Most physicians will do as they been shown and are unlikely to change their ways, nor think outside the box. This is called: See one, Do one, Teach one learning. There is rarely an “explain one” in the process of training due to how busy it is in most hospitals. trainers often say, “go home and read a book”. What if the book is wrong? A book is an opinion, not necessarily fact. If you ask why a surgeon will do certain things, the answer will be: “that’s how they showed (trained) me!” Surgery is a profession where the techniques are passed down and demonstrated to the trainee. Skill is not learned or taught but rather an innate ability at birth. There are limits to everything and learning the rules does not make you skilled. Mimicking is not necessarily KNOWING. The “why” we do things is often more out of habit than cerebral. If a surgeon does not provide you with the rationale and reasoning behind anything we do, you should start wondering if he knows why things are done! There are reasons for everything. Most of the answers are elusive to the average surgeon. In a consultation, ALL your questions should be answered before you ask your questions! That is the definition of a great consultation.
All pre surgery and post surgery instructions should be provided BEFORE the procedure and not after. Pre and Post-operative instructions are just as important as the procedure itself. Wearing compression after surgery has historically been to decrease swelling and bleeding post-operatively. Swelling and especially bleeding increases the risks for capsular contracture. However, in a simple Breast Augmentation ( one where nothing is being fixed or repaired) you are NOT to wear compression! Compression also increases the risk of capsular contracture. The space was created for a reason! No one is born with a space for an implant. If you do not have a space and a surgeon must create a space for an implant, then a surgeon is essentially creating a wound. Wounds HEAL!. Capsular contracture (less space) is the natural process of a space healing or closing! In all surgery (except for two) we want you to heal. There are two surgeries that if you heal it causes problems. In a Joint replacement bending the joint maintains the space and prevents extensive healing of a wound. This maintains the space that was created so that when you heal (glue) you will have space to actually bend the joint. If you heal too much in joint surgery, the joint won’t bend as well. Healing is the process of gluing together. Scar is actually the glue that the human body makes. Scar (Fibrin Glue) is what the body creates when injured. In Breast augmentation and joint surgery we do not want the space that was created to heal completely. In Breast Augmentation the space was created in order for the implant to remain soft. Breast Implants are balloons filled with saline or silicone gel. Balloons are soft because when squeezed the contents are displayed (MOVES out of the way). Space is needed for this to occur. By having space around a balloon it gives the illusion of softness. If the space heals (closes) there is less room or no room. This is Capsular Contracture. Capsular Contracture is defined as less space. If this occurs it can distort, displace, or make the balloon feel firmer or harder. A combination of these occurs as well. The key is prevention. Compression after creation of a space will narrow the space.
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