Breast Augmentation. Introduction. Gel 115,000 (THB) Tear Drop 145,000(THB) Endoscopic 130,000 (THB)

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1 Information provided is intended d to inform clients of expected procedures and outcomes. However, not all patients, procedures,or surgeons are the same, and information may not be applicable to all procedures. The Hospitals may reserve the right to vary the way that a procedure is performed or which technique is used. Breast Augmentation Introduction Hospital Admission 1 Days Duration Thailand 9 Days More and more women who are unsatisfied with their breasts have been turning to breast augmentation surgery. Over the past ten years the surgery has become more accepted by the public and more women have become less hesitant to go under the knife. Even though this kind of surgery has become less invasive, it s still very important that an individual take all the proper steps to understanding what is all involved and what to expect after breast augmentation surgery, before making a final decision When an individual chooses to have breast implant surgery, that person is choosing to take risks. Any kind of surgery has potential risks involved, although it s a chance individuals are willing to take in order to gain something in return. It s essential that a person takes the time to prepare for a realistic outcome, as cosmetic surgery cannot make things perfect. Aside from understanding the potential outcome, it s also important that before choosing to have breast augmentation surgery that the individual takes a look at all of their options before choosing what type of surgery they would most benefit from. Breast augmentation can be performed alone or in conjunction with other breast-enhancing procedures. For example, a breast lift (mastopexy) can help perk up your sagging breasts. Or your breast augmentation may be part of your ultimate mummy revamp(the name given to a combination of plastic surgery procedures that together can help new moms look and feel like their old pre-pregnancy selves generally breast implants and a tummy tuck is a mummy revamp). Gel 115,000 (THB) Tear Drop 145,000(THB) Endoscopic 130,000 (THB) Candidates for Breast Augumetation PRICE (AUD) $ 4, PRICE (AUD) $ PRICE (AUD) $ 5, AUD$ prices are correct as of 20 J 201 and can change according to currency rate fluctuations. One or more of the following feelings or conditions may indicate that you are a good candidate for breast augmentation: You are 20 Year or older You are bothered that your breasts are too small Clothes that fit well are often too large at the bust line You feel self-conscious about your breast size Your breasts have become smaller and lost their firmness After having children Weight loss has changed the size and shape of your breasts One of your breasts is noticeably smaller than the other Your plastic surgeon will request photographs of your breasts once booking forms are received by Meditravel and a request for an appointment has been made. He will then provide post surgery recommendations based on the information in your booking form and the photographs taken. This will not replace the actual consult that you will have prior to your surgery when arriving in Thailand. During both the photographic consult and the physical consult the Surgeon will examine your breasts He will consider such factors as the size and shape of your breasts, the quality of your skin and the placement of your nipples and areolas (the pigmented skin surrounding the nipples). If your breasts are sagging, a breast lift may be recommended in conjunction with augmentation.

2 The Day of Surgery NOTHING by mouth. Anything more than a small amount of water as needed for brushing teeth or swallowing medication may result in the need to cancel surgery. This includes candy, gum, mints. Dress appropriately. Do not wear cosmetics, jewelry of any kind, contact lenses, hair clips, body piercing: (If there is something you cannot remove, let the admitting nurse know right away.) Wear comfortable, clean, loose-fitting clothing: Do not wear jeans or any tight-fitting bottom; rather have a pair of loose, drawstring sweatpants to wear home. Wear slip on, flat shoes with a slip proof sole Wear (take with you) clean cotton socks, as the operating room can feel cool. For your comfort, wear a zip or button front top. Make arrangements with your travelling partner or ask hospital staff to call home once your surgery is complete to reassure family you are doing well. Have your surgery payments organised.as the hospital requires payment in full prior to surgery. The Consult During the physical consultation when you arrive in Thailand, you will have to make a choice and in agreement with your surgeon about: Your desired cup size Placement of the Implant Placement of incision Type of Implant (fill) Shape of Implant Texture of Implant Implant Profile Most Importantly your expectations after the surgery To assist our meditravel clients we have put together an information sheet. This information sheet is designed to provide you with the facts on the available breast implant options not influence you one way or another, but to help you make the most informed decision possible about all of the variables involved in your surgery. If you are a smoker, you will be asked to stop smoking 2 weeks in advance of surgery. Aspirin, Pandol and certain anti-inflammatory drugs can cause increased bleeding, so you should avoid taking these medications for a period of 2 weeks before surgery. Pre-Surgical Tests are standard hospital procedures. Prior to surgery, your surgeon will require you to undergo laboratory and other examinations to ensure that you are fit for surgery. However, additional diagnostic test can be requested by the surgeon on case to case basis. You should come to the consultation prepared to discuss your medical history. This may also include information about any medical conditions, drug allergies, medical treatments you have received, previous surgeries including breast biopsies, and medications that you currently take. You will be asked whether you have a family history of breast cancer and about results of any mammograms. It is important for you to provide complete information. Medications are administered for your comfort during the surgical procedure. under general anesthesia. The procedure takes approx 2 hours, when surgery is completed, you will be taken into a recovery area where you will continue to be closely monitored. Your breasts will be wrapped in gauze dressings or your surgical bra. You will stay in the hospital overnight for observation and discharged the next day after your surgeon has determined that your recovery is on track. A follow up appointment will be made with you at this time, normally 7 days later. The hospital staff will liase direct with you for the appointment time and transfers will be arranged for you to attend this appointment. You will have your consult with your surgeon first prior to pre-surgery tests. If you have any last minute questions, you will have time to discuss them during your consult.

3 RECOVERY -WHAT TO EXPECT It's the moment you have been waiting for. Your breast augmentation surgery is over, but you are about to embark on the breast augmentation recovery process. Here's what you can expect now After Surgery After you wake up and are brought into the recovery room, a nurse will monitor you until you are ready to be taken back to your room. How long this takes varies, but usually it takes at least two hours. As the anaesthesia wears off, you will feel sore and possibly confused. Your vision may be blurry and you may be extremely sleepy. If you feel any pain, ask for a pain reliever. You may also feel very cold and start shivering immediately after your surgery. This is usually from the medications. The shivering can also be due to the temperature of the operating room or there may have been ice packs applied to the breasts after breast implant surgery. If you have had general anaesthesia, you may feel nauseated. Make sure to tell your surgeon or anaesthesiologist if you don't feel well. Your surgeon may have placed one or more drains in your incision to remove excess fluid. (The fluid may be pinkish or brownish.) These thin plastic tubes will be removed prior to discharge. Breast Incisions Keep your incisions/suture line dry. Your surgeon may have placed Steri-Strips on top of your incision line and sutures or you may have had internal sutures and tissue glue to bind the incision edges. Do not let creams, lotions into the incision, as these products may cause inflammation Monitor your Tempature Take your temperature regularly during your recovery. An elevated temperature could mean you have an infection. Upon discharge from the hospital you will be given oral antibiotics, make sure you complete the full course of antibiotic therapy. Wound dressing materials, pain and anti-swelling medications will also be provided. Change the wound dressing at least twice a day. But some surgeons do not need the patient to change the dressing until the follow up day Post Op Pain If your breast implants are placed over your chest muscle, your recovery will most likely be shorter and less painful than if your implants are placed under the muscle. Pain medication, can help. Do not take pain relievers with aspirin or ibuprofen until your surgeon says that it is ok to do so, since they can cause excessive bleeding. You may be swollen for three or four weeks after breast implant surgery. Drinking water, cutting back on salt and engaging in light exercise can help reduce this swelling (edema).the swelling usually will resolve within 2 weeks You will probably have some bruising after your breast implant surgery, but this will fade. Certain herbal remedies such as arnica or bromelain may help. Ask your surgeon what he or she recommends. If you still have discolorations after several months, talk to your surgeon. Know the signs of infection. This includes fever temperature over 37.8, pain not relieved by meds, redness, pus formation, excessive swelling, excessive tenderness. When signs and symptoms of infection is noted, call your doctor immediately.

4 In the days and weeks right after your surgery, your breasts will be quite firm and will sit high up on your chest. Don't worry. They will soften up and will drop. The wearing of correctly fitting compression garments will assist in the final position and comfort.remember, the breast on your dominant side (your right side, if you are right-handed) may not drop as fast as the breast on your non-dominant side. In the weeks and months following your breast augmentation procedure, your breasts may appear off in shape or position. They also may feel itchy or sensitive. This is because your skin has been stretched over the implants, making your breasts very firm and high. The full results of your breast augmentation won't be seen completely for many weeks, so be patient Sleeping With Your New Breast Sleeping is difficult right after your breast implant surgery. You have to sleep on your back with your upper back and head elevated to reduce swelling and pain. Be sure to have someone wake you up to take your meds, eat healthy meals, and drink your fluids Bathing You may shower the day after surgery. If you prefer to bathe, do not Do not submerge in swimming pools or bath tubs Leave the adhesive strips (steri-strips) on your skin. A moist environment is inviting to some bacteria,so it is important that you keep the wound or the incision dry and stay in a cool room especially if you have the armpit incision Tip: You may not be able to wash your hair for a week because you should not raise your hands over your head. Wash your hair the night before your surgery and braid it or place it in a ponytail Compression Bra s The Compression bra s acts as a "dressing," holding the breasts and implants in perfect position. Try to keep the bra "even." If the bra feels too tight or hurts, switch immediately to any bra that feels comfortable. A bra that is too tight can cause ulceration of the skin We advise you to wear a bra at all times for 2 weeks. After 2 weeks, you may sleep without the bra. You should not go braless during the day for 4-6 weeks after breast enlargement surgery. It is more comfortable not to wear an underwire bra. Breast Scars and Keloid Prevention Your incisions will heal slowly and scars will form. These scars may be raised and red before they eventually flatten and become paler. Some people may develop lumpy, raised scars called keloids. If you have dark skin, you are more likely to form keloids. Talk to your surgeon about keloid prevention. Visit our Scar Treatment Section for more information. Loss of Sensitivity You may lose some sensitivity in the nipple or the surrounding skin after breast augmentation surgery. This usually subsides within a few weeks. In rare cases, however, loss of sensation can be permanent. As sensation returns to your nipples and breasts, you may experience sharp pains, itchiness, heat, tingling and prickling. These temporary sensations occur because nerve function is returning. Nipple Over Sensitivity Many women complain of very erect and sensitive nipples after breast implant surgery. You can protect your nipples by using a Band-Aid (especially the large round ones), large corn pads, or nursing pads. These pads will protect your overly sensitive nipples from the abrasiveness of your clothing and shield your erect nipples. Activities Walk around as soon as you are able while recovering from surgery. This will help prevent blood clots and can also help relieve swelling. Do not engage in strenuous, vigorous activities, or exercise, for at least 4-6 after your breast surgery.

5 Risks and Complications The vast majority of breast augmentations go well, but no surgery is risk free. The subject of risks and potential complications of surgery is best discussed on a personal basis between you and your plastic surgeon Some of the potential complications that may be discussed with you include reactions to anesthesia, blood accumulation that may need to be drained surgically and infection. Although rare, an infection that does not subside with appropriate treatment may require temporary removal of the implant. Changes in nipple or breast sensation may result from breast augmentation surgery, although they usually are temporary. When a breast implant is inserted, a scar capsule forms around it as part of the natural healing process. The capsule may sometimes tighten and compress the implant, causing the breast to feel firmer than normal. Capsular contracture can occur to varying degrees. If it is severe, it can cause discomfort or changes in the breast's appearance. In such cases, more surgery may be needed to modify or remove the scar tissue, or perhaps remove or replace the implant. If you are at an age when mammographic examinations should be conducted on a periodic basis, it will be important for you to select a radiology technician who is experienced in taking x-rays of augmented breasts. Additional views of your breasts will be required. Your plastic surgeon, in some instances, may recommend other types of examinations such as ultrasound or magnetic resonance imaging. Risks During Implantation The following are some of the major breasts implant risk factors related to the surgical procedure itself: Anaesthesia reaction Infection Excess bruising or bleeding Hematoma Seroma Granulomas Risks During Recovery Breast implant risk factors can also be related to unfavourable symptoms that occur after surgery. Breast implant surgery patients should expect to experience some degree of the following symptoms for the first month or longer following plastic surgery: Pain Swelling Bruising Tenderness Loss or reduction of sensation in the breast Scarring Bleeding Capsular Contracture Almost every woman with breast implants has scar tissue surrounding her implants. This scar capsule doesn t show -- it s inside her breast, and is her body s natural way of protecting her from a foreign object. Sometimes, however, that capsule is too tight for the implant. Capsular contracture is when the capsule is too tight and feels like it is squeezing the implant. Capsular contractures range in severity from mild annoyance to devastating deformity. When the capsule tightens and hardens, you may experience any or all of the following symptoms: * hardening of the breast * pain in the breast * asymmetry of the breasts * painful deformity of the breast In the past, the only remedy for capsular contracture was removing the implant and the residual scar tissue, but times are changing. Today, there are treatments for severe capsular contracture. Some surgeons may squeeze your breast and implant to break up the capsule. This can be painful, and may cause implant deflation or bleeding. Other surgeons prefer to surgically lance the contracted tissue surrounding the implant to loosen it and break it apart. Additional treatments may include steroid injections and vitamin E. New technologies are being developed to treat capsular contracture, including the use of sound waves to soften the breasts. However, even if your symptoms are effectively treated, it is possible to develop capsular contracture again. Delayed healing and tissue atrophy are more rare, but are potential breast implant risk factors.

6 Breast Massage Breast massage is advised differently,depending on the surgeon or the type of implants. Usually it may be started on the third day following surgery. You surgeon may also advise to wait until the sutures are removed. You will be taught by the Surgeon how to massage directly only your own breast. Do not worry, you cannot break the implant. The best time to massage is in the shower or when you are warm and relaxed. You should massage once or twice a day for minutes for around 3 months. If swelling is noted on the first few days of massage, you should stop the exercise and resume after a few days At the earliest sign of hardening of the implant you must advise Destiny Meditravel office. Hardening can occur weeks, months, or even years after your surgery. If you catch it early it is possible to reverse the trend without further surgery. If you wait too long to inform Destiny Meditravel who will then inform your surgeon, you may need additional surgery to release the scar tissue around the implant. this needs to be done in an operating room under general anaesthsia How to Preform Breast Massage Imagine that you divide your breast into four quadrants. a) upper outer quadrant b) upper inner quadrant c) lower outer quadrant d) lower inner quadrant Remember to move your implant in all the fourquadrants using a slow steady movement. Position your palms on the outer quadrants of your breasts and press slowly inward. You can feel and see the implants bulge toward the inner quadrants of the breast. Press and hold for 20 to 30 seconds. Repeat four times. Press the breasts slowly outward such that a bulge on the outward quadrants of the breast will be noted. Press and hold for 20 to 30 seconds, repeat four times. Position your palms on the lower quadrants of the breast and push slowly upward. Bulging of the implant on the upper quadrants of the breast should be noted. Press and hold for 20 to 30 seconds. Repeat four times. Do the same for the downward movement.