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Fees and Insurance
We collect all fees for aesthetic plastic surgery prior to surgery. Costs depend on the complexity of the operation, where the surgery takes place and which anesthetic is administered. Please note that in addition to the cost of surgery (including the surgeon, facility and anesthesia fees), there will likely be additional fees for labs and medications required for surgery. All fees and payment arrangements and options will be discussed during the consultation appointment.
As a rule, aesthetic plastic surgery is considered elective and is not covered by most insurance plans. If you have any questions about insurance coverage, please ask during your consultation appointment.
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Scheduling Surgery
We want you to provide you with a wealth of information, so that you can make a well-informed decision to have surgery. You can expect that your consultation will last anywhere from one to two hours in our office, which will typically include a consultation video on the procedure and a meeting with Dr. Mills and one of our patient coordinators. At this time, Dr. Mills will be gathering information on your needs and expectations and giving you his treatment recommendations. When you are ready to schedule surgery, we will review our surgery schedule to determine possible dates that will fit into your schedule. There are certain times of the year when the surgery schedule is very busy and will determine how quickly you can have your surgery. Upon scheduling surgery, we require a non-refundable 25% deposit to hold the date. At that time, we will schedule a preoperative appointment about 2 weeks prior to surgery to prepare you for surgery.
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Surgical Facilities and Anesthesia
Surgery can be performed in a number of locations. Generally, aesthetic plastic surgery takes place in a hospital or an ambulatory surgery center. We perform the majority of our cases at Oceanview Ambulatory Surgery Center, Inc., which is a Medicare-certified ambulatory surgery center adjacent to our office suite. This facility meets strict health care guidelines and is equipped with the latest in surgical technology. Additionally, our surgical facility is located next to South Coast Medical Center.
For some aesthetic surgical procedures, you will be given general anesthesia so that you sleep through the entire operation. During surgery, you will be carefully monitored by a certified registered nurse anesthetist. In other cases, a local anesthetic will be administered to numb the area to be treated, along with a sedative to relax you. Postoperative discomfort is normally controlled with medication.
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Risks and Complications
Although some of the procedures described appear to be relatively simple operations, it is essential for you to understand that aesthetic plastic surgery, like all surgery, has risks.
Plastic surgeons perform thousands of successful aesthetic procedures each week, but as with any type of surgery, a patient can have an adverse reaction to the anesthetic or be affected by postoperative complications such as blood clots, infection or poor healing. These problems can occur even when the surgeon has performed the operation with the utmost skill. Since smoking may interfere with proper healing and aspirin may increase the risk of excessive bleeding, you will be advised to avoid them before and after surgery. Occasionally, surgical revisions may be desirable to achieve optimal results.
It is important for you to remember that aesthetic plastic surgery molds and reshapes living tissue, and the results are not absolutely predictable. No surgeon can offer risk-free surgery or guarantee a perfect result.
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Recovering From Your Surgery
During your consultation and preoperative appointments, we will inform you of any restrictions to your normal activities following surgery. In general, you should avoid strenuous exercise and other activities that raise your blood pressure (including bending) for several days to weeks after surgery. It also takes time for the visible signs of healing (e.g. bruising, swelling) to subside. Do not expect to see the final results of your surgery right away. Plan your social activities to allow sufficient time for recovery.
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Follow-up Visits
Since you are making an investment in your body or face, we encourage you to come see us for routine follow-up care. Some procedures will require routine follow-up visits to monitor your progress and healing. Please note that any follow-up visits related to an aesthetic procedure are included in your surgery fees. We encourage you to come see us on an annual basis. For our out-of-town patients, we encourage you to send us pictures of your progress via email or regular mail. We love to keep in touch with our patients.
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Other Considerations
The results achieved in some aesthetic surgical procedures, such as surgery of the nose, ears and chin, are permanent. In others, particularly those that diminish the effects of aging, results may be long-lasting, but are not permanent.
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Choosing the Right Surgeon
As with any surgery, the single most important factor in the success of aesthetic plastic surgery is the surgeon you select. Do not take this responsibility lightly. In most states, it is legal for any physician who holds a medical license, with or without surgical training, to advertise as a plastic or cosmetic surgeon. That is why it is essential for you to understand what makes a surgeon qualified and research the qualifications of any surgeon that you are considering. We recommend that you conduct your own research to verify training and experience and weigh your decision carefully. There are a number of places and ways to examine a surgeon's credentials and we encourage you to check these out before having surgery.
- Check for certification with the American Board of Plastic Surgery (ABPS)
Certification with the ABPS means that the surgeon has obtained an undergraduate degree and completed medical school, a minimum three year approved surgery residency and an additional two to three year approved plastic surgery residency. After completing these educational requirements, the candidate has to practice two years in plastic surgery and pass rigorous written and oral examinations administered by experienced plastic surgeons. It is important to note that the ABPS is the only nationally recognized board by the American Board of Medical Specialties (ABMS) to certify the plastic surgery specialty. Do not be confused by any other official-sounding boards and certifications. Additionally, there is no separate, ABMS-recognized certifying board for cosmetic surgery. If there is confusion about a surgeon's board certification, you may consult the ABMS Directory of Certified Medical Specialists, which is available in most libraries.
- Check for membership in The American Society of Aesthetic Plastic Surgeons (ASAPS)
The ASAPS has the strictest requirements of any plastic surgery organization for protecting the public. All members of this professional society are fully trained in plastic surgery and are certified by the American Board of Plastic Surgery. After medical school, applicants must also have completed at least three years of basic surgery training (usually general surgery), then two to three years of specialized plastic and reconstructive surgery training. Recommendation by the training Program Director is mandatory, as well as passing both the oral and written board examination. After board approval, there is a two-year waiting period before applications are accepted. The majority of procedures that are performed in the physician's practice must be aesthetic procedures. From any patient's perspective, membership in this society gives the assurance that the surgeon has the training, experience and background that will yield a superior aesthetic result.
- Check for membership in the American Society of Plastic Surgeons (ASPS)
Like the ASAPS, the ASPS requires its members to be certified by the American Board of Plastic Surgery. The ASPS represents the full scope of plastic and reconstructive surgery and provides ongoing training and support to its members. Both the ASAPS and ASPS host annual meetings to discuss the latest innovations and techniques in plastic surgery.
- Check the surgeon's hospital affiliations
All qualified hospitals have been accredited by the Joint Commission of Accreditation of Healthcare Organization (JCAHO). An appointment to a surgical staff of an accredited hospital indicates that the surgeon's capabilities and performance have been reviewed and judged acceptable by medical colleagues. Be sure that your surgeon has hospital privileges to perform the specific surgical procedure that you are interested in, even if you plan to have your surgery performed in an ambulatory surgical center.
- Talk candidly with the surgeon
After you have checked a surgeon's credentials, use the consultation appointment to ask questions about the surgery and discuss your expectations. A qualified and reputable plastic surgeon will be happy to spend time with you, answer your questions and inform you of all the possible risks and side-effects associated with surgery.
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Liposuction
Most men and women seek a fit and well-proportioned body. Dr. Mills see patients everyday in consultation that complain that some areas of their body are just resistant to change, even with the strictest of diet and exercise programs. As an option to sculpt these areas and remove excess fat, Dr. Mills offers lipoplasty or liposuction. Liposuction is not a weight loss program; in fact, there is a maximum amount of fat (5000 cc) that can safely be removed in one procedure. However, liposuction is an ideal solution to treat those "problem" areas that are disproportionate to the rest of the body. Liposuction is most effective for men and women of normal weight who simply want to improve their body contour. Dr. Mills can use liposuction to slim the hips and thighs, flatten the abdomen, sculpt the chin and shape the calves, lovehandles, back, ankles, knees and upper arms. Most patients who have this surgery feel more confident in the way that they look and how their newly-sculpted body fits into clothing.
Dr. Mills uses several different liposuction techniques or combinations thereof to achieve optimal results. Dr. Mills always uses the tumescent technique, in which the fat is pre-injected with a sterile salt-water solution containing small amounts of adrenaline and local anesthetic. In addition, he may recommend suction assisted lipectomy (SAL), ultrasonic-assisted lipectomy (UAL) or power-assisted lipectomy (PAL), depending on your specific needs and fibrousness of the area to be treated. SAL involves making a tiny incision or incisions near the treatment area. Wherever possible, Dr. Mills places the incisions within natural folds or contour lines to hide them. Dr. Mills places a slim, hollow tube called a cannula through the incision, so that its tip penetrates the underlying fat. By contouring with one or multiple cannulas, Dr. Mills vacuums the fat into a suction pump. He pays close attention to the measurements, the 3-D contours and fat removed to achieve optimal symmetry.
UAL has gained much popularity in recent years because it aids in skin contraction. This form of liposuction contracts from underneath the skin and works very much like a laser on the facial skin. This technique involves a two-step process that uses the energy from sound waves to liquefy the fat prior to suctioning. As such, Dr. Mills is able to more effectively extract the fatty tissue from an area. Dr. Mills uses PAL to treat very fibrous or scarred areas, such as the back, flanks and above the belly button. Dr. Mills is adept at using this new technology and has seen a more even result in fibrous areas.
Typically two weeks prior to surgery, you will meet with our pre-operative coordinator to review all of your pre-operative instructions and make sure that you complete all the necessary laboratory tests and health screenings. Dr. Mills will likely have you donate 1 - 2 units of your blood to a blood bank for use during your surgery. The use of your own blood during surgery will aid in your recovery and enable you to 'bounce back" more quickly. If you are a smoker, Dr. Mills will recommend that you quit smoking at least 2 weeks prior to surgery and not to resume for at least 2 weeks after your surgery. Additionally, there are certain medications, herbs and potions that your pre-operative coordinator will ask you to cease taking from several weeks prior to your surgery to several weeks after your surgery. Your pre-operative appointment will also be a time for you to ask any final questions, so that you are fully prepared for surgery and your recovery period.
Upon admission to the facility, you will spend about an hour with a nurse who will prepare you for surgery. Your surgical and recovery time will vary, depending on the number of areas to be treated. During your surgery, you will have a team of people caring for you. Dr. Mills' team includes a nurse anesthetist, registered nurse and surgical technician. Dr. Mills has been working with most of these staff members for many years and some since close to the beginning of his practice. You will need a responsible adult to accompany you to our facility and be available via phone, so that we can alert them of your discharge time. Additionally, you will need someone to stay with you for the first 24 hours after your surgery.
After your surgery, you will wear a tight surgical garment that will help "set" your new body shape. This garment can be removed for short periods of time in your first post-operative week for showering, but should be worn at all other time for 4 - 6 weeks. Dr. Mills will advise if and when you can switch to a lighter garment, such a bike pants. It is important that you wear the surgical garment as advised because it provides the necessary support for the skin and tissue to re-drape the newly contoured line. Further, it is important that you keep all post-operative areas free of creases and wrinkles throughout the healing period to achieve the smoothest skin contour possible. Dr. Mills will advise you not to sit upright, especially if you have had liposuction to your stomach. He recommends standing or lying down to decrease the risk of any unnecessary creases from forming.
Dr. Mills will advise that you return for a follow-up visits at 5 days, 2 weeks, 1 month, 3 months and 6 months post-operatively. You will likely have some bruising to she surgical areas, but these should completely fade within the first couple of weeks. Dr. Mills advises that you keep your surgical area out of the sun for at least 8 weeks to avoid permanent bruising and discoloration. Additionally, you might note a slight weight gain in the first few days and even weeks after surgery. This is most likely due to fluid replacement, retention and swelling and should subside in the first couple of months.
Within several days after surgery, you should be able to go back to your normal routine. You can start walking and do light work-outs within 2 weeks from your surgery. Dr. Mills will advise you on when you can resume more strenuous work-outs. You can expect to return to work after about one week.
Most patients see a noticeable difference in their body shape after about 2 weeks. As the swelling subsides, you will continue to see more definition and change. Generally, patients see their final results after about 3 months. One development in medical research that Dr. Mills participates in conjunction with liposuction is stem cell banking. Stem cells are present in adipose or fat tissue and can be extracted during your liposuction procedure. Medical researchers anticipate that stem cell research will likely yield future treatments in key areas of medicine, possibly enabling doctors to cure some diseases, injuries and the effects of aging.
When you schedule your surgery with Dr. Mills, you will have the option of banking the stem cells from the fat tissue removed during your surgery. Currently, we work with a stem cell bank that will process and store your stem cells for a fee. When and if you need stem cell therapy, you will have immediate access to your own healthy stem cells. If you are interested in learning more about these medical discoveries, Dr. Mills can provide you with further literature at your consultation.
Dr. Mills looks forward to meeting you in consultation to develop a surgical plan that best suits your needs. He will let you know which technique best suits your particular case based upon your goals, medical history and skin texture and turgor. In the meantime, please feel free to email our patient coordinator through our contact us page with any specific questions that you might have about liposuction.
Dr. Mills is confident that he can provide you with the new body you have looking for and you will be excited about the way you look.
Liposuction Post-Operative Information
You can expect:
- To drive after 3 - 5 days (after all pain medication has been discontinued).
- To resume normal activities after several days.
- To resume light aerobic activity after 2 weeks.
- To see bruising for the first month.
- To experience mild to moderate pain.
- To wear a compression garment for 4 - 6 weeks.
- To visit our office post-operatively at 5 days, 2 weeks, and 1, 3 and 6 months and 1 year post-operatively.
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Abdominoplasty / Tummy Tuck
Many men and women wish for a flatter and firmer stomach, especially after their abdominal muscles have been stretched to a point where the elasticity has been lost. We most commonly see the loss of abdominal elasticity in cases of significant weight loss and pregnancy. Both men and women come to our office complaining that their abdominal "pooch" will not respond to diet or exercise. An abdominoplasty or 'tummy tuck' is generally the recommended solution for removing the excess skin and fat from the middle and lower abdomen and tightening the muscles of the abdominal wall, resulting in a flatter and more toned stomach.
Upon performing a physical examination and reviewing your goals and medical history, Dr. Mills will present your surgical options to you. One available option may be liposuction alone. This option is best for individuals with good skin elasticity and only excess abdominal fat.
The next available option is a 'mini abdominoplasty.' This procedure is best if you have a "pooch" from the belly button down and no laxity of skin above the belly button. Dr. Mills performs this procedure most often for women that have a hysterectomy or C- section scar with a little "pooch" above the scar.
The final option is a full abdominoplasty, which is best for those who have so much extra skin that they even have excess skin above the belly button. With a full abdominoplasty, Dr. Mills can also tighten lax abdominal muscles above and below the belly button. Dr. Mills generally places the incision in the panty line in a way that is even hidden when wearing a french-style bikini and/or low-rise jeans. We recommend that our patients come with a touch of a tan line at the panty line, so that Dr. Mills can more effectively determine where to place your incision. Most patients who undergo a 'tummy tuck' are so happy with the way their clothes fit and the concealed placement of the incision that the scar is of minimal concern. A two-piece bathing suit can generally be worn after surgery, discreetly hiding the scar, but allowing the new flatter stomach to be "shown off."
About two weeks prior to surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary lab tests and health screenings. If you are a smoker, you will be advised to quit smoking at least four weeks prior to surgery and not to resume for at least four weeks post-operatively. Additionally, there are certain medications, herbs and potions that we will ask you to cease taking for two weeks prior to surgery and up until two weeks post-surgery. This appointment will also be a time for you to ask any final questions, so that you are ready for surgery and have an optimal recovery period.
On your day of surgery, you should allow approximately 3 - 4 hours for your surgery. From the moment that you enter our facility, you will be cared for by Dr. Mills' experienced surgical team. This team includes Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. This group is committed to providing you with the best care possible from the time you are admitted to the moment you are discharged. Dr. Mills has worked with some of these surgical team members since the beginning of his practice and all members share in his core values and patient care standards.
You will likely be required to stay at an overnight facility with a post-operative care nurse after your surgery. The nurse will closely monitor you, administering your medications and assisting you with walking. In addition to traditional pain medications, we offer a new device called a pain pump to decrease pain and discomfort during your post-operative period. Since offering this product in conjunction with an abdominoplasty, we have seen a marked decrease in our patients' post-operative pain levels and recovery time.
You will need to have a responsible adult pick you up the morning following your surgery and stay with you the next 1 - 2 days. Once home, we encourage you to walk around the house at frequent intervals to keep the blood circulating. You will want to bend over a little as you are up and walking to ease the tension on your flat new abdomen. This process will become easier with time and practice. Dr. Mills will also likely recommend the use of an oxygen tank for the first week following your surgery, as he has seen faster healing and reduced scarring.
Within several weeks after your surgery (after your final sutures have been removed), you can increase your activity level. Recovery time varies; we have seen some patients bounce back quickly, returning to work after one week. Others take about three weeks to resume normal activities. Dr. Mills typically recommends mild exercise after 2 weeks, as it will aid healing, reduce swelling, lower the chance of blot clots, and help tone muscles. You should avoid vigorous exercise until Dr. Mills indicates that you are ready.
Your incision site may appear to become more red in the first 3 - 6 months as it heals. This is normal and should fade with time. You can expect your scars to flatten out and lighten in color after about 9 months to a year. While the scars will never disappear completely, Dr. Mills tries to place your incisions so that the scars are concealed by your clothing, including most bathing suits and low-rise jeans.
If you are looking for a flatter and firmer tummy, we are confident that we have a solution for you. We look forward to meeting you in consultation to further discuss your needs. In the meantime, feel free to email any questions to our patient coordinator from our contact us page. Additionally, if you would like to talk to one of our patients who has had an abdominoplasty, we would be happy to connect you with a patient. Let us know how we can best serve you, because we want this to be a great experience for you.
Abdominoplasty Post-Operative Information
You can expect:
- To drive after you are completely off your pain medications, which is usually about 7 days.
- To use oxygen for the first week post-operatively.
- To use a pain pump for the first 5 days after surgery.
- To use a drain for about the first week post-operatively.
- To resume normal activities after 2 - 4 weeks, depending on how you heal.
- To avoid strenuous workouts for the first 3 - 4 weeks after surgery.
- To visit our office post-operatively at 2 days, 5 or 7 days, 2 weeks and 1 month. (We also recommend annual follow-up visits.)
- To see your abdominal scar fade after about 9 - 12 months.
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Brachioplasty
Brachioplasty is the medical term for an upper arm lift plastic surgery procedure. During the brachioplasty procedure excess fat and skin is removed from the upper arm area in order to create a firmer more youthful looking arm contour. A brachioplasty can enhance the appearance of arms that, with age or weight loss, have lost their natural firmness and shape.
A brachioplasty procedure may not be appropriate for people with certain medical or physical conditions. Patients who have had mastectomy surgery may not be able to have a brachioplasty because of the increased risks associated with a procedure of this nature. Patients who have experienced repeated armpit infections or experience excess sweat production may also not be good candidates for brachioplasty cosmetic surgery.
A good candidate for brachioplasty surgery is a patient in good health that has realistic expectations about the procedure and its results. Brachioplasty patients will have a more positive experience with cosmetic surgery if they are fully informed about what to expect before, during and after brachioplasty surgery.
Brachioplasty cosmetic surgery is an outpatient procedure that is done under a general anesthetic. The average brachioplasty procedure takes two hours plus time for anesthesia and initial recovery time. Brachioplasty surgery can also be performed in conjunction with a liposuction procedure if the patient and the surgeon have determined that dual surgical procedures are optimal.
The average time of healing and recovery from brachioplasty surgery is two to six weeks during which time your surgeon may recommend the use of compression garments and may prescribe pain medications. Depending on the technique used during the surgery, drains and/or stitches may need to be removed in the first week or two of recovery. Many patients are able to return to work one to two weeks after their brachioplasty surgery.
Brachioplasty does carry some risks common to all surgical procedures. Complications involving anesthesia, bleeding or blood clots, scarring, nerve damage, and infection are all possible side effects of brachioplasty and virtually any surgical procedure, but are often preventable when proper precautions are taken.
Brachioplasty results are long-lasting and can produce dramatic improvement in the firmness and appearance of the upper arms.
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Blepharoplasty / Eyelid Surgery
Many men and women come to Dr. Mills, complaining that their droopy upper and lower eyelids make them look tired, sad or older than they feel; they desire a more rested and refreshed look that better reflects how they feel on the inside.
Dr. Mills generally suggests blepharoplasty, or eyelid surgery, to help them achieve the appearance that they desire.
With blepharoplasty, Dr. Mills can generally reshape the excess fat and drooping skin of the upper eyelid. Additionally, he can minimize bags under the eyes and tighten the lower eyelid skin. Most of Dr. Mills' eyelid surgery patients remark that the surgery resulted in a more rested, refreshed and happy appearance. Oftentimes, their friends and family never guessed that they had surgery that made their appearance look better.
While most people opt to have eyelid surgery to minimize the signs of aging, even some people in their late 20s and early 30s benefit from the procedure.
You will likely benefit from blepharoplasty if you have any of the following conditions:
Upper Eyelids
- Excess skin that hides the natural fold of the upper eyelids
- Loose skin that hangs down from the upper eyelids
- Puffiness in the upper eyelids (or excess fat)
Lower Eyelids
- Excess skin and fine wrinkles of the lower eyelids
- Puffy "bags" (or excess fat)
It should be noted that crow's feet, dark circles and/or a sagging brow are not treated with a blepharoplasty, but these conditions may be treated with other procedures. Many patients believe that they only have upper eyelid skin laxity, but oftentimes have a droopy or sagging brow (or a combination of eyelid skin laxity and droopy brow). In this case, Dr. Mills would likely suggest a browlift (with or without blepharoplasty, depending on the case). He may talk to you about the different types of brow lifts, (i.e. coronal, endoscopic or lateral browlift) or even midface suspension, if indicated.
In your consultation, Dr. Mills will assess the amount of excess fat and skin in your eyelid areas, the position of your eyebrows and the condition of the muscles around your eyelids to determine whether you are an ideal candidate for surgery on your upper eyelids (e.g. "upper blepharoplasty"), lower eyelids ("lower blepharoplasty") or both ("quad blepharoplasty").
Many patients opt to have eyelid surgery in conjunction with other facial procedures, such as a browlift to tighten a sagging brow or face lift to smooth out the loose skin of the face and neck. Combined with eyelid surgery, these procedures generally yield a very polished and pulled-together look.
With an upper blepharoplasty, Dr. Mills typically makes the incision in the natural crease of the eyelid, from the inside corner slightly beyond the outside corner into the crow's feet or laugh lines. The incision is typically concealed when healed because it follows the natural contour of the upper eyelid.
With a lower blepharoplasty, Dr. Mills conceals the incision just below the lower lashes. Through this incision, he can remove any excess skin, muscle and fat. Sometimes, Dr. Mills will perform a "transconjunctival blepharoplasty," placing the incision inside the lower eyelid. This technique does not require an external incision, but is mostly beneficial for patients without excess lower eyelid skin.
Within the last few years, the trend in plastic surgery is to blend or rearrange the tissue and fat to give a better contour and more youthful appearance rather than removing fat of the lower eyelids. This creates a more youthful appearance, instead of a hollow or sunken look. This method can also sometimes help a prominent "tear trough." Dr. Mills prefers this technique of lower lid blepharoplasty.
Additionally, there are those who have lost tone in their midface who can use this lower eyelid approach to suspend the midface to the brow, and even lend support to the lower lid. This procedure is, however, much more involved and has a typical recovery period of 4-6 weeks.
About two weeks prior to surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary lab tests and health screenings, including a "tear test" and possible visual field study. If you are a smoker, you will be advised to quit smoking at least two weeks prior to surgery and not to resume for at least two weeks post-operatively. Additionally, there are certain medications, herbs and vitamins that we will ask you to cease taking for two weeks prior to surgery and up until two weeks post-surgery. This appointment will also be a time for you to ask any final questions, so that you are ready for surgery and have an optimal recovery period.
Prior to your surgery, Dr. Mills suggests that you take the herbal supplements, Arnica Montana and Bromelain, which helps to reduce swelling, bruising and inflammation after surgery.
On your day of surgery, you should allow approximately 1-2 ? hours for your surgery. (The length of your surgery will depend on whether you do upper or lower blepharoplasty or both.) From the moment that you enter our facility, you will be cared for by Dr. Mills' experienced surgical team. This team includes Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. This group is committed to providing you with the best care possible from the time you are admitted to the moment you are discharged. Dr. Mills has worked with some of these surgical team members since the beginning of his practice and all members share in his core values and patient care standards.
While healing rates vary by patient, Dr. Mills has seen most patients feel pretty good within a couple of days. For the first 72 hours, you will want to elevate your head and keep crushed iced compresses over your eyes non-stop. You will reduce your swelling and bruising around your eyes significantly by following these instructions. The swelling should subside within 7-10 days, if you ice continuous for the first 3 days. You can cover any discoloration with camouflage makeup. Sutures will be removed in 5-7 days post-operatively. Once your sutures are removed and incision lines are healed, Dr. Mills will advise you regarding eye makeup and contact lenses. You need to keep your face out of the sun to avoid permanent bruising for 3-6 months following your surgery. Dr. Mills advises that you not resume any vigorous physical activity for at least 4 weeks post-operatively.
It is important for you to protect your eyes to ensure proper healing. You need to wear darkly tinted sunglasses to protect you eyes from wind and sun irritation. It is normal to have some dryness for the first few weeks, so Dr. Mills will have you use eye drops frequently during the day and ointment at night for the first month. Also, you will want to be careful with any sun exposure to your face for 2 weeks before surgery and for 6 months after surgery. Dr. Mills will recommend that you use a high SPF sun block on your eyelids to protect your delicate skin for the first 6 months after your surgery.
Dr. Mills will schedule frequent follow-up visits in the months following your surgery to closely monitor your healing. If you experience any unusual symptoms between visits, we encourage you to call our office.
With blepharoplasty, the complications are infrequent and usually minor. Complications may include excess skin removal, changes in vision, bleeding, swelling, bruising, dryness of the eyes, ectropian, infection, scar, asymmetry and risks of anesthesia.
We understand that changing any facial feature is a very significant decision and want you to feel comfortable before opting for surgery. We look forward to meeting you in consultation to hear your goals and objectives. In the meantime, feel free to email any questions to our patient coordinator through our contact us page.
Blepharoplasty Post-Operative Information
You can expect:
- To drive after you are completely off your pain medications and the swelling is down, which is usually about 5 days.
- To keep your head elevated and continuous crushed eye compresses over your eyes for the first 72 hours. This will help to keep your eyes moist and keep the swelling down.
- To frequently use eye drops prescribed by Dr. Mills during the day (as often as every hour) and ointment at night for the first month.
- To resume normal activities after 5-7 days, depending on how you heal.
- To avoid strenuous workouts for the first 4 weeks after surgery. (You may start to get your pulse up to 120 after 2-3 weeks.)
- To visit our office frequently in the first several months after your surgery.
- To see your final result after about 3-6 months, after the swelling has subsided.
How quickly can I go back to work?
Most patients can return to work about 5-7 days after their surgery, or after the swelling has subsided and you are no longer on pain medication.
When can I return to using my contact lenses?
You can generally expect to wearing your contact lenses after 2-3 weeks, when the chance of your eyes drying out is diminished. Be careful not to put any pressure or tension on the incisions and not to let your eyes dry out too much. Dr. Mills will evaluate each case individually and will tell you specifically when you can use your contact lenses again.
When can I wear eye makeup?
You may not wear any eye makeup until 2 days after your sutures are removed to make certain that you do not tattoo the skin. Also, be very careful and gentle in removing the eye makeup after your sutures are removed. The incision sites are very tenuous and any tension may widen your scar.
When can I expect the swelling or bruising to go away?
If you ice continuously for the first 3 days, it typically takes 7-10 days for the swelling and bruising to subside. For those who do not ice continuously as indicated, it will take approximately 3 weeks for the swelling and bruising to diminish.
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Facelift
Both men and women complain that they cannot stop the hands of time. From sagging eyelids and facial skin to a droopy neckline, Dr. Mills sees many patients that desire to reverse the effects of age on their face and neck. Most patients say that their wrinkles and sagging skin do not reflect their youthful spirit and energy level. They consult with Dr. Mills for options to refresh their look. Dr. Mills performs many variations of rhytidectomy, or facelift surgery, to smooth out the loose skin of the face and neck, tighten the underlying tissues and muscle and remove any excess skin. Ultimately, a facelift will allow you to turn back the hands of time and better reflect your youthful spirit.
There are several surgical options that Dr. Mills performs and each addresses a different area of the face. The first option is the Sub Muscular Aponeurotic System (SMAS) facelift. This facelift is often the most effective and longest-lasting means of addressing jowling, facial wrinkling and excess skin to the face and neck. This procedure is especially effective in addressing the issue of a turkey-gobbler neck. We all know how time can cause the facial skin to sag and lose its elasticity. Dr. Mills uses the SMAS facelift to lift and secure the sagging skin and underlying muscle structure to a firmer and smoother position across the face and neck. The incisions are inconspicuously hidden in the natural contour of the ear and extend around the earlobe and back into the hairline. There is also a tiny incision under the chin.
If you are experiencing a flattening out of the mid portion of the face, Dr. Mills will likely suggest a Midface suspension. This type of facelift literally repositions the cheek fat pads, which over time become low and less prominent. The Midface suspension also reduces and smoothes out prominent naso-labial folds. Dr. Mills places small incisions in the hairline and at the lower eyelash line. Of all the facial rejuvenation procedures, the Midface suspension generally yields the most dramatic results. This procedure will actually change your look a bit.
Dr. Mills can perform the SMAS and Midface suspension either individually, together or in conjunction with other facial procedures that will enhance the entire face. Oftentimes, Dr. Mills will combine a facelift with blepharoplasty (eyelid surgery) to address droopy or puffy eyelids. Dr. Mills can also add the volume that your lips have lost over time with fat transfers or smooth out the fine lines around the mouth with dermabrasion. Additionally, Dr. Mills can correct any sagging forehead skin with a coronalplasty (browlift). Just let Dr. Mills know what facial enhancements you are looking to achieve and he will tailor a surgical plan to give you the rejuvenated look that you desire.
During the consultation and other pre-operative visits, Dr. Mills will walk you through your particular facelift design. Dr. Mills places high importance on your goals, physical examination and medical history. During your physical examination, Dr. Mills will assess your facial bone and underlying tissue structure, skin thickness, texture, and elasticity and the extent of facial wrinkles and folds. Dr. Mills will use all of this information to tailor a surgical plan that best suits your features.
Typically two weeks prior to surgery, you will meet with our pre-operative coordinator and Dr. Mills to finalize all of your surgical details. Your pre-operative coordinator will review all of your pre-operative instructions and make sure that you complete all the necessary laboratory tests and health screenings. If you have not done so within six months prior to your surgery date, you will need to have a medical evaluation (EKG, etc.) If you are a smoker, you will be advised to quit smoking at least one month prior to surgery and not to resume for at least one month after your surgery. Additionally, there are certain medications, herbs and potions that your pre-operative coordinator will advise you to cease taking from several weeks prior to several weeks after your surgery. We have vitamins and medications that will aid in your recovery by minimizing inflammation and swelling. These supplements are completely optional, but are available for purchase should you desire. It is really important that you follow all Dr. Mills' instructions diligently to optimize your surgical results and recovery period. Your pre-operative appointment will also be a time for you to ask any final questions, so that you are physically and mentally prepared for your surgery and recovery period.
On your day of surgery, you will be cared for by an experienced surgical team that includes Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. Dr. Mills has been some members of his surgical team since the beginning of his practice. Each person has a unique role in your surgery, but each individual shares in Dr. Mills' philosophy and commitment to superior patient care standards.
Your surgical time will depend on the combination of procedures that you elect. You will likely be required to stay at an overnight facility, under the supervision of a specialized and experienced aftercare nurse. As her only patient, she will change and refresh your facial ice packs, administer medications and oxygen and assist you with your snacks and walking. After a night of constant monitoring, you will be discharged the following morning. At this time, you will need someone to pick you up and care for you for the next 48 hours.
Prior to your discharge, your bandages will be changed from a full head wrap to a lighter wrap. Dr. Mills will remove the light head wrap on your second day post-operatively. Additionally, we will assist you in washing your hair at this visit.
Dr. Mills believes that oxygen therapy significantly promotes healing. As such, our office will make arrangements to provide you with in-home oxygen therapy after your surgery. The oxygen tank will be delivered to your house and picked up, so you do have to make any inconvenient trips. Dr. Mills will monitor your healing progress and advise you when to cease using the oxygen.
For the first week after surgery, Dr. Mills recommends an extra dose of rest and relaxation. You will need to keep your activity levels very light and sleep with your head elevated. You may shower once the bandages are removed, but you will want to be extremely careful with washing your hair. Dr. Mills will ask that you not comb or brush over your suture areas. You will likely see the swelling reach its peak and then begin to subside within the first week. Dr. Mills will have you come in for routine follow-up visits, including removal of your stitches at 7, 10 and 14 days post-operatively.
After a couple of weeks, most of your bruising and swelling should subside and you may resume your normal activities, including non-strenuous work. You can generally expect that you can exercise after several weeks, but Dr. Mills will advise that you avoid direct sun exposure. You should always wear a hat and high SPF sunblock to protect your skin. (Dr. Mills will recommend that you consistently cover your face from sun exposure beyond the post-operative period to protect your skin and maintain your results.)
We understand it can be emotionally uncomfortable to be seen in public during the first couple of weeks after your surgery. While we know the healing will be worth the wait, we want to make this period as comfortable as possible for you. Our in-house aesthetician will apply some camaflouge makeup to cover any bruising and show you how to do this on your own. Additionally, she will set up an appointment for a complementary facial and review a regime to keep your skin looking radiant and beautiful.
We encourage you to come to our office for routine post-operative visits for the first six months so that Dr. Mills can evaluate your progress and healing. Between these checkups, we want you to call us with any questions, needs, or just to keep in touch. Dr. Mills wants to build a long-term relationship with his patients, so we always welcome on-going communication.
With facial surgery, potential complications may include hematoma, delayed wound healing, infection, numbness and wide or depressed scars. It is crucial that you attend all follow up visits and maintain a restful post-operative period to minimize the occurrence of any potential complications.
Dr. Mills understands that this is likely a very significant decision in your life. He looks forward to meeting you to hear your specific needs and discuss how he can refresh your appearance. We would also happily connect you with past patients so that you can ask them questions about their experience. In the meantime, we welcome any questions that you might have via email or phone. You can call our office or contact our patient coordinator through our contact us page. It is our practice philosophy to strive to provide every patient and prospective patient with the best service and care possible, so please let us know how we can best serve you.
Facial Rejuvenation Post-Operative Information
You can expect:
- To require assistance for the first 2 - 7 days following your surgery.
- To drive after 7 - 10 days.
- To resume normal activities after about 10 - 14 days.
- To resume any light aerobic activity after 1 month.
- To see bruising and swelling subside after 2 - 4 weeks.
- To take approximately 2 - 4 weeks off from work.
- To feel a bit "down" for 2 - 3 weeks post-operatively.
- To visit our office post-operatively at 3, 7, 10 and 14 days and 1, 3 and 6 months post-operatively. (We also recommend annual follow-up visits.)
- To wear support stockings for 1 week after your surgery (or until you are moving normally).
- To be on oxygen therapy for 6 hours per day for the first week post-operatively.
- To see your final results at about 6 months, after your skin has contracted.
- To feel tightness for the first 2 weeks (or until the swelling subsides).
What areas of the face does a facelift treat?
Many people fear the word facelift; they think this procedure covers the whole face. A facelift covers the neck and jowls. If you have loose skin around your neck and/or some jowling around your mouth, then you are probably a perfect candidate for a traditional facelift.
Do I have to stay overnight?
Dr. Mills prefers that our patients stay overnight in a facility after a facelift. A nurse with ACLS certification will stay with you to administer pain and nausea shots or pills, change your icepacks, and monitor your overall recovery. Our nurse is also helpful in keeping you calm that first
night, as the head dressing is bulky and can make some people feel claustrophobic.
Will my incisions be noticeable?
Dr Mills prides himself on his scars. He will hide the incision inside and behind the ear and in the hairline. Within a few months, the scars will most likely only be found by your
hairdresser.
Will I be in pain after surgery?
Most of our patients would say that the procedure is not painful, but there is a lot of anxiety. Some patients do complain of some ear pain, but this can be treated with medication.
Will I be really bruised?
Most of our patients experience bruising for about 1-2 weeks. We do recommend an anti-bruising agent prior to surgery and will provide you with complementary camaflouge makeup to minimize the appearance of bruising.
How much time should I take off work?
You should plan on taking about two weeks off. If you have a more strenuous job, we recommend that you take a month off to fully recover from surgery and minimize any potential post-surgical
complications.
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Rhinoplasty / Nasal Surgery
Many men and women wish to reshape their nose to better fit the proportions of their facial features. In fact, changing the nasal shape is one of the most common reasons an individual consults a plastic surgeon. If you want to decrease or increase the size of your nose, change the tip or bridge shape, narrow the span of the nostrils, or alter the angle between your nose and upper lip, Dr. Mills can perform a rhinoplasty to reshape your nose. Dr. Mills can also use this procedure to correct a birth defect or injury, or in some cases to help relieve some breathing problems.
While there is no age cap for rhinoplasty, Dr. Mills prefers not to operate on individuals until they have hit the mid to late-teens, when the nose is near full development. Typically, Dr. Mills recommends the earliest age of around 16 years for girls and about 18 for boys. This standard typically yields the best result, as one's facial proportions tend to change significantly through puberty.
Dr. Mills performs a variety of rhinoplasty techniques and will determine what best suits your needs and expectations after a comprehensive consultation. His recommendations will be based on your facial and nasal structure and your personal objectives. (We suggest that you bring pictures of nasal shapes that you like.) In your consultation, Dr. Mills will take photographs of you and review your various options. Typically, Dr. Mills uses a closed surgical approach for simple refinement and an open approach to complete more extensive re-sculpting work. Dr. Mills uses tiny incisions that will be very hard to find after several months following your surgery.
Several weeks prior to surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary laboratory tests and health screenings. If you are a smoker, you will be advised to quit smoking at least one month prior to surgery and not to resume for at least one month after your surgery. Additionally, there are certain medications, herbs and potions that she will ask you to cease taking from two weeks prior to surgery to two weeks post-surgery. This appointment will also be a time for you to ask any final questions, so that you ready for surgery and have an optimal recovery period.
On your day of surgery, you will need a responsible adult to accompany you to and from the surgery center. This individual will need to be available by phone, so that they are ready upon your discharge. You will need someone to stay with you for your first 24 hours following surgery, since you will be under light general anesthesia.
You should allow approximately 4 - 5 hours for pre-operative surgical admission, surgical time and post-surgical recovery on your day of surgery. You will be in the hands of our experienced surgical staff, several of whom Dr. Mills has been working with for more than 15 years. Our surgical team includes Dr. Mills, a nurse anesthetist, a circulating nurse and a surgical technician. All team members share in Dr. Mills' values and are committed to providing superior patient care.
After your surgery, you will have a splint or 'cast' on the outer aspect of your nose and may have gauze packing in your nose. You will also have a 'drip bandage" taped under your nose to catch any surgical drainage. Dr. Mills recommends that you remain upright as much as possible for the first few days. We suggest propping yourself with several pillows and a wedge to maintain an upright position. This position will help you breath and sleep easier. You should expect to breathe through your mouth for the first several days and we encourage you not to sneeze, blow your nose, or put your head lower than your heart.
Your face will likely feel swollen and puffy for at least the first 24 hours after your surgery. In addition to sitting upright, Dr. Mills recommends that you pack ice around the surgical area for the first 3 days to relieve discomfort and reduce swelling and bruising. You will likely bruise around your eyes and cheeks, but this should decrease within 2 - 4 days and markedly fade within 2 weeks. You will likely have some bleeding and drainage from your nose, so the 'drip bandage' will need to be changed periodically for the first several days.
In the first days and weeks following surgery, you will begin to see your new look. Typically, Dr. Mills removes the packing at 1 - 3 days post-operatively and the splint 5 days post-operatively. You will likely experience some swelling for the first 3 months, so the final result may not be apparent for a year or more, as you continue through the healing process.
Your healing will depend significantly on how well you follow your post-operative instructions. You will likely feel pretty good within a couple of days, but will want to wait to return to work or school until after about 5 days. (We see patients return to work or school anywhere from 5 - 14 days after surgery.) Sutures, if any, will be removed 5 - 7 days post-operatively. At 2 weeks, you will likely feel close to 100%, but Dr. Mills advises that you not resume any physical activity for at least 4 weeks post-operatively. Until Dr. Mills advises otherwise, you will also need to avoid any contact sports.
It is important for you to closely monitor and control contact with your nose to ensure proper healing. You need to avoid bumping your nose or face, blowing your nose, and contact with heavy glasses (or sunglasses) for about the first month. Lastly, you will want to be careful with any sun exposure to your face for 2 weeks before surgery to 8 weeks after surgery.
Dr. Mills will schedule frequent follow-up visits in the months following your surgery to closely monitor your healing. If you experience any unusual symptoms between visits, we encourage you to call our office.
With rhinoplasty, the complications are infrequent and usually minor. There is always a possibility of infection, nosebleed, or reaction to anesthesia. In rare cases, a secondary procedure may be required. Examples include correcting a mild deformity and/or further refinement.
We understand that changing any facial feature is a very significant decision and want you to feel comfortable before opting for surgery. We look forward to meeting you in consultation to hear your goals and objectives and encourage you to bring pictures of what you are looking to achieve. In the meantime, feel free to email any questions to our patient coordinator through our contact us page.
Rhinoplasty Post-Operative Information
You can expect:
- To drive after you are completely off your pain medications, which is usually about 5 days.
- To resume normal activities after 5 - 14 days, depending on how you heal.
- To avoid strenuous workouts for the first 4 weeks after surgery.
- To visit our office frequently in the first several months after your surgery.
- To avoid any type of contact with your nose, including sun exposure, use of glasses and/or nose blowing for at least a month.
- To see your final result after about 9 - 12 months, after the swelling has subsided.
Does nasal surgery hurt?
Most of Dr. Mills' patients have said the recovery is not very painful, but there is some discomfort. We recommend ice to treat the discomfort and do prescribe pain pills for the recovery process. Most patients only need the pain pills for the first couple of days.
Will my nose look drastically different?
Dr. Mills likes to be a little conservative, so that he does not make you look completely different. However, Dr. Mills recommends that you bring pictures of noses that you like, so that he can visually see what kind of change that you are looking for.
How much time should I take off of work?
Since most people do not want their co-workers to see their bruising, most rhinoplasty patients take about 7 ñ10 days before returning to work.
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Breast Augmentation
Many women wish to increase the size and/or fullness of their breasts to make them more proportional to the rest of their body. Women of all ages come to our office desiring to enlarge their breasts for a number of reasons. Generally, women that have a genetic pre-disposition toward small breasts tell us that they desire to better fill out their clothes or bathing suits. Women that have lost breast volume after weight loss or breast-feeding typically tell us that they want to regain their breast fullness and/or cleavage. In all these cases, breast augmentation is usually the optimal way to increase your breast size, which can improve the way you look and feel about yourself.
There are many surgical approaches for breast augmentation, which include inconspicuous incisions in the armpit, underneath the breast (just above the crease), around the areola or in the belly button. Dr. Mills can perform all these approaches, but prefers the transaxillary approach. Referred to as a TransAxillary SubPectoral Augmentation (TASPA), this technique involves making a small incision in the armpit to place a breast implant beneath the chest wall muscle. Dr. Mills feels that a TASPA generally yields the most natural-looking result with minimal scarring.
During your consultation and other pre-operative visits, you will select your implant size and type. Dr. Mills will review all of your implant options and provide you with pictures and suggestions, but ultimately you will choose which style and size that best fits your needs. To aid you in the decision, you will be given the time and opportunity to try on different 'breast sizers,' which will give you a better idea of how your new shape will fill out your clothing and bathing suits. (We recommend that you bring different types of shirts to your initial consultation to try on with the breast sizers and see your "enhanced" look.)
Breast implants will not last forever and will likely need to be replaced with a subsequent surgery. Most women have saline-filled implants for their first breast augmentation surgery. Saline implants are made of a silicone shell and filled with sterile saltwater. Silicone gel implants are only available for secondary surgical or reconstructive procedures, but may be more widely available in the future (possibly in 2003). You can also talk with Dr. Mills about the latest in implant research and development, including the cohesive gel implant. If you have any implant-related questions or concerns, Dr. Mills would be happy to discuss these and provide you with information on the latest research.
Once you have chosen your implant size and type and schedule surgery, you will meet with our pre-operative patient coordinator. She will review all of your pre-operative instructions with you and make sure that you complete all the necessary laboratory tests and health screenings, based on your personal medical history and surgical plan. If you are a smoker, you will be advised to quit smoking at least two weeks prior to surgery and not to resume for at least two weeks after surgery. Additionally, there are certain medications, herbs and potions that she will ask you to cease taking from two weeks prior to surgery to two weeks after your surgery. This appointment will also be a time for you to ask any final questions, so that you are physically and mentally ready for surgery and have an optimal recovery period.
On your surgery day, you should allow approximately 4 hours for pre-operative surgical admission, surgical time and post-surgical recovery. Our surgical team, including Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician will be with you throughout your surgery and recovery. We ask that you have a responsible adult accompany you to and from the surgery center. This individual should be accessible by phone while you are in surgery and should be at our facility when you are ready to be discharged. After your surgery, you should have someone with you for the first 24 hours.
You will have an office visit the day following your surgery, as well as several post-operative visits within the first week. These appointments are extremely important and we encourage you to come to our office daily for the first week or so, for additional help with your post-operative regime. Your post-operative regime includes displacement exercises to keep the breast pocket open, which should result in softer and more natural-looking breasts. Dr. Mills and a patient coordinator will assist you in the displacement exercises during these initial post-operative visits.
At first, these exercises may be a little difficult, but we will take as much time as you need to feel comfortable with the exercises. It is often helpful to have a friend or spouse assist with the exercises, so we encourage you to bring them to your follow-up visits. Dr. Mills strongly feels that these exercises are critical to yielding the best result, while minimizing potential complications.
At your first post-operative visit, Dr. Mills will remove your surgical bra and wrap before assisting you with your exercises. Dr. Mills will determine what post-operative garment you should wear at this time. After this initial visit, you will be able to shower. You will usually have two sets of sutures, which will be removed at post-operative days 7 and 14, respectively. You will be advised not to use deodorant for the first 2 weeks, but can use a non-scented liquid deodorant after that time, treating the suture line with care. In the first couple of weeks, Dr. Mills will continue to monitor your progress and advise you in your post-operative regime and instructions. It is exceptionally important that you come to all recommended post-operative visits in order to minimize post-operative risks and and achieve optimal results.
The most common complication associated with breast augmentation is capsular contracture. This condition, which involves a tightening of the scar tissue around the implant, may result in varying degrees of breast firmness, pain and change in breast appearance. While the national average for capsular contracture is 10%, Dr. Mills has maintained an average rate of 5.9% since the start of his practice. Other risks include implant rupture or leakage, changes in nipple or breast sensation (both temporary and permanent), and adverse reactions to anesthesia.
Within a short time following surgery, you will be able to resume your normal routine and enjoy your new shape. If you want to show off your new shape by summertime, we recommend that you schedule your surgery in the spring (or before). Springtime is the busiest time of the year in our office for that very reason.
We look forward to meeting you in consultation to develop a surgical plan that best suits your needs. In the meantime, feel free to email our patient coordinator through our contact us page with any specific questions that you might have. Dr. Mills wants this to be a great experience for you and his staff will do everything we can to serve you.
Breast Augmentation Post-Operative Information
You can expect:
- To drive after you are completely off your pain medications, which is usually about 5 days.
- To resume normal activities after about a week.
- To avoid strenuous and/or upper-body workouts for the first 2-4 weeks after surgery.
- To visit our office frequently for the first month to monitor your progress.
- To visit our office post-operatively at one month, three months, six months and one year. (We also recommend annual follow-up visits.)
- To perform your displacement exercises 5 times per day for the first 6 months, then 1 time a day thereafter (for the lifetime of your implants).
- To perform monthly self-breast examinations.
- To see your final results at about 6 months, after your skin and muscles have relaxed.
- To avoid wearing any underwire bra for the lifetime of your implants. Underwire bras will change the look of the breast and make the nipple appear to point downward.
- To take prophylactic antibiotics when any dental work is done to protect the implant from infection.
- To eventually replace your implants with a subsequent surgery.
How much time should I take off of work?
While recovery time may vary, you should generally expect to take one week off for an administrative or desk-type job.
Does having breast implants increase my risk of breast cancer?
Breast augmentation does not increase nor decrease the risk of breast cancer. Dr. Mills prefers to place the implants under the chest muscle and breast tissue because it does not interfere as much with mammogram readings.
Can I breast feed after surgery?
Since Dr. Mills prefers to place the implants through an armpit incision under the muscle, breast augmentation surgery should not interfere with breast-feeding. Dr. Mills only recommends breast-feeding for the first three critical months in the baby's development because breast-feeding can cause infections in your breasts (e.g. mastitis).
Can Dr. Mills do a breast lift and augmentation at the same time?
Dr. Mills prefers to do these surgeries at separate times to allow for better wound healing and minimize the appearance of scars.
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Breast Lift
Many women wish to regain the youthful shape and contour of their breasts. These women complain that loss of skin elasticity, gravity and other factors such as weight loss, pregnancy and breast-feeding have changed the shape and firmness of their breasts. Discontent with their saggy or droopy breasts, women want to know what they can do to have a more "perky" and firm breast shape. When women consult with Dr. Mills about a breast lift or mastopexy, they are generally looking to accomplish one of two things (or a combination of both). The first goal is to replace the fullness in the upper pole of the breast that they have lost. In this case, an implant is typically required to achieve your desired results. (Refer to section on breast augmentation.) The other goal that women typically have is to lift the nipple that may have started to droop. If you fall into this second category of women, you are likely a good candidate for a breast lift to enhance the shape and contour your droopy breasts.
There are varied incisional approaches for lifting the breast, including the crescent, standard and flip-flop mastopexy. During your consultation, Dr. Mills will evaluate your case individually and suggest how to best meet your goals. If you are a good candidate for a breast lift, Dr. Mills will determine which approach would be best based upon how much your nipple needs to be lifted and how much upper pole fullness is needed. Typically, Dr. Mills makes an incision around the nipple-areolar complex and in the crease just under the breast. He repositions the nipple-areolar complex higher and removes any excess skin, reshaping the breast's contour. If a patient is additionally looking to add breast volume, Dr. Mills might also suggest placing breast implants. However, Dr. Mills usually prefers to place the implants in a staged manner with a second surgery to allow for better wound healing, safety and minimal scar appearance. (See section on breast augmentation).
During your consultation and other pre-operative visits, Dr. Mills will review your shape and personal goals. Two weeks prior to surgery, you will meet with our pre-operative patient coordinator, who will review all instructions with you and guide you through all of the necessary laboratory tests and health screenings. If you are a smoker, you will be advised to quit smoking at least four weeks prior to surgery and not to resume for at least two weeks after surgery. Additionally, you will be advised which medications (including aspirin and ibuprofen), herbs and potions that you need to cease taking from two weeks prior to surgery to two weeks after your surgery. This appointment will also be a time for you to ask any final questions. We want you to be physically and mentally ready for surgery, so that you have an optimal recovery period and great surgical results.
On your surgery day, you should allow approximately 5 - 6 hours for pre-operative surgical admission, surgical time and post-surgical recovery. During your surgery and recovery, you will be in the hands of our experienced surgical team, which included Dr. Mills, a nurse anesthetist, a registered nurse and surgical technician. We ask that you have a responsible adult accompany you to and from the surgery center. This individual should be accessible by phone during your surgery and should be at our facility when you are ready for discharge. After your surgery, you will need to have someone care for you for the first 24 hours.
You will have an office visit the day following your surgery, as well as several post-operative visits within the first week. These appointments are extremely important and we encourage you to come to our office daily for the first week or so, for additional help with your post-operative regime. Upon returning the day after surgery, Dr. Mills will remove your surgical dressing. You will be advised to wear a sports bra for three months to support the breasts, which is very important, as your breasts will need extra support as they heal. After this initial visit, you will be able to shower. Additionally, Dr. Mills will suggest that you use oxygen to breathe post-op (6 hrs/day for the first 2 weeks) because he has noted better scars and healing with those patients who have used oxygen.
You will return to our office at one week, two weeks and one month to remove sutures and to change surgical tape. In the first couple of weeks, Dr. Mills will continue to monitor your progress and advise you in your post-operative regime and instructions. It is exceptionally important that you come to all recommended post-operative visits in order to minimize post-operative complications and achieve optimal results .
The most common complications associated with a mastopexy are bleeding, scarring, infection, asymmetries, changes in nipple or breast sensation (both temporary and permanent), and adverse reactions to anesthesia.
Dr. Mills looks forward to meeting with you in consultation to put together a custom surgical plan that best meets your needs. Should you have any questions in the meantime, please feel free to email our patient coordinator through our contact us page. We want to make sure that you are well informed about this and any other procedure. Dr. Mills wants this to be a great experience for you and we will do everything we can to serve your needs.
Mastopexy Post-Operative Information
You can expect:
- To drive after you are completely off your pain medications, which is usually about 3 - 5 days.
- To resume normal activities after about a week.
- To avoid strenuous and/or upper-body workouts for the first 3 - 4 weeks after surgery.
- To visit our office post-operatively at one day, 1 week, 2 weeks, 1 month, 3 months, 6 months and 1 year. (We also recommend annual follow-up visits.)
- To perform monthly self-breast examinations.
- To see your final results at about 12 months, after your skin and tissues have relaxed and the scars subside.
How much time should I take off of work?
While recovery time may vary, you should generally expect to take one week off for an administrative or desk-type job.
Can Dr. Mills do a breast lift and augmentation at the same time?
Dr. Mills usually prefers to do these surgeries at separate times to allow for better wound healing and minimize the appearance of scars (although there are some exceptions to this rule). In doing both a lift and augmentation at the same time, the blood supply to the nipple is sometimes strangled. As such, Dr. Mills usually does not feel that combining these procedures is safest for the patient.
When can I work out again after surgery?
You can generally do low impact aerobics after about 3 weeks after surgery. You should not do higher impact aerobics for at least 3 months after surgery. Dr. Mills does not want your breasts to be bouncing while they are healing.
How long after my surgery can I go in a hot tub or pool?
When you immerse your scar into water, you lessen the tensile strength (e.g. natural skin strength), causing the scar to widen. With normal healing, your tensile strength returns to 70% after about 3 weeks and 90% after 8 - 10 weeks post-surgery. Dr. Mills discourages swimming or hot tubs for the first 10 weeks after surgery. Other than getting in the shower, you should avoid any immersion in water during this time.
How long after my surgery can I sunbathe topless or go in a tanning bed?
You should stay out of the sun and artificial tanning lights for anywhere from 6 - 12 months (and maybe even longer). When premature scars are exposed to the sun (or tanning bed lights), they will tan at a different rate than the surrounding skin and become redder or darker. This pigment can become permanent, like a tattoo. You should keep your scars out of the sun, until the scars are no longer red, indicating that the scar has matured. Again, this healing process typically takes anywhere from 6 - 12 months. Healing rates depend highly on skin thickness. The chest typically takes longer to heal since it is thicker skin.
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