases without complications of very well qualified patients are generally performed under local anesthesia. With the use of general anesthesia, the patient will be asleep during the entire surgery and will feel more security and control. The Surgery The time required to perform an Augmentation Surgery is between 1 and 2 hours. It may last more if it is combined with other surgical pro-cedures such as Mastopexy (mammary suspen-sion), local liposuction and mammary contour. Some surgeons prefer not to perform combined wounds. Then, he substitutes the surgical elas-tic bandage or the post op. bra for a sports bra that the patient must use and maintain during 3 to 4 weeks. The suture may begin to be removed after the seventh day after the surgery. Usually, there is no significant discomfort after the sur-gery. If there would be any discomfort it would be minor and would be easily treated with an analgesic or anti-inflammatory medication prescribed by the medical doctor. The presence of severe or persistent pain, as well as any in-flammation or a sudden increase in the volume of the breast must be immediately reported to the Surgeon. The medical doctor must also pre-scribe antibiotics to prevent any infection. The Venezuela