Strategies to help patients recover quickly after breast surgery [Adam Schaffner, MD, New York City]

I'm Adam Schaffner. I'm a plastic surgeon. I'm located in New York City. We're on Fifth Avenue between 47th and 48th, two blocks south from Rockefeller Center.

When you have a patient who's had a previous breast augmentation or multiple breast surgeries, how do you handle the incisions the second or third time around and work around scars from previous surgeries?

When we have scars that are existing, we cut out the old scar because we know that that scar tissue doesn't have as good a blood supply and is not as strong as native tissue. So we will cut out that scar tissue at the time of the surgery, and then sew healthy skin to healthy skin.

Sounds like a bonus.

Exactly.

Does it take longer to recover from a second or a third breast surgery?

It does depend on what is being done at that second or third breast surgery. If it's an extensive reconstruction, it certainly can. If it's just a direct implant exchange without manipulation of the muscle, then no, not necessarily.

What kinds of things do you do to help your patients recover quickly after breast surgery?

So we have them take medications beforehand to block multiple pain pathways. As long as there's no reasons not to, we have them take Tylenol and Celebrex and Gabapentin. We have them up and walking, same day, stretching exercises, range of motion exercises, sleeping on the back with their head of bed elevated, deep breathing exercises. We try to minimize the use of narcotics. We inject pain medication in the operating room to minimize the discomfort after surgery.

Where do you inject that pain medication?

Subfascial, meaning below the muscle fascia, the lining over the muscle, as well as in areas where the nerves we know are located, as well as in the tissue around where the incision was made.

How long does that last?

Depending on which type of pain medicine, we use a longer acting pain medication that lasts on average four to six hours.

Okay. Where can we find you on Instagram and what's your website address?

So on Instagram, you can view us at Dr. Schaffner, Dr. Adam Schaffner, D-R-A-D-A-M-S-C-H-A-F-F-N-E-R. And our website, you can either go to drschaffner.com, D-R-S-C-H-A-F-F-N-E-R.com, or plasticsurgeoninnyc.com, P-L-A-S-T-I-C-S-U-R-G-E-O-N-I-N-N-Y-C.com, or you can call us at(212) 688-6600.

Thank you for your wisdom.

Thank you very much.

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