We want breast augmentation with Dr. Feldman to be a positive experience, but that positivity requires preparation. Let’s discuss aftercare, and what Dr. Feldman believes is important, and what is not, as aftercare, or lack thereof, is a huge influence on the end result. There are many ways around the mountain, every surgeon has his/her own approach, and therefore no one is right or wrong, just different.
If you trust Dr. Feldman to perform your surgery, please trust his restrictions, instructions and appointment scheduling, to get you to heal with the best result and lowest possible complication rate. Remember he and his staff have done this over 3000 times. Dr. Feldman is the @breastexpert and has established an overwhelmingly successful process, that focuses on education, and empowerment, more so than frequent “check ups” as so many of his patients travel great distances for surgery.
Many of the complications encountered after breast augmentation are preventable and directly attributable to not following activity restrictions, supportive bra use and/or massage after surgery. Compliance with our instructions, and restrictions, plays as large a role, or even larger, in your result and chance of complication as the surgery itself. Unfortunately, actions have consequences, and many times, unapproved overuse, will lead to complications including but not limited to bleeding, bruising, hematoma, contracture, implant malposition or symmastia. Most of Dr. Feldman's patients overdo it, most get away with it, but about 5% don't, meaning approximately 5 out of every 100 surgeries require another operation in the first 6 months that could have been avoided by following our instructions. Following the instructions given by a friend, or what is posted on RealSelf, does NOT overrule or replace our specific restrictions and information. Now is not the time to get creative.
As such, we ask all of our patients, and their caregiver(s), to sign a compliance pledge. These are our expectations: Commit to four mandatory appointments: Your pre-operative appointment (1-2 weeks before surgery), your surgery, your post-operative appointment (1-3 days after surgery) and follow-up appointment (2 weeks after surgery). The timing of these of these appointments is essential and therefore non-negotiable. We expect patients to be attentive when in the exam room, not distracted by children, recreational drugs, or their phone during all of these appointments. Surgery is serious, and results depend on the information discussed at these appointments. Unfortunately, just coming to these appointments is not enough. Patients need to fully commit to the healing process, following each and every restriction, instruction and recommendation precisely. Physical presence in Dr. Feldman's office does NOT prevent complications, compliance does. As this is not Dr. Feldman's first rodeo, compliance will be confirmed by exam, as patients often tell us what they think we want to hear, while their breasts are screaming a different story. You can't over take it easy, but every little thing adds up to affect your result.
Our patients are always welcome to come back for an optional "bra check" appointment during the first six months after surgery, if that provides additional peace of mind, or is needed to reinforce our guidelines and instructions. Since Dr. Feldman spends so much time with each and every patient, and blocks an hour for any long term follow-up appointment, the schedule remains full. We do our best to prioritize the urgency of add-on appointments, triaging with questionnaires or photos submitted electronically. Depending upon time of year “well visits” can indeed take a few weeks to be scheduled. What other doctor, forget just surgeons, will personally spend an hour or more with you at a consult, 15-30 mins per appointment at your two mandatory follow up appointments, and another hour, if needed, to discuss healing, bras and long term progress? Unfortunately, an extra 30 minute appointment, commonly requested seeking reassurance following non-compliance, doesn’t prevent a complication, rather, following Dr. Feldman's restrictions and instructions 24/7 does. It takes way more work and discipline to behave 24/7 during the healing phase than it does to request an extra appointment, but the proof is in the reliable, predictable, pleasing results and low complication rates achieved by compliant patients who follow our instructions.
Aftercare and compliance with activity restrictions, what Dr. Feldman collectively calls “pride of ownership” is so important, Dr. Feldman starts talking about this during the initial consult. He discusses that patient non-compliance is the most frustrating part of his job and the largest obstacle to an amazing result. 4 out of 5 complications requiring revision surgery are preventable and avoidable. Patients must become their own best advocate. Unfortunately showing up for a couple, or more appointments, seeking reassurance, is not a substitute for following the detailed instructions and restrictions provided religiously. Being physically present at appointments whether there are two or two-hundred, while doing things we ask patients not to do, or choosing not to do things we instruct patients to do, between those appointments, predictably leads to sub-optimal results and/or complications. It’s also important to remember a surgeon really only has one trick, and that’s more surgery, for additional cost yielding less pleasing results. Hope is not a surgical technique or recovery plan.
We use the “teach a patient how to fish, rather than giving them a fish” approach with in-depth, hands on, education at the two week follow-up where we go over bra sizing, massage and long term return to activities, in detail. Countless patients’ friends and family who have had surgery elsewhere, and are present for these visits, always comment that they were never given any of that information. They most likely had a higher number of follow-up appointments with staff, but may have never seen the surgeon again or may have gotten just a quick “pop in." Quantity is NO substitute for quality.
As such, it’s not the quantity of appointments, but rather the quality of education that occurs during the appointment that truly matters, in Dr. Feldman’s opinion.
All of our patients are provided detailed instructions verbally by Dr. Feldman, Jeannette, our RN, as well as instructions in writing via email, paper handout and it’s all posted electronically on the website. In addition, we have 65 frequently asked questions and answers, in an easily understandable, bluntly honest format on our site. No other surgeon goes that far, or spends that much time and effort educating patients about aftercare with so many delivery methods. I encourage all of my prospective patients to look at competitors sites, before and and after photos and to get second opinions to see first hand who is truly focused on your education, result and aftercare, versus who promises "negligible complications, rapid recovery, and wish list picture results." We go to these extreme lengths because we’re focused on one thing, the result. What patients do after surgery is as big an impact on the result as the surgery itself. In fact most competitors deliberately sugar coat, hide or minimize restrictions to avoid scaring off potential patients. We can lead a horse to water, but it’s up to the horse to drink. All of our patients are provided the same information and tools to setup them up for success, but ultimately it’s up to the patient to become their own best advocate thereby possessing true, pride of ownership.