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Preparing for breast reconstruction


Pre-operative appointment

  • On the day of your pre-operative appointment, we will review your procedure in detail and go over the surgical plan with you. We will also address any questions and concerns you may have. Please read over the procedure consent prior to this appointment and have any questions ready so we can discuss them.
  • During your pre-operative visit, we will provide you with all the aftercare instructions as well as necessary medication prescriptions. You will also be provided with a post-operative appointment for follow up after your surgery.

The weeks before surgery

  • Please do not smoke (cigarettes, vape, or pipe) or use any nicotine products 4 weeks prior to and after your surgery. Smoking and nicotine greatly impair healing, which can cause increased risk for infection and complications, such as delayed incisional healing or wound opening which lead to worse scarring. Please stay away from second hand smoke as well, as this can also cause wound healing problems. If you use nicotine products, you will need to stop 4 weeks prior to surgery and then you will need to undergo a cotinine test prior to surgery to ensure that the nicotine is out of your system.
  • Please do not drink alcohol before or after your surgery (until cleared by your surgeon). In addition, please do not drink alcohol while taking pain medication, as this can have serious, and life-threatening side effects.
  • Please leave all valuables at home. If you have body piercings, kindly remove them prior to surgery.
  • Please have someone available to drive you home. Due to the lasting effects of the general anesthesia, you will be unable to operate a car after surgery. A taxi or car service is not adequate either. You will need a family member or friend who can assist you.
  • You may have been asked to obtain pre-operative tests at a lab facility or your primary care physician. Your pre-operative tests (labs, X-rays, EKG, etc.) need to be completed at least three days before your surgery. If you have them done at your doctor’s office, the results will need to be faxed to (210) 362-1582.
  • The surgery facility will call you the day before your surgery to let you know what time and where you should arrive.
  • Shower the morning of or the night before your surgery with your normal soap and water. Do not use deodorant, lotion, cream, perfume, aftershave, oils, or makeup after bathing.
  • Do not take Advil, Aleve, Naproxen, Fish Oil, Garlic, CoQ10, Omega 3,6, Motrin, Excedrin, Ibuprofen, Aspirin, medications for arthritis or any medication that contains these medications for ten days prior to your surgery and two weeks after.
  • Do not eat or drink anything after midnight the night before your surgery.
  • Please call our office if you have an infection of any kind prior to your surgery.

The day of breast reconstruction surgery

  • On the day of surgery do not take the following blood pressure medications or medications with generic names that end in “-pril,” “-sartan. ”If you are on metformin, you will be asked to not take it on the day of surgery.
  • On the day of surgery, your plastic surgeon will meet you in the pre-operative area to go over any last minute questions or concerns you may have. Your plastic surgeon will make some preoperative markings and will perform extensive checks with careful attention to detail, ensuring high quality care and safety. You will meet the anesthesiologist and their team, as well as the members of our plastic surgery operative team.
  • During the plastic surgery procedure, our plastic surgeons pay meticulous attention to detail and work as a highly experienced team to ensure a great result. Your family will be updated of your status periodically and will be able to talk with the plastic surgeon in person after the procedure is completed. The incisions will be placed in a dressing or a compression bandage. Instructions for care on these will be given to you in your preoperative paperwork.

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Aftercare

To make your recovery faster and more comfortable, we recommend that you prepare before your surgery. Things you can do are:

  • Prepare a sleeping area that is easy to reach. Keep your toiletries close by and prepare food ahead of time. Arrange for someone to be with you the first night after surgery.
  • You may receive your post-operative medications at your pre-operative appointment. You should pick up these medications prior to your surgery.
  • If you’re having an outpatient same-day procedure you will be released to go home the same day and will need to arrange for a friend or family member to drive you home, and someone to stay with you for the first few days.
  • Review your post-surgery instructions given to you at your pre-operative appointment
  • If you may experience nausea or vomiting after anesthesia, please let us know, as we can prescribe anti-nausea medications and take extra steps to prevent nausea and vomiting after surgery.
  • When undergoing general anesthesia, you will need to have someone drive you home. You will not be allowed to undergo surgery without a confirmed adult driver who you know.

Medications:

  • After surgery you will have discomfort and the goal of pain medications is to reduce pain, but it will not completely remove all pain. A good measure for if you need more pain control is that you should be able to take a deep breath without severe pain. Do not wait until your pain is unbearable to take the next dose of pain medication because it will take longer to get your pain under control again.
  • You may resume your home medications after surgery except blood thinners and as determined by your surgeon. We will give you a prescription for pain medication. If you are prescribed medications that contain acetaminophen (Tylenol) it is important that you not exceed 3500 milligrams of acetaminophen (Tylenol) per day. Do not drive, operate heavy machinery or make important decisions while taking narcotic pain medications.
  • Narcotic medications may cause constipation. Ensure you have adequate (>25 grams/day) of fiber in your diet and drink at least 64 oz. of water daily. You may also wish to take an over the counter stool softener such as MiraLAX or Colace once or twice daily.
  • You can alternate your narcotic medication with Ibuprofen 600mg every 6 hours and/or Gabapentin 300mg three times a day. Take ibuprofen with food to protect your stomach from irritation.
  • If you have a history of nausea or vomiting after anesthesia, you may be prescribed an anti-nausea medication (Ondansetron) which can be taken as needed.
  • Before prescribing any narcotic medications, we are required to check the Texas controlled substance history database (Texas Prescription Monitoring Program). If you currently have a pain medication contract with another physician or are currently on narcotic medications, we will have to coordinate your medications with that physician.
  • We will prescribe pain medications for recovery after surgery, but do not prescribe long-term pain medications and do not do more than one refill for any pain medications. If you have pain that is beyond what is usually anticipated for your surgery and there is no surgical reason that can be found, we will help by referring you to one of the many pain management specialists that we work with.

Surgical site care

You may shower 48 hours after your surgery. Do not scrub the incisions, just let the water run over them and gently dab them dry afterwards. Apply gauze or ointment over the surgical site daily as needed for light drainage. Do not immerse your incisions in baths or hot tubs until at least 2 weeks after surgery. More specific instructions will be provided during your pre-operative visit.

Drain care

Sometimes it is necessary to place a drain after surgery. The purpose of a drain is to remove excess fluid from the surgical area. Empty the bulbs and measure the output whenever the bulbs are half full or at least twice a day. You will be given a sheet to record how much is coming out of the drains. Bring this sheet to your follow-up appointment. In general, drains remain in place until there is less than 30mL (1oz) out of the drain for two days in a row.

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Non-emergency questions

During business hours (8 AM – 4:30 PM): call (210) 658-3555.
After hours and on weekends/holidays: call (210) 658-3555 and you will be forwarded to the on call surgeon.

If you are having any serious problems or symptoms such as difficulty breathing or chest pain, call 911 or proceed to your nearest emergency room.

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Watch for these symptoms, and call us at once if they occur

Please call if you have the following signs/symptoms:

  • Temperature above 100.5 F
  • Bleeding or pus draining from the wound site. If you have bleeding, apply direct pressure to the area for 20 minutes
  • Increasing pain that is not controlled on oral pain medications
  • Increasing redness or size at the surgical site
  • Your drain is not holding suction
  • If your incisions come apart
  • Any other concerns
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Your activities Restrictions during your recovery

You must avoid any vigorous activities, including lifting, housecleaning, yoga, jogging, or lifting any item (including pets!) that weigh more than five pounds. You must avoid activities that could raise blood pressure or heart rate. Take gentle walks every day, and you can climb stairs after surgery. It is important to move your body with gentle walks, rather than lying in bed, as blood circulation helps to speed healing and avoid complications.

Your first follow up appointment

Your clinic appointment will be scheduled at your pre-operative appointment before surgery. If you need to change your appointment time or date, please contact our clinic at (210) 658-3555.

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