What is a Rapid-Recovery Augmentation Mammoplasty?
The name, Rapid-Recovery Augmentation Mammoplasty explains the essence of the breast enhancement procedure with breast implants. But what makes it rapid-recovery?
Usually the post-operative course is one with significant discomfort and the inability to function near normal capacity for several days, if not weeks. Many patients are told to limit motion of their arms with no lifting for several days. This is often routine, but obviously not rapid recovery.
To achieve Rapid Recovery starts in the operating room. First, a long acting anesthetic must be injected into the breasts and surrounding muscles and tissues. This limits the cycle of both pain and muscle spasms, each potentiating the other, post-operatively. Next, the dissection under the muscle must be done very carefully. Remember that just under the pectoralis muscle are the ribs and the intercostal muscles, which are the muscles between the ribs. No instrument must touch the periosteum of the ribs as this will bruise the ribs and cause post-operative pain. They can only be touched with gloved fingers. This does make the dissection more difficult, but it can be done. Finally, all of the bleeding must be meticulously stopped with coagulation, again taking care not to touch the ribs.
Postoperatively patients are given both pain medications and muscle relaxants, again to stop the cycle of pain and muscle spasm.
Post-operative instructions are very important to achieve rapid recovery. After about 6 hours following surgery, the patient is to raise their arms overhead three times every hour while awake. This will stretch the pectoralis muscle and result in relaxation, much like stretching after exercising or running. Starting the next day, the patient is to lie in the prone position on their breasts for 15 minutes a day. This stretches the pocket and further relaxes the muscle. If this is too uncomfortable, they are to lean into their mattress gently at first then more firmly. On the fourth or fifth day, they are to return to the office and will be given their massaging exercises to perform at least 5 times a day.
With this program, they should be able to carry on their daily activities after a day or two, with the limitation of lifting no more than 25 pounds for the first week or pushing heavy objects. Heavy exercising can be resumed after the third week, with the exception of pectoralis exercises (pushups, bench presses and fly’s), and these can be resumed after 6 weeks.
Uniformly patients have been amazed at how little discomfort they have had after surgery and how much more they can do than they expected.
E. Ronald Finger, MD, FACS