Preoperative Instructions for Breast Reduction
Contents
1. 3 You may resume your preoperative medications with the exception of blood thinners aspirin or ibuprofen containing products herbal supplements and Vitamin E to avoid prolonged bruising Complete your course of antibiotics note that antibiotics may impair birth control pills Take your pain medication as prescribed typically 1 2 tablets every 4 6 hours as needed It is recommended that you take the minimal amount of narcotic pain medication necessary to relieve your pain and transition to Extra Strength Tylenol as soon as possible after your surgery to minimize narcotic associated side effects often worse than the pain related to the surgery 4 You may remove your dressings and shower 48 hours after your surgery Remove your surgical bra while in a lying position after 5 minutes sit up If you are not dizzy you may stand with assistance and walk to the shower Do not use hot water as this may cause dizziness as your blood vessels dilate in response to the warmth Keep your back to the showerhead and do not rub your incisions You may wash your hair with care to avoid rundown of the shampoo onto your incisions Pat your incisions dry lightly and replace your surgical bra dressings and gauze Thick padded cotton ie sanitary napkins may be substituted for medical gauze and provide protection from your incisions being irritated from the surgical bra Do not apply lotions over the incisions 5 Your first postoperative visit should be sche2. either side or on your drains after surgery Lay in a recliner or keep your chest head elevated on pillows b Do not push pull lift climb reach over your head or do any strenuous activities as this will elevate your blood pressure which may increase bleeding bruising In addition these activities will lead to wound separation and prolong your recovery time secondary to wound healing problems c You may apply towel padded ice packs over your dressing for limited periods 15 minute intervals only for comfort and to minimize swelling d Do not drive until you are not taking narcotic pain medication and you are cleared by Dr Ranieri e Walk around the house every hour while awake to help maintain your circulation to minimize your chance of a blood clot starting the day of surgery Be careful when you change positions the first week as you may experience mild dizziness or lightheadedness f Wear UV protection SPF 30 or greater to protect your incisions from burns and hyperpigmentation Avoid lengthy sun exposure 2 You may resume your preoperative diet as tolerated Start with clear liquids advance to full liquids and then regular food as your nausea resolves and bowel movements become more regular No alcohol salt or soy sauce the first week to minimize swelling Stay well hydrated Do not let nausea progress to vomiting Take over the counter stool softeners to prevent narcotic anesthetic associated constipation No smoking
3. of surgery wash daily with an antimicrobial soap to decrease your chances of infection In addition at your preoperative appointment you will be given a Hibiclens scrub brush that you should use the morning of surgery If you have an active rash or infection your surgery will be delayed until it is resolved 4 Do not drink or eat anything after midnight the day prior to your surgery to minimize the risk of aspiration or other anesthetic related problems This includes water coffee gum mints etc The anesthesiologist will cancel your surgery if you eat or drink anything after midnight 5 Bring a list of your medications and herbal supplements the morning of surgery for review with your anesthesiologist If you have a history of breathing problems bring your inhaler to the surgery center 6 Do not wear contact lenses to the surgery center hospital Bring a case for your glasses Day of Surgery 1 Please arrive at the surgery center 2 hours prior to the surgical start time During this time you will complete paperwork change into a surgical gown receive intravenous fluids and preoperative medications and women of child bearing age will be given a urine pregnancy test You will have an opportunity to review any questions with Dr Ranieri and the anesthesiologist In addition Dr Ranieri will perform a series of preoperative markings 2 You must have a responsible adult available to drive you home after surgery and stay with you for at l
4. there are no restrictions regarding the specific bra you must wear you may go bra shopping and buy the bra you always wanted to fit into All swelling will not subside for six months wearing a bra will help this occur faster at which point your final result will be evident Avoid direct or indirect sun exposure to the operative site to minimize pigment changes that may become permanent This instruction sheet is written to answer most common questions regarding breast reduction surgery If any addition questions arise or postoperative problems occur that are not detailed above please do not hesitate to call the office during regular hours or the answering service after hours at 904 633 0130
5. UF amp ShandsjJacksonville l Plastic Surgery ag Preoperative Instructions for Breast Reduction Preoperative 1 A preoperative appointment will be scheduled one to two weeks prior to your day of surgery This appointment will not be made until your surgery has been authorized by your insurance company At this appointment your medical history specifically your list of medications and herbal supplements will be reviewed Two weeks prior to surgery all herbal supplements Vitamin E and aspirin or ibuprofen containing products should be discontinued to decrease bleeding and subsequent bruising Depending on your age preexisting medical problems and facility where your surgery is scheduled you will be sent for blood work and possibly an EKG In addition you may be asked to obtain formal medical clearance from your family doctor internist or an appointment may be set up at Shands to undergo preadmission testing PAT at which point an anesthesiologist will review your medical history and order additional tests if warranted to safely clear you to undergo general anesthesia 2 You must quit smoking at least 3 weeks prior to surgery Your surgery will be cancelled if you continue to smoke as smoking increases your chances of respiratory problems and wound healing problems This is an elective procedure with multiple incisions that will not heal resulting in a poor cosmetic outcome and long term wound care if you continue to smoke 3 The week
6. duled within the first week after your surgery This appointment should be scheduled by my office staff on the day of your preoperative appointment As previously mentioned bring a record of your drain output to this appointment to determine if your drains may be removed 6 Problems or questions concerning drains should be addressed to the office during regular hours The only concern related to the drains that would necessitate a call to the office after hours is drainage greater than 50 mL hr or significant bleeding All other concerns including burning at the drain site normal and leaking around the drain often means the drain is clogged can be addressed by the office staff during regular hours Postoperative Weeks 2 6 Most patients are able to return to work in 3 4 weeks after their surgery at least part time or with restrictions You may resume long leisurely walks and increase non strenous activity gradually You should continue to avoid lifting pulling pushing or reaching above your head for 3 4 weeks or until all incisions are healed This includes picking up children Aerobic activity and upper body exercise may be resumed at 6 weeks if there have been no would healing problems Lower body exercises may be resumed with restriction in 3 weeks You should wear your surgical bra for 4 weeks after your surgery or until all incisions are healed and there has been return of normal sensation underneath your breasts At this point
7. east the first 48 72 hours after surgery If you have young children you need to arrange for childcare Keep in mind that you will be prohibited from picking up your child for 3 4 weeks after surgery and appropriate assistance should be set up before surgery This is related to wound edge separation and prolonged wound healing which results from any lifting pulling and pushing in the immediate postoperative period 3 Please leave all valuables at home including body piercing jewelry Metal will conduct electrical currents and may lead to burns 4 To reduce infection do not wear makeup lotions or deodorant on the operative area 5 To simplify anesthetic monitoring do not wear nail polish on either hand 6 You will stay in the recovery area for approximately 1 2 hours Typically it takes this amount of time until your pain is well controlled you are alert and you can drink without being nauseated A Foley catheter will be placed prior to surgery once you are asleep to monitor your fluid status This will be removed before you are awakened from anesthesia You must urinate spontaneously prior to release to ensure no problems with urination once you are released Postoperative Week 1 1 Your activities will be restricted in order to minimize bleeding swelling and separation of your incisions that can result in unfavorable scarring Swelling may increase the first 48 hours before it starts to diminish a Do not lie on your stomach
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