Pre & Post Instructions

CONTENT:

Pre-operative Preparation

Common Post-Operative Symptoms

Uncommon /Rare Post-Operative Symptoms

Following Discharge from the Hospital, until your First post-op Appointment

Following Your First post-op Appointment, until Your 4-6 Weeks post-op Appointment

Following your 4-6 weeks’ post-op appointment

Following your 9 months’ appointment

 

The purpose of the instructions within this document is to help you prepare for surgery and to also make your recovery as smooth as possible. It is important that these instructions are adhered to and followed. Mr Rezai will discuss the relevant instructions with you at each follow up appointment. If you are unsure of anything please contact us immediately.

Pre-Operative Preparation

Dont’s:

  • Do not Eat or Drink after 12 midnight on the night before your procedure, unless instructed otherwise by Us.
  • Do not smoke for at least 6 weeks before and 6 weeks after surgery. Although it is better NOT to resume smoking after your surgery, particularly if you are having breast implants as this will increase the risk of implant related complications.
  • Stop your alcohol intake 2 weeks prior to surgery and 1 week after.
  • Stop intake of multivitamins and supplements at least 2 weeks prior to and 1 week after surgery.
  • Do not Take any Anti-inflammatory medications at least 1 week before and after surgery. These include but not limited to:
    • Ibuprofen, Nurofen, Voltarol, Naproxen, Piroxicam, Indocid, Surgam, Froben, Lederfen
  • Do not Take any Anticoagulants (medications to thin your blood) containing Aspirin/salicylates or any cold or Flu medication e.g. Lemsip etc for at least 1 week before and after surgery.
  • Avoid eating Garlic or foods containing Garlic, 1 week before and after surgery, as this will increase the risk for bleeding.
  • Remove ALL piercing, nail varnish, or artificial nails prior to coming to the hospital on the day of surgery.
  • Do not wear any contact lenses, and eye or face makeup on the day of surgery.
  • NO Sun Holidays should be planned for until 6-8 weeks post-op.

Do’s:

  • Take any regular medication previously approved by Mr Rezai, prior to, and up to, the day of surgery- check with Us if you are not sure.
  • Shower or bath on the morning or evening prior to surgery, cleansing your entire body.
  • Remove any contact lenses, nail polish, jewellery, and all makeup whilst at home on the day of surgery.
  • Wear comfortable, front opening and loose clothing to the hospital.
  • Bring your post-surgery Bra and Breast band, if applicable, to the hospital.
  • Arrange for someone to stay with you during the first 3 days following surgery, as you may find it difficult to move around.
  • If you will be on your own (not recommended), you should shop for food such as prepared meals, fruits and such in advance. You can also cook a few meals ahead of time and freeze portions.
  • Purchase Micropore surgical tape (paper version) and bio oil or any type of lotion/cream that has vitamin E, you will be needing these after your first week post-op.
  • You will receive Antibiotics and Pain Medication before your discharge from the hospital, However, if you prefer, you may also purchase Paracetamol and have that at hand, for when you run out of the pain medication received from the hospital. It is important that you take your antibiotics and pain medication as prescribed, and not overdose. If in doubt, contact Us.

Common Post-Operative Symptoms

Typical symptoms following Breast Surgery, and what symptoms to watch out for:

  • Tightness/heaviness in the chest and/or stiffness; tingling, burning or intermittent shooting pain: These are normal experiences as the skin, muscles, tissues, and sensory nerves heal, and as the muscles and tissue stretch to accommodate the implants (if applicable). Pain medication will help you cope with any discomfort. Consistent sharp pain should be reported to Us Immediately.
  • Shiny skin or any Itching: Swelling can cause the breasts to appear shiny. As the healing process advances, you may also find a mild to severe itching of the incision area or the breast itself. An antihistamine, such as Claritin, can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact Us Immediately.
  • Bruising and Swellingwill mostly resolve within 2-4 weeks; however, residual swelling may persist for a longer period.
  • Asymmetry, the breasts look different, or heal differently. Breasts may look or feel quite different from one another and heal at different pace in the days and weeks following surgery. This is completely normal; no two breasts are perfectly symmetrical in nature.

Uncommon / Rare Post-Operative Symptoms

CONTACT MR REZAI’S TEAM IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • High fever, severe nausea and vomiting, continued dizziness, or incoherent behaviour, such as hallucinations.
  • Consistent sharp pain or any pain that cannot be controlled with your pain medication.
  • Bright red skin that is hot to the touch in the surgical area.
  • Excessive Oozing of blood and fluid from the incision (some oozing of blood and fluid is normal)
  • A severely misshapen breast or bruising that is localised to one breast or region of the chest.

Following Discharge From the Hospital

You will only be released to the care of a responsible adult, unless otherwise have been agreed with Mr Rezai in Advance. All of these instructions must be clear to the adult who will monitor your health and support you, around the clock in your first days at home from the hospital.

  • We call you every day, to see how you are doing, until you come for your first post-op appointment.
  • Rest, but not bed rest: While rest is important in the early stages of healing, equally important is that you are ambulatory: meaning that you are walking under your own strength. Spend 15 minutes every 2 hours engaged in light walking indoors as you recover.
  • Recline with your head and chest slightly elevated above your lower body. This will be more comfortable and can help reduce swelling. You may use two pillows under your head.
  • Monitor post-surgical symptoms and be alert to possible complications. These are defined, along with the actions you should take, on pages 1-2 of this document.
  • Fluids are critical following surgery. Stick to non-carbonated, non-alcoholic, caffeine-free, and green tea- free beverages including fruit juices and water, milk, and yogurt drinks. You must consume at least 1 glass (about 250ml) of fluid every 2 hours.
  • Good nutrition is important during recovery. Stick with soft, bland, nutritious diet for the first 24 hours. Constipation and bloating are common after surgery. This can be improved by increasing fluid intake, reducing salt intake and eating foods such as bananas and bran products. Having a stool softener, such as Miralax, at home may also help alleviate constipation. Taking prescription pain medicine with food, such as a few crackers or applesauce, will help to reduce any nausea you may experience with this medication.
  • Take all medication, exactly as prescribed. Complete all antibiotics unless told otherwise by Mr Rezai.
  • Keep incisions and dressings clean and dry. Dressings should be left in place until you visit our clinic for your 1stfollow up appointment, 5-7 days after surgery, or until you are instructed to remove them. Your incisions will ooze fluid and some blood for a short time after surgery. You may sponge bathe with assistance, or use baby wipes.
  • Do not smoke. Smoking can greatly impair your safety prior to surgery and your ability to heal following surgery, resulting in more noticeable scars. You must not smoke at least 6 weeks after your surgery, and your caregiver must not smoke anywhere near you.
  • Limit your arm use to daily activities such as brushing your teeth, eating, and combing your hair for the first few days. Avoid vigorous arm motion that requires pushing, pulling or lifting.
  • You must wear the surgical garment/support bra around the clock, as directed. (For patients with implant under the muscle breast band must be worn for 1-2 weeks, day and night). You may remove your garments 1hr/day or have it removed 20 minutes/morning, 20 minutes/midday, and 20 minutes/evening.
  • You may apply a cool, not cold, compress to affected sites to alleviate discomfort, swelling or bruising. Wrap crushed ice or ice packs in a towel before applying to skin. DO NOT apply ice or anything frozen directly to the skin. Cool compresses should be applied for no longer than 20-minute intervals. DO NOT apply heat to affected areas as this will only worsen swelling.
  • Relax. Do not engage in any stressful activities. Do not lift your hands over your head. Do not lift anything heavier than a paperback book (i.e. nothing greater than 3KG). Take care of no one, and let others tend to you.
  • DO NOT drive until after your first post-operative appointment. Depending on your healing, driving can normally be resumed 10 days to 14 weeks after surgery.
  • Your first post-op visit will be around 7 days after surgery. At this time, your dressing will be changed and your initial healing will be assessed.

Following Your First Post-op Appointment

You will continue to heal and you will feel better day after day. It is important to ease into your daily activities. You will receive clearance to begin driving or return to work at your 1 week post-op visit. It is important to follow the instructions given and if in doubt about anything, ALWAYS contact us and NOT search online.

  • Easing into your Normal Daily Activities. You should now start gently, easing into your daily routines, however, still NO heavy lifting, exercise, or strenuous activity.
  • Continue wearing your post-surgery bra,day and night, until your 4-6 weeks’ appointment.
  • Scar Care. To reduce tension over your scar and to aid its healing, you should apply Micropore tape on your incision area as instructed during your 1stpost-op appointment.
  • Shower, NO Bath. You still cannot take a bath, however warm, not hot showers are fine. Limit your shower to 10 minutes and follow the following steps:
    – DO NOT remove the Micropore tape.
    – Take a shower with Micropore tape still on.
    – When out from the shower, dry the tape with the COOL AIR of a hair dryer.
    If tape is clean (i.e. no oozing) leave it, and change it every 2 days, if not change it to a new one.
  • Continue to cleanse wounds as directed and change the Micropore tape every other day.
  • Moisturise the skin of your chest as it tends to feel dry, flaky, and itchy. Use Bio Oil or any cream containing Vitamin E.
  • Maintain daily walking. Walking is essential every day to prevent the formation of blood clots.
  • Maintain a healthy diet.
  • Do not smoke. While incisions may have sealed, smoking deprives your body of necessary oxygen that can result in poorly healed, wide, raised scars.
  • You may sleep on your side 2-3 weeks following surgery. If you are a side-sleeper, a soft pillow under your mid-back and shoulders may offer more comfort and support than a single pillow under your head. You Should NOT sleep on your stomach at this stage.
  • At your 4-6 weeks’ post-op appointment, we will show you how to massage your breasts and take care of your scar.
  • NO sun holiday should be booked, for during this period.

Following Your 4-6 Weeks Post-op Appointment

Although it may appear that you have completely healed, your body is still healing inside and may continue to heal for another 6 -9 months. It is important to follow these instructions as advised until your 9 months’ post-op appointment.

  • You may ease into your regular fitness routine. However realise that your upper body may require some time to return to prior strength. ALWAYS wear High impact Sports bra during exercise. If you feel pain when exercising, wait 5 minutes, and gently resume your exercise. If you feel pain in your breasts following workout, you may take Ibuprofen.
  • Discomfort/tightness, bruising and swelling. Most of it should have resolved by now, however, for some patients it may take longer.
  • Do Not resume smoking, If you can.
  • Massage your breasts with Bio-Oil, as instructed, 10 minutes each breast /day for 3-4 months. The longer you continue the massage the better, as it will increase blood circulation to your breasts, aid the healing process, resulting in your breasts feeling softer and settling faster. NEVER Massage staright after Shower or Bath as the risk of implant rotation is high.
  • Continue Scar care as directed at you 4-6 weeks’ appointment. You should start applying circular light pressure massage over your scar, using Bio-Oil. This is to aid the healing and to improve the appearance of the scars. Continue to do this for 3-4 months. The longer, the better. Your scars will be firm, pink, and bumpy to start with and will improve with time, especially after you start the circular massage following you 4-6 weeks’ appointment. It normally takes between six months to a year for the scars to fade into fine lines and flatten. They never disappear completely.
  • Your scars will continue to heal. If they become raised, red or thickened, or appear to widen, contact our clinic. Early intervention is important to achieving well-healed scars. refined to fine incision lines one year after surgery.
  • Practice good sun protection.Do not expose your breasts and scars to direct sunlight for up to ONE year. If you are outdoors, or on holiday, apply at least SPF 50 to your chest, breasts and over your scars, and always wear bikini/ bathing suit/ clothes while undre the sun. During your healing process, your chest region and breast are sensistive and direct sun exposure may cause inflammation of tissue which may result in unnecessary complications.
  • DO NOT wear ANY underwired bra for 6 months after surgery. If you are attending a party and need to wear one for few hours, you can, but this should NOT be made a routine.
  • NO need to wear bra at night. However, you should support your breasts at all other times as otherwise gravity, and weight of implants, if applicable, will result in your breasts sagging faster than they normally would.
  • At your 9 Months’ post-op appointment, Mr Rezai will advise you on how to do a monthly breast self-exam, and what to look for. Mr Rezai will also inform you of what symptoms to look for, when it comes to implant related complications. This will be your LAST Routine follow-up appointment.

Following Your 9 Months Post-op Appointment

At this point, your breasts may have almost or completely settled, for some patients, it may take longer, especially if implants were had and placed Submuscular.

  • Continue with the monthly self-examination of your breasts.
  • If you have breast implants, Mr Rezai will see you for Complimentary annual check-up. Call us to book your annual appointment, when it’s time. However, you are welcome to contact us at any time or make an appointment to see Mr Rezai, if you have any concerns.
  • If you have implants, Mr Rezai recommends that you have a routine Ultrasound Scan every 3-4 years to check the integrity if the implants.
  • When having a Mammogram, always inform the Radiologist of your surgery, regardless of the type of breast surgery you had.

We are always here to Help, feel free to contact us if in doubt, or if you have any questions.