Breast lift (mastopexy) pre and post operative instructions

Standard

If you are scheduled to arrive at 6:00am please ensure you allow for traffic conditions, rain etc and arrive punctually at 6:00am.

As you are having a General Anaesthetic you need to have no food or drink for at least 6 hours prior to your procedure. Check with Canossa Hospital for the time of your procedure.

You will be given a General Anaesthetic for this procedure which means that you will remain drowsy for up to 24 hours following the procedure. For this reason, you must arrange an adult to care for you during this period.

We also ask that you do the following:

  1. Due to the sedation, you will also legally not be able to drive for 24 hours. Please arrange for transportation home after your procedure and for transportation back to the surgery the next day for your check up. The person who you arrange for this must be nominated with their contact details at the end of this form. This must be an adult that you know and cannot be an Uber or taxi driver

2. If you live alone and are unable to arrange a carer for the 24 hours following surgery, we can recommend that you contact Right At Home – In home care and assistance.

Phone: 1300 362 609     1300 363 192       0478750192

www.rightathomeaustralia.com.au  

3. Furthermore, you should also not operate machinery or sign any important documents in the 24 hours following surgery. As well as avoiding being in a situation where you will need to negotiate stairs or an unfamiliar environment.

4. Avoid aspirin, aspirin-containing or aspirin-like medications (Eg: arthritis medicines, some cold and flu remedies, Nurofen or Brufen), Vitamin E, (or multi vitamins that contain Vitamin E) fish oil, glucosamine supplements, gingko biloba, ginseng, valerian, black cohosh and chondroitin sulphate, These have been known to thin the blood and prolong bleeding.  Many other herbs have also been known to work in the same way. Avoid these for 3 weeks before surgery.

5. If you use prescription “blood thinners” such as Warfarin, be sure to discuss this with your well in advance of your surgery.

6. Unless you are advised otherwise, continue using all of your regular medications in their normal dosages.  Be sure to discuss this with your doctor.

7. Stop smoking at least six weeks prior to surgery.

8. Avoid alcohol for two weeks prior to your surgery and for three weeks following your surgery. This also acts to thin the blood and prolong bruising.

9. REMOVE ALL NAIL POLISH AND IF YOU HAVE FALSE NAILS PLEASE REMOVE 2 NAILS ON EACH HAND PRIOR TO SURGERY.

A prescription for Stratamed, Panadeine Forte and stemetil will be posted to you prior to the procedure. Please have the prescription filled at least 2 weeks prior to surgery and start using the arnica spray 4 puffs, 3 times daily underneath the tongue for 2 weeks prior to surgery. If you log onto www.epharmacy.com.au you will find a list of discount pharmacies in your area.

10. Allow for 7 days away from work in order to recover if your job is not too physically demanding. If your work requires physical energy you’ll need to allow more time for recovery.

11. The morning before surgery we recommend you do a pregnancy test to ensure you are not pregnant. The reason for this is that the drugs used during surgery may be    harmful to the fetus or the stress of the procedure may result in a miscarriage.

ON THE MORNING OF SURGERY

·         Wash with PHISOHEX . Also do this the night before surgery. Start by washing your breasts, then after that, wash your whole body.

·         Thoroughly remove all cosmetics and nail polish.

·         DO NOT WEAR JEWELLERY, WRISTWATCHES OR ANY METAL THAT CAN CONTACT YOUR SKIN. Also do not wear hairpieces.  Do not bring articles of value with you.

·         Wear loose-fitting comfortable clothes that do not have to be pulled over the head.  Avoid tight collars or belts. Wear loose fitting tracksuit pants.

·         If you use prescription medicine or eye drops on a regular basis, take your regular dose on the morning of surgery.  This is especially important with blood pressure medicines.

·         If you develop any sign of infection, pustules or boils on the face or body before surgery the doctor should be notified immediately.

·         BRING ALL YOUR MEDICATIONS TO THE SURGERY 

THE OPERATION FROM THE PATIENT’S PERSPECTIVE

Following signing of the surgical consent, you will be taken to a room to be prepared for surgery.

While the nursing staff should already have a copy of your medical history and physical examination from your doctor, be sure to discuss any special or unusual medical requirements or concerns with the staff, including allergies to medications, problems with abnormal bleeding, or asthmatic reactions.

You will be asked to put on a surgical gown and then a small intravenous cannula will be inserted into your hand to be able to receive the anaesthetic drugs once you are in the surgery.  You will also be given a dose of antibiotics into this tube. You will also be given an anti-nausea medication and a sedative. All your particulars will be double checked by the nurse.

You will then be moved into the operating room and monitoring equipment will be attached to you. Your arms will be placed onto arm rests outstretched from your body and you will then be put to sleep.

Your surgery is performed under General Anaesthetic so you will not be aware of anything during the surgery.

After the procedure, you will be fitted with a sports bra.  This should be left on until your check up the following day.

ON THE AFTERNOON AND EVENING OF SURGERY

You should rest as much as possible. In the evening, you may have a sponge bath if someone is there to help you.  Watching television is acceptable.

Discomfort or pain will occur, particularly if the implant is placed in a sub-muscular position.  In this instance, Panadeine Forte (for strong pain) can be taken every 6 hours. Alternatively, Mersyndol (for mild pain) can be taken every 6 hours. Do not take both together as both preparations contain paracetamol. Also, do not take these medications closer together than every 6 hours because excessive paracetomol is dangerous.

The discomfort improves gradually over a few days.  As the pain reduces, use only Mersyndol as it is less likely to cause nausea. If you are prone to nausea then just take Panadol. Remember to take Stemetil 1 tablet every 6 hours to reduce nausea if you are taking Panadeine Forte. If you are not experiencing any pain then do not take any analgaesia. Avoid Nurofen, aspirin or other anti-inflammatories.

Rest as much as possible and keep your feet elevated, but try to keep your calves active by moving your feet up and down.

It is good to walk around the house a few times from the day after surgery in order to keep your calves active. Wear the TED stockings for 3 days post operation. If, at any time, you develop calf pain then call the surgery or Dr Szalay immediately.

Providing you are not nauseous, start taking Keflex (if you are allergic to Penicillin, you will be taking Clindamycin instead). It is best to take these with some yoghurt. If you are nauseous, wait until this subsides before you start your antibiotics.

You will continue taking the antibiotics until 1 week after your surgery date.

Swelling and bruising will occur and will gradually subside over the next 7 to 14 days. Continue to use the Arnica spray taking 2 puffs under the tongue, three times a day.  This may be helpful in reducing any bruising.

BEGINNING THE NEXT MORNING

You will have an appointment for your first post-op check and dressing.  You must attend this appointment as we give important wound care instructions. It is also important to enable Dr Szalay to assess your results post procedure.

Leave the sports bra and dressing intact until your appointment.

Only continue the Panadeine Forte for as long as you are experiencing significant pain. Please note that these medications do cause drowsiness.

LATER INSTRUCTIONS AND INFORMATION

Keep the steristrips on until they fall off naturally. Then apply Stratamed gel until there are no scabs. Then apply Strataderm gel. The dressings need to continue until all the scabs have gone. The wounds must be kept dry during this time.

Wear your surgical bra 24/7 for 2 months post op.

Should any problems occur after surgery contact Dr Szalay.

For example: if your temperature becomes elevated, if one of your breasts is noticeably more swollen and tender, painful, red or inflamed, or if you develop increasing discharge from a breast.

You should also let Dr Szalay know if you develop a side effect to your medication such as a rash, nausea, vomiting or diarrhea.

You will have a check up with Dr Szalay 1 week after the operation and again at 2 weeks, 1 month, 2 months and 3 months.

You may experience a burning sensation in your nipples for about 2 weeks, but this usually subsides as bruising fades. The swelling in the breast may take 3 to 5 weeks to resolve. It is normal for you to experience swelling of your stomach area for several days post operation – it will resolve within 1 week.

Your breast will be sensitive to direct stimulation for 2 to 3 weeks, so you should avoid much physical contact. After that, breast contact is fine once your breasts are no longer sore, usually 3 to 4 weeks after surgery.

Moderate activity can be resumed after 3 days, although bending and straining should be avoided for 7 days. Moderate exercise (easy walking) may be resumed in 7 days. Avoid driving for 1 week following surgery, and avoid exercise for 3 weeks and swimming for 6 weeks.

You need to keep the wound dry, so bath instead of showering until the wound is completely healed with no scab. You should avoid immersing your breasts in a spa pool for 1 month as these can cause infection.

If at any time you notice the wound become increasingly red or painful then contact the practice immediately.

The scar will then continue to fade and soften for about 12 months or more.

In order to minimise the scar we recommend that you apply Stratamed gel to the wound after the steristrips have come away use this until there is no scab then change to Strataderm gel.

The incision may feel slightly tender for a few months.  Itching is common.  If at any time you feel a prickly feeling when you touch the wound, it may be an internal stitch coming through. Apply Betadine twice daily on this until it is no longer there but also come in so Dr Szalay can check it as soon as you notice it. If this area gets red or painful, antibiotics must be started immediately.

Do not try to evaluate the success of your surgery during your early recovery.  Allow 3 months for complete recovery.

FUTURE CARE OF YOUR IMPLANTS

Dr Szalay recommends supporting your implants with a supportive bra as much as possible as well as sleeping in one. This can reduce bottoming out, sagging and the breasts sliding to the side when you lie down.

PICK UP ARRANGEMENTS FOR AFTER SURGERY

Please describe the arrangements you have made for someone to drive you home following the procedure and to the appointment the following day.

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