One of the biggest impediments to getting a tummy tuck is patient’s fear that they will throw up after surgery. Who wants to get their tummy tightened and then spend the next several days throwing up? Options to prevent nausea prior to getting a tummy tuck have vastly improved to over the past few years.
The first development was the approval of the medication Emend by the Food and Drug Administration in 2006. Emend works through a novel mechanism,which primarily blocks nausea and vomiting signals to the brain and has been shown to have a tremendous benefit in reducing postoperative nausea and vomiting prevention caused from general anesthesia. Dr. Jejurikar prescribes Emend to all patients prior to surgery and has seen a huge effect in lessening nausea the first 48 hours after surgery.
The second development is the introduction of better anti-nausea pills for patients. Dr. Jejurikar prescribes Phenergan (Promethazine) for his patients to take the first few days after surgery. It is particularly effective for dealing with the nausea and vomiting that result from taking narcotic pain medications postoperatively.
The third development is the introduction of better local anesthetic agents that can tremendously lessen the need for postoperative narcotic pain medication. Exparel is a novel new local anesthetic agent that Dr. Jejurikar routinely injects into the abdominal walls of patients undergoing tummy tucks. It can block nerve fibers that cause pain for up to 72 hours postoperatively. Because of less pain, patients are taking less narcotic pain medication and, as a result, are experiencing less nausea and vomiting.
The most important thing to remember is the symptoms of uncomfortable nausea and vomiting can be controlled and even prevented. If you have any questions regarding tummy tuck surgery, do not hesitate to contact Dr. Jejurikar’s Dallas or Plano offices at 214-827-2814.
Much excitement has been generated with the introduction of Juvederm Voluma, a new injectable filler designed to add volume to the mid face and cheeks, making the face look more youthful and lifted. Unlike like other hyaluronic acid fillers, Voluma lasts for up to two years, which is a game changer in the world of injectable fillers!
Here’s an example of the power of Voluma. This is a 34-year-old woman from Dallas who complained that she had developed a tired and gaunt appearance to her face, which had developed over the previous 4-5 years. She underwent injection of one syringe of Voluma into each cheek (total volume of 2 mls). On her right is her picture one week after injection of Voluma. Voluma was injected predominantly into the cheek bones and the junction of the lower eyelid and the cheeks. Note the incredibly natural contour to her cheek and the youthful fullness.
Patients should expect slightly more bruising with Voluma than with other injectable filler treatments to the lips or marionette lines (nasolabial folds). Because Voluma is injected deeper, as well as into a region with a plethora of blood vessels, it is very common to bruise. Patients should refrain from taking medications that make them prone to bleeding for a few days ahead of their treatment, such as aspirin, ibuprofen, toradol, and other NSAIDs. Icing their cheeks for the remainder of the day after the procedure also considerably lessens bruising.
Through July 1, Dr. Jejurikar is offering special promotional pricing on Voluma. Given that Voluma lasts for two years, taking advantage of this pricing today will benefit you for years to come! Call Dr. Jejurikar’s Dallas or Plano offices at 214-827-2814.
Common questions from women who want breast augmentation with silicone implants:
- How likely is it that my breasts will harden?
- Will my breasts encapsulate?
- Will I get capsular contracture with silicone implants?
All valid questions, given the bad press that older generation silicone implants received. The current data looked at 2560 breast augmentation patients who underwent breast augmentation for the first time with Sientra implants (November 2013, Plastic & Reconstructive Surgery). The authors looked at a variety of factors over a 5 year period to determine their effects upon capsular contracture, including implant placement in front of or behind the chest wall muscle (subglandular versus submuscular), different incisions, and textured versus smooth implants.
The investigators had some very interesting findings:
- Placing an implant in the subglandular position (in front of the muscle) versus the submuscular position (behind the muscle) increased the risk of a capsule by 4.6 times
- Placing the implant through a periareolar incision (at the edge of the nipple-areola complex) versus an inframammary incision (in the crease at the base of the breast) increases the risk of contracture 1.5 times
- Sientra smooth implants had a greater rate of developing contractures than Sientra textured implants, particularly when placed in front of the muscle.
Implant Shell Pocket Capsule Rate
Smooth Subglandular 21%
Textured Subglandular 5%
Smooth Submuscular 5%
Textured Submuscular 2%
Based on this data, Sientra has rolled out a unique guarantee program. If any patient who received Sientra textured implants develops capsular contracture within 2 years of surgery, they will replace the implants for free. No similar program exists with any of the other implant manufacturers.