On the night before of any Plastic Surgery procedure, I recommend that my patients take an anti-anxiety medication called Lorazepam (Ativan) to calm their nerves and help them get to sleep.  And also the day of surgery, when they are in the car on the way to the hospital or surgery center, I recommend a second Ativan – with a baby sip of water – to make the entire surgery experience more pleasant.  By quelling the “fight or flight response” which is natural when you are nervous, your veins are open, the IV goes in more easily, and you can still provide consent but you won’t feel like you want to bolt for the door.

Comfortable clothes are key going into surgery. Loose pants, zip-up sweatshirt & easy to get on shoes.

Excited for our day!

I did take an Ativan the night before (and had crazy dreams, dreaming that I let Mary Pasache do my surgery! :O ).  The morning of surgery, we met in Dr. Haws’ office again to record more video of two women Plastic Surgeons discussing breast augmentation.  I shared reasons WHY I had decided to have surgery, HOW I chose my surgeon, and MY personal approach to caring for breast implant patients.  Mindy shared her breast augmentation experience as well, having had a breast augmentation years ago and a revision more recently.  So no Ativan that morning! 😉

Having a surgical colleague, a friend and a Mentor perform your surgery is the best feeling in the world. Thank you, Mindy!! XO

Next, we walked to the outpatient surgery center that was BUSY!  Tons of outpatients getting ready for surgery.  They had a well-run, safe outpatient surgery system down perfectly, and I felt comfortable and honored to be there.

Registering as a patient

My preop bed awaits me…

Putting on compression stockings, known as TED hose. These compress leg veins and prevent against blood clots in the legs during surgery, known as DVT (deep venous thrombosis)

Most surgery centers & hospitals institute double coverage against DVT, including the addition of SCDs, sequential compression devices, which pump your calves during surgery and keep the blood flowing in your legs

Patient ID bracelet and pencillin allergy

Mary recorded my intravenous (IV) going in (caution for those who are squeamish) and the discussion with my Anesthesiologist.

Meeting my Anesthesiologist

IV inserted, ready to go!

Next, Dr. Haws marked me for surgery.  She recently started adding liposuction to the armpit region with breast surgery – something that I always incorporate for the very best aesthetic results.  The liposuction markings are in the “axillary rolls”.  I was surprised I had some fat there, but like all my thin patients, there was a few tablespoons that could be removed!

Thank you to Mary for recording all these awesome videos the day of surgery! Best surgical partner and helper EVER.

On the way to the operating room, they slipped a strong relaxing mediation into the IV so by the time I arrived, I was dizzy and intoxicated.  I had intended to fully take in my surroundings, take a selfie (of course) with my surgeon and remember the entire going to sleep experience…  But the next thing I knew I was in the recovery room, with a nurse asking me to open my eyes and to start waking up.  Because of the medication they slipped in the IV en route to the O.R., it was lights OUT!  ZZZZZ…

After surgery, in the recovery room, I was very sleepy and preferred to sleep, but learned I had already been there for 20-30 minutes.  It really was like closing your eyes, opening them a split second later and being done!

Ice chips are the first thing you get in the recovery room. Very hazy memory of this. I had apparently been there for 30 minutes and apparently preferred to keep sleeping.  The Nurse insisted it was time to wake up.  I never get to sleep in!

Thumbs up are the international sign that you’re doing okay but are still stoned on anesthesia

Drains in place with a normal color. More on drains in a future blog post…

I had very little discomfort.  I felt a slight burning in my armpits from the axillary roll (armpit area) liposuction, which was expected.  I was wrapped with an ACE wrap that felt a little tight, but it was mostly numbness I felt and a strange sensation that my breasts did not belong to me.  That is very typical, as your sensory nerves go to sleep after any surgical procedure.

Ready to be discharged

More thumbs-up 😉

This is a great look #sockswithflipflops

Mary brought me back to the hotel, where we got takeout barbeque (SO GOOD) and I felt comfortable sitting up in bed.  I caution patients not to eat anything too creamy or spicy after surgery – just comfort food (which for me, is meat!).

Dinner of champions

I learned later the reason why I was so wired (I felt like I had drank 5 cups of coffee and was more alert and awake than I could remember, ever!) until 3 o’clock in the morning was that the Anesthesiologist had given me a dose of steroid to prevent nausea.  Zero nausea, but I couldn’t sleep!!

I did exactly what I tell my patients NOT to do – emailed my staff all night (complete with typos and nonsensical content), created a brand new Instagram account and brainstormed new projects I could do as soon as I got back to San Francisco.  I’m sure my team just shook their heads.  I should have taken another Ativan…

More about my first few days after surgery soon…  Subscribe to my blog in the space below to get access to my next blogs about surgical recovery after breast augmentation.