Christina, age 26, developed breast sagging after having two children. She was referred to Dr. Swanson’s office by her mother-in-law, a former patient herself. Christina wished to have a similar breast volume, just repositioned, like she was before her pregnancies. She decided to have a breast lift, with implants, to correct the sagging and restore fullness to the upper poles of her breasts.

Two weeks before surgery, she attended her preoperative appointment. Her blood test was performed. She received prescriptions for painkillers and antibiotics. She was given preoperative instructions. She knew not to eat or drink anything the morning of surgery. She and her husband arrive one hour before her scheduled surgery time at the Surgery Center of Leawood. She is met by the circulating nurse, also a former patient, and changes into a gown. The nurse checks her vital. Her pregnancy test is negative. Dr. Swanson takes photographs and marks the breasts.

Next, the anesthetist meets with Christina, asks her some questions, and starts the I.V. Christina walks to the operating room, her I.V. already started. The operating nurse has prepared the table with sterile instruments.

In the operating room, she lies down on the operating table. She puts her arms out on the arm boards. The anesthetist puts on a blood pressure cuff, some EKG leads, and an oxygen monitor. The circulating nurse attaches some booties to her feet and ankles (these squeeze intermittently during surgery to help prevent blood clots).

At the head of the table, the anesthetist opens a vial of a milky substance (propafol) and loads it into an infusion pump. The medication makes its way through the I.V. tubing and Christina falls asleep. The anesthetist puts in an oral airway and gives oxygen. Christina is now asleep, but breathing on her own. Dr. Swanson injects local anesthetic and proceeds with the surgery.

Two hours later the surgery is complete. The nurses apply the dressings and Christina is transferred to a gurney and wheeled into the recovery room. The anesthetist gives report to the recovery room nurse who will be looking after her as she wakes up.

Within ten minutes, Christina is wide awake. Dr. Swanson checks in on her. She’s smiling. She feels better than she had anticipated. She is not having pain. The local anesthetic used in surgery and the I.V. medications are working well. The nurse checks her breasts. No unusual swelling.

Her husband joins her in the recovery room. The nurse checks her vital signs one more time and helps her to the bathroom. She gets dressed and ready to go. The nurse gives her husband the instructions. A short wheelchair ride and she gets in the car. She’ll be back tomorrow for her postoperative office visit.