Aesthetic Surgical Images: Helpful FAQ's

What can I expect in my consultation?

On the day of your consultation you will be greeted by our friendly, professional staff. You will enjoy the home-like setting of our office design. Your surgeon will listen carefully to your goals regarding breast enlargement and carefully answer all of your questions. He will carefully go over all of the known risks of the procedure. You will then undergo a physical examination. After the physical examination your doctor will discuss the different options available to you regarding placement of incision, location of the implant, size of the implant and type of implant to be used.

What do I have to do to prepare for the operation?

On the day of your surgery you will arrive at our Surgical Suite approximately one hour prior to your scheduled operating time. You will meet with our anesthesiologist and your doctor will visit with you and answer any questions you may have at that time. Your surgery typically takes 1½-2 hours. Once you are recovered and ready to go home, someone needs to pick you up and spend the rest of the day and the night with you. If you live outside of Omaha, we will ask that you spend the night at one of the neighboring motels offering discounted pricing for our patients. You will wear either a wrap around your breasts or possibly a post surgical bra. This will be up to the discretion of your surgeon. You will be given appropriate medications to control discomfort after surgery and you will be placed on an antibiotic for a few days after surgery. You will likely also receive a medication for control of postoperative nausea. On the day after surgery you will return to our office for a visit. Your wrap may be removed on that day and your surgeon will examine you.

What will the rest of my follow up be like?

You will be closely followed during your postoperative course. Your scheduled visits may depend somewhat on the distance you travel. Your stitches that need to be removed will be removed at 10-12 days after surgery. One of our doctors is on-call 24 hours a day, 7 days a week to help with any of your concerns.

How long will I be swollen?

Swelling and bruising will diminish over the next several weeks; however most of the bruising will be gone in 7-10 days. Usually 80% or more of your swelling will be gone in two weeks and the last 20% gradually fades over the next several weeks. You will be asked not to put your elbows above your shoulders for the first two weeks and not to engage in any heavy lifting for the first three weeks. Your surgeon and the staff will carefully help tailor your recovery to take into consideration your necessary daily activities.

How is breast enlargement performed?

Breast enlargement is accomplished by placing an implant (either saline or silicone) underneath the chest muscle or less commonly under the breast tissue itself. The choice for incisions include the armpit, the crease underneath the breast or on the edge of the areola. The areola is the darker skin which surrounds the nipple. All of these incisions typically heal very well and are usually inconspicuous after healing is completed. Scientific evidence has demonstrated that placement of the implant beneath the muscle of the chest wall has many advantages. It is generally accepted that implants placed under the muscle have a greater chance of staying soft and has a less chance of visible wrinkling. It usually makes moremammography easier to perform and therefore more accurate.

Are their different types of implants available?

The majority of women who undergo breast enlargement currently request saline implants. Implants are available in different shapes. The two basic shapes are a round implant or a so-called "tear drop" implant. There are advantages and disadvantages to both. Some implants have a smooth surface and others have a more roughened texture to the surface. The choice of incision, type of implant and type of surface texture should be made after your surgeon has carefully explained the pros and cons to you. Your surgeon should be experienced in the use of all these choices and help you decide which is best for you.

Recovery after Breast surgery

Recovery following breast surgery is generally swift. Most of the swelling and discomfort generally resolve within five to ten days. Most women can resume work approximately two to five days after a breast lift. Aerobic activities may need to be deferred for four weeks post-operatively. Most of the sutures will be absorbable but some may need to be removed after about a week. Within the first week or two, the surgeon will likely recommend wearing a soft bra for several weeks. Swelling and discoloration around the incisions generally subside in a few days. Temporary changes in sensation of the nipples and skin is normal, and will improve with time. Scars after breast surgery are permanent, but surgeons make every effort to make scars as inconspicuous as possible and they will fade over time. Since incisions are usually made around and below the nipple, scars should not be noticeable even in low-cut clothing.

What type of anesthesia is used?

General anesthesia will be administered by an anesthesiologist, a doctor who specializes in anesthesia.

How long does the operation take?

A breastlift normally takes 1½ to 2 hours. It will take longer if a breast implant is placed at the same time.

How is it done?

Your surgeon will carefully examine you and take special measurements of your breasts to determine the amount of skin to be removed and the new location of the nipple. Often, the darker skin surrounding the nipple called the areola is larger than you would like. During a breastlift this area is made smaller. Once the measurements are made with you in an upright position you are taken to the operating room and the operation is performed. Once the extra skin is removed from the lower parts of the breast special stitches are placed to uplift and reshape the breast to a more youthful appearance.

Will I be able to go home afterwards?

Yes.

What can I expect after surgery?

Your surgeon will place you in a surgical bra after surgery. You will go home after your recovery with someone who plans on staying with you that night. You will wear the bra and your dressings until you are seen the next day in our office. At that time your surgeon will give you instructions on how he would like you to care for your breasts. Specific instructions will be given to you before the operation regarding limitation of activity. In general, you will be expected not to lift your elbows above your shoulders for several days after surgery. Special instructions regarding hair washing will be given to you. You will be asked to refrain from heavy lifting for up to four weeks. Your doctor will give you more specific instructions depending on the type of activity you will be returning to. You will be given sufficient medication to control your discomfort postoperatively. You will also be given an antibiotic for a few days and possibly some medication to have on hand in case nausea develops.

What can I expect during the recovery period?

Much of the discomfort will be gone in the first 48 hours. Your breasts will remain slightly swollen and may have some bruising for up to ten days. Normally the stitches dissolve and do not have to be removed. The incisions will remain reddened for several weeks. Over the course of the next several months the redness will slowly diminish.

What can I expect long term?

Long term we expect significant fading of the redness and the incision areas. You may develop some looseness over time. The vast majority of women however enjoy the improved shape for many years and never require another lift.

Recovery After Breast Surgery

Recovery following breast surgery is generally swift. The swelling and discomfort generally resolve within five to ten days. Most women can resume work approximately two to five days after a breast lift. Aerobic activities may need to be deferred for four weeks post-operatively. Most of the sutures will be absorbable but some may need to be removed after about a week. Within the first week or two, the surgeon will likely recommend wearing a soft bra for several weeks. Swelling and discoloration around the incisions generally subside in a few days. Temporary changes in sensation of the nipples and skin is normal, and will improve with time. Scars after breast surgery are permanent, but surgeons make every effort to make scars as inconspicuous as possible and they will fade over time. Since incisions are usually made around and below the nipple, scars should not be noticeable even in low-cut clothing.

How successful is breast reduction surgery?

Breast reduction surgery is highly effective in relieving the problems of neck, back and shoulder pain. In addition to alleviating the added weight associated with large breasts, the operation will lift them and provide a more shapely and youthful appearance.

Does insurance pay for this procedure?

Many insurance companies recognize the effectiveness of breast reduction surgery in alleviating the pain and discomfort associated with overly large breasts. At your private consultation, your doctor will examine you to determine whether or not you are a suitable candidate for this procedure. A letter will be sent to your insurance company along with photographs. The photographs do not show your face. Your insurance company will review the information and make a determination as to whether they are going to provide benefits for you. The entire process for prior-authorization may take up four to eight weeks before we receive your insurance company's response. You may then schedule your surgery

What should I expect in the consultation?

Breast reduction surgery is commonly performed at Aesthetic Surgical Images. Our staff is very experienced in the individual needs and goals of women requesting this type of surgery. After being greeted by our staff, you will have a lengthy consultation with your surgeon who will explain the risks and benefits associated with this procedure, perform a physical examination and determine whether or not you are a suitable candidate for breast reduction surgery. After the consultation and physical examination, your doctor will discuss with you how much breast weight will be removed. Our staff will then discretely photograph you. Your face will not be in the picture and the photographs of your breasts along with your individual history will be sent to your insurance company with a request for pre-authorization.

What do I need to do before surgery?

After you are scheduled for surgery you will be given instructions on medications which you should not take prior to surgery. These include aspirin or aspirin-containing compounds and ibuprofen. Other medications are listed and will be discussed by our nursing staff. You will be instructed not to smoke for at least two weeks before surgery and for at least two weeks after surgery. Approximately 1-2 weeks before surgery you will be scheduled for a preoperative visit. This is a good time to ask any additional questions you may have.

What can I expect on the day of surgery?

On the day of surgery you will arrive 1-1½ hours before your scheduled operation. You will visit with the anesthesiologist and will be given the opportunity to ask your doctor any additional questions.

How long does the operation take?

This operation normally takes two hours.

What can I expect after surgery?

A surgical support bra will be applied immediately following the surgery. Beneath the bra there may be some additional bandages. You will stay in our recovery area until you are fully recovered. You will then be allowed to go home accompanied by someone who will spend the rest of the day and the night with you.

What can I expect after that?

You will return to our office the next day to be examined and have your dressings changed. The next follow up visit will be scheduled approximately 3-5 days after that.

What will my limitations be after surgery?

During your preoperative visit you will be given specific instructions on your postoperative care. You will be asked not to lift anything over five pounds for two weeks and not to raise your elbows above your shoulders. You can still wash your hair and fix your hair, but high reaching will be discouraged. You will also be requested not to do any heavy lifting for up to four weeks. Other details regarding your postoperative care will be discussed by your doctor.

Recovery After Breast Surgery

Recovery following breast surgery is generally swift. The swelling and discomfort generally resolve within five to ten days. Most women can resume work approximately five days to two weeks after a reduction. Aerobic activities may need to be deferred for four to six weeks post-operatively. Most of the sutures will be absorbable but some may need to be removed after about a week. You will wear the support bra from surgery for several weeks. Swelling and discoloration around the incisions generally subside in a few days. Temporary changes in sensation of the nipples and skin is normal, and will improve with time. Scars after breast surgery are permanent, but surgeons make every effort to make scars as inconspicuous as possible and they will fade over time. Since incisions are usually made around and below the nipple, scars should not be noticeable even in low-cut clothing.

What type of anesthesia will be used?

General anesthesia will be used. It will be administered by an anesthesiologist, a doctor who specializes in anesthesia

Do my stitches have to be removed?

All of the stitches placed for breast reduction dissolve and do not have to be removed.

How long will bruising and swelling last?

Bruising is normally gone in two weeks after your operation. Approximately 80% of your swelling will be gone in 3-4 weeks after surgery. The last 20% will gradually leave over the next several months. The scarring associated with the surgery normally fades over a period of 12-24 months.

What is the cost of a consultation?

Cosmetic consultations are complimentary. This gives you the opportunity to meet with the doctor and have your questions answers with no obligation.

What hours are available for consultation?

Cosmetic consultations are offered most afternoons and evenings until 8pm.

What is a cosmetic consultation?

Any procedure that may be run through insurance is not considered cosmetic in nature. The following proceudres are often considered cosmetic (exceptions may apply): Breast Augmentation, Breast Lift, Liposuction, Tummy Tuck, Facelift, Browlift, Eyelid Surgery and Rhinoplasty.

What happens at a consultation?

Your Consultation Will Include:

Discussion with your physician
Evaluation with your physician
Computer Imaging (except breast surgery)
Fee Quote
Tour (when operating room is available)

Consultations usually last an hour to an hour and a half. During your appointment, you will have the opportunity to discuss your concerns and goals with your physician and have your questions answered. You may discuss as many procedures as you wish at your appointment, as it is quite common, and safe, for patients to have more than one procedure performed at the same time. Your physician will evaluate you for the procedure(s) you are considering and inform you about all of the associated benefits and risks with surgery. Computer imaging will also be used to help you have realistic expectations regarding your post-surgical result. Unfortunately, the computer technology is not capable of breast imaging, but for most other procedures the imaging is very accurate. Feel confident when you visit ASI, you will receive an honest opinion regarding your concerns.

To Schedule an Appointment:
We'd love to hear from you!
Please call us at 402-390-0100 or 800-331-5001.
Appointments are available from 1:00 p.m.-7:30 p.m. Monday through Thursday. (Some exceptions can be made based on the physicians' surgical schedules if you have limited availability)

*Complimentary consultations apply only to strictly cosmetic surgery procedures and treatments. Procedures which may be covered by insurance, for example, breast reduction surgery, we must bill the initial consultation to your insurance company.

What is Liposuction?

Liposuction is the removal of unwanted fat through incisions that are usually less than a quarter of an inch in length. Through these small incisions a device called a cannula is inserted. The cannula is moved back and forth thereby breaking up the fat. The fat is then suctioned through the cannula, through a tube, into a container.

What is the main difference between liposuction of the abdomen and a tummy tuck?

Liposuction of the abdomen removes only excess fat. A tummy tuck will remove excess fat, redundant skin, many stretch marks and will also tighten the abdominal wall muscles. These muscles may have been stretched from pregnancy. Your doctor can help determine which procedure will best achieve your goals.

How is it performed?

On the day of surgery you will be marked in a standing position. We mark you in a standing position because we know that skin and fat shifts when you are laying down. Your surgeon will determine at that time approximately how much fat he will remove in each of these areas. You are then taken to the operating room and either general anesthesia or local anesthesia will be administered. The fat to be removed is first injected with a special fluid. The fluid contains epinephrine (adrenaline), saline solution and in some cases lidocaine (a local anesthetic). The fluid is intended to create pressure in the fat to reduce bleeding. In addition, the adrenaline will shrink the small blood vessels in the fat which also reduces any bleeding. A cannula is then placed through incisions less than a quarter of an inch in length. With a back and forth movement, the fat is broken up and suctioned into a canister.

Is the fat removal considered permanent?

Although there are exceptions to every rule it is very rare to see reaccumulation of fat in areas which have undergone liposuction.

What is tumescent liposuction?

The word tumescence means "tenseness". In tumescent liposuction enough fluid is placed into the fat to make the fat feel quite tense and almost hard to the touch. As mentioned, this pressure in the fat will cut down on some bleeding that may occur during liposuction. The fluid may also contain epinephrine (adrenaline) which shrinks blood vessels and further prevents bleeding. It may also contain a local anesthetic in order to remove feeling from the area. Tumescent liposuction can be done under a local anesthetic or under general anesthesia.

What is ultrasonic liposuction?

Ultrasonic liposuction is another liposuction technique. The cannula utilized in ultrasonic liposuction emits ultrasonic waves at its tip. When these ultrasonic waves contact the fat, the fat is liquefied. This technique is used most frequently on men and on other more fibrous areas of fat.

Is ultrasonic liposuction better than tumescent liposuction?

Tumescent liposuction works very well on most patients. At Aesthetic Surgical Images we were one of ten practices to be invited to participate in the only national study done to evaluate ultrasonic liposuction. Along with other investigators we learned that ultrasonic liposuction may be better in cases where the patient has had previous liposuction and there is some scarring in the fact. We have also found that it may be helpful in removing the tougher fat found in the male love handle area and also in male breast reduction. In general however, tumescent liposuction works well for most people. At Aesthetic Surgical Images we will discuss our experience with you and help decide which technique is best for you.

Is general anesthesia safe?

Yes, general anesthesia is safe. Our anesthesia is performed by a physician who specializes in anesthesia and is skilled in taking care of the patient undergoing liposuction. We are fortunate to have the same anesthesiologists each day. With the concentrated experience they have in liposuction and other cosmetic procedures they are ideally suited to perform anesthesia. Most of the complications with liposuction which have achieved national notoriety were the results of these procedure performed by inappropriately or poorly trained physicians.

Will I go home after surgery?

Yes. You will go home on the day of surgery.

What can I expect in the first 24 hours?

In the first 24 hours after surgery you will need to be accompanied by someone who will stay with you throughout the day and the night. On the next day we will see you back in the office for a postoperative check.

What about the rest of my recovery?

During the first week we will expect you to wear the compression garment we have selected for you. You will have your choice between either a surgical long-legged girdle or two pairs of panty hose. Both of these give adequate compression. Compression is important because the cannula creates small hollow areas which we want to collapse and be molded into an optimal shape. You will wear your garment continuously for the first week. You can shower with the garment on and blow dry it with a blow dryer on a low setting. At the end of the week we will see you and remove the few stitches you have in. You will then be expected to wear your compression garment as much as possible for the remaining three weeks.

When can I resume normal activity?

This depends on the type of activity you plan to return to and the amount of fat removed and the number of sites liposuctioned. Going on a walk the next day should not be a problem. We recommend, however, that you refrain from aerobic exercise for approximately three weeks. Some people return to work the next day; many people however prefer two more days of recuperation before they return to their work place.

When will I see my final result?

During the first week to ten days you will notice swelling. Following this the swelling subsides and your final result gradually unfolds. Everyone is different. Some people retain their swelling longer than others. In any event, you should notice a significant improvement a few weeks after the operation. We would expect continued improvement over the next 2-3 months.

What are the risks associated with liposuction?

As with any operation a risk of infection is present. This, however, is extremely rare in patients undergoing liposuction. Bleeding is also a risk which is equally rare. Problems with blood pressure can develop if too much fat is removed. At Aesthetic Surgical Images we closely adhere to the guidelines suggested by the American Society of Plastic Surgery. If a person for some unusual reason requires the removal of more fat it will either be done in a separate operation or possibly in the hospital with an associated hospital stay.

Can more than one area be liposuctioned at the same time?

Yes. The number of areas to be liposuctioned is not as important as the total amount of fat removed. Many patients undergo liposuction with a total amount well below the upper limits of safety recommended by the American Society of Plastic Surgery. What this means, is that you can safely have your hips, thighs, buttocks and abdomen all contoured at the same operation. This cuts down on your recovery time and markedly reduces your cost.

What is the difference between a mini-tummy tuck and a full tummy tuck?

The basic difference between a mini-tummy tuck and a full tummy tuck is that the belly button is not repositioned during the course of a mini-tummy tuck and the muscles are usually not tightened. In a mini-tummy tuck the improvement is generally restricted to the lower part of the abdomen between belly button to the pubic bone. The incisions for a mini tummy tuck are shorter and a limited amount of skin is removed. In a full tummy tuck the tightening goes up through the rib cage margin and allows the surgeon to tightnen the muscle layer from the rib margin down to the bone of the pelvis. When this operation is perfomred it requires that the belly button be brought out through a new incision after the skin is pulled down.

How do I know if a mini-tummy tuck is best for me?

Your surgeon will carefully evaluate you during your consultation. If he or she feels that liposuction alone will leave you with loose skin but does not feel that you need a full tummy tuck, then a mini tummy tuck will be recommended.

How long is recovery from a full tummy tuck?

With a full tummy tuck a longer incision is made. Every effort is made to plan the incision in such a way that it will be covered by the briefest of clothing. This normally is your bathing suit. Through the incision, skin and fat is lifted off of the muscle up to the belly button. At that point an incision is made around the belly button to allow for the skin between the belly button and the bottom of the rib cage to be freed up. The extra excess skin is then measured and removed. The muscle is then tightened. Once the muscle is tightened the incision is closed. Normally one or two suction drains are placed to remove fluid which may accumulate in this area in the postoperative period. The suction drains remain until drainage diminishes.

Why are the muscles tightened?

Many women who undergo child bearing develop a separation of their abdominal muscles. Unfortunately this separation cannot be improved with exercise and sit ups. In order to correct this problem, specialized stitches in the muscle area are required. Once the muscle is tightened the excess skin and fat is removed, the abdomen has undergone the maximum amount of recontouring.

What is the recovery with a full tummy tuck?

Complete recovery from a fully tummy tuck may take 6-8 weeks. During the first ten days to two weeks you will usually remain at home resting comfortably. During this time patients are encouraged to walk around the house. After the initial recovery you will ease back into your daily activities during the next 2-3weeks. You should refrain from heavy exercise for 6-8 weeks after the operation.