How long do I need to take off from work? (please specify whether your job is physical or sedentary, such as an office job)
-7 to 10 days, full recovery 6 weeks.

When can I exercise again?
-30 to 45 days.

I have a small child. She/he weighs 25lbs. When can I safely lift him/her?
-3 weeks.

When can I resume sexual relations?
-2 to 3 weeks.

When can I drive?
-10 days.

Do you recommend ScarGuard, silicone sheeting, Mederma, etc and if so, when may I start using it? 1 week after surgery.

Will I need a mammogram prior to my surgery?
-Yes, i folder tan 40 years old and younger breast ultrasound.

How soon can I shower after surgery?
-Next morning.

When is it safe to soak my incisions in water( such as taking a tub bath, going swimming, or getting into the hot tub?
-3 days after surgery, always dry well after.

Do you recommend that I massage my implants, and if so, how often and can you show me the technique I should use?
-First post op treatment with ultrasound then 2 weeks after massage 2 times per day.

Do you feel that vitamin E helps to prevent capsular contracture? When may I start taking it?
-Yes, 2 weeks after.

Will my breast implants sag after a period of time?
-They should not.

Do you perform surgery on women that are menstrating?If so, is there a rule on the type of feminine product that I use on the day of surgery?

Sanitary napkin or tampons.

Should I remove fingernail/toenail polish prior to surgery?
-Yes, it is recommended

Can I wear contacts during surgery?
-No, you may suffer  corneal laseration.

Can I wear makeup on the day of surgery?
-No

What are the chances of me being able to breastfeed successfully after my surgery? Does the areola lessen my chances?
-It may  reduce up to 1% the amount of milk produced.

When will I receive my breast implant device cards?
-Next appointment.

What type of medications do you prescribe to be taken post-operatively? When will receive the prescriptions(before or after the surgery)
-Before surgery, we recommend arnica pills to reduce swelling and black and blues, after pain killers, anti inflammatory medications and antibiotics (oral and topic).

Narcotics tend to constipate me. Should I have a problem with this, is it safe to take a gentle laxative?
-Yes, you can use over the counter laxatives.

Do you recommend diuretics fot post-operative swelling?
-Only in special cases.

Do I need to purchase a particular type of bra to wear after I get out of surgery? What about a “strap”?
-Will I need to wear one of those? Yes, I will send you to try and choose what you like from a special store.

If I have a problem in off-hours, will I be to contact you, or will I have to see the plastic surgeon on-call at the hospital?
-If its during the week I will give you my pager number and during the weekend I may have some one on call or If I am in town I will take care of you personally.

Can I email you with questions after my surgery?
-Of course, my email is joseph@setton.md

How long have you been certified?
-3 years.

Do you have hospital admitting privileges? If so, with which hospitals?
-Hospital Punta Pacifica and Hospital San Fernando, Centro medico Paitilla, hospital nacional, CIRPA, clinica hospital de cirugia plastica.

How many breast augmentations do you perform per year?
-About 350 per year.

What is your rate of complications (capsule contracture, bottoming out, infection, etc)?
-Less than 1%.

What's the most common complication your patients experience?
-Discomfort at the pectoral muscles.

What is your re-operation rate with breast implants, and what is the most common re-operation you perform?
-Less than 1%, change of size.

What incision site do you prefer, and why?
-Periareolar, less noticeable and inframammary fold, does not touch the lymph nodes and doesn’t alter nerve endings.

What placement do you prefer? Do you perform both over the muscle and under the muscle implants?
-Retropectotal, under the muscle, less incidences of capsular contracture.

 Will breast implants provide some lift, or will I need a breast lift / mastopexy?
-It depends on your measures and skin quality, we perform a physical exam and determine if you are a candidate for mastopexy.

Do you recommend massage? Why, or why not?

Massaging the breasts helps to prevent capsular contracture and allows the muscles around the implant to soften, allowing for a natural look and feel

Where do you perform your surgeries?  Hospital, outpatient surgical center, or your own surgical suite? Is your facility accredited, and if so, by who?
-Hospital and outpatient centers facilities acredited by the AAAASF and AAASH.

Are all post-op visits free? If so, for how long?
-Yes up to four visits are cost free. We like to follow up with patients and ensure they are inan optimum state.

Regarding reconstructive surgery vs. plain breast augmentation, which do you do more often?
-I do more often breast augmentations, but also perform reconstructive surgery.


Do you recommend round or anatomical implants for me? Why?
-Round is better because 14% can turn around.

Silicone, more natural?
-Yes in some.

Which type of implant do you recommend? Saline or silicone? Will my creases need to be lowered?
-Yes, in some cases.

What medications do I need to stop taking prior to my surgery?
-Antiinflamatory medicine and blood thining agents including aspirine, alka seltzer, peptobismol, ginko biloba, green tea and fish oil.

What herbal remedies should I stop taking prior to my surgery?
-Green tea, ginko biloba and fish oil, ginger.

Do you recommend Arnica Montana and/or Bromelain for bruising and swelling?
-Yes I do.

Do you use dissolvable stitches, and if not, when do the stitches come out?
-Yes, if not 8 to 10 days.

What pain medications do you prescribe?
-Antiinflamatory and analgesics, also antibiotics.

Will I have surgical tape on the incisions, and if so, can you put some on me now, so that I can see if I will have an allergic reaction to it?

-Yes, steri-strips.

(If you already know that you have reactions surgical tape, PLEASE let your surgeon know at the consult.)

Does smoking affect the healing process? Do I need to quit before surgery, and if so, how long should I be smoke-free before I have my surgery?
-Need to quit 3 weeks before.

Do you make over-sized pockets?
-No.

I have fibrocystic breasts. Is it safe for me to have breast augmentation?
-Yes, same risk as without surgery

Do you use a certified anesthesiologist, or a nurse anesthetist (CRNA)?
-Yes

What type of anesthesia will I receive? General, or twilight with sedation? What is the difference between the two?
-IV sedation, mainly with propofol, difference, faster recovery, can eat after the surgery, less nause or vomiting.

Will I receive anti-nausea meds during surgery, and will I get a prescription for anti-nausea medication?
-Yes if needed.

If I have a problem, or a redo, can the same incision be used, or will you have to make a new incision?
-Yes.

Will my breasts feel natural, to me, as well as my significant other?
-Yes

Will my implants lose their shape and/or sag, after a long period of time?
-They should not if they are cohesive gel.

Will I be able to breastfeed

-Yes

Will I be able to scuba dive with my implants? How about skydiving, will I be able to do that?
-Yes.

Do you fill the implants to the manufacturers recommendations, or do you overfill (fill PAST the maximum amount recommended by implant manufacturers)?
-Usually we do not use saline.

How long do breast implants last?
-Mainly 10 years, but if OK, do not need reoperation.

Do you prescribe antibiotics to be taken before and/or after the surgery, and will I receive antibiotics in my IV?
-Yes, 30 minutes before surgery IV, oral after.

How will my breasts look if I decide to have children?
-Natural.

Will I lose sensitivity in my breasts/nipples?
-What are the odds of this being permanent? If around the nipple you can loose sensitivity  but will recover in 3 months.

Do you use sizers (disposable implants) during surgery to best determine size?

-Yes when needed.