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Post Operative Instructions - BREAST

Please refer to one of the following post operative instructions concerning your specific breast procedure. Please call the office at any time if you have questions or concerns. We are always available to help. If the office is closed you will be given instructions on how to page Dr. Marble.

Breast Augmentation Post Operative Instructions

1. Take your antibiotics as prescribed.
2. Take 500 milligrams of Vitamin C twice daily.
3. Ice as needed for swelling—making sure you have a shirt OR towel between you and ice.
4. Take Arnica for bruising (you may purchase it at Dr. Marble’s office or at a health food store) topically and/or orally.
5. Wash under your arms with soap and water daily. No showering or any other moisture on the incisions until 24 hours after suture removal.
6. Call Dr. Marble immediately if you develop a fever, redness around your breasts or wounds, drainage, or increased pain.
7. Wear your garments as directed, bra and band/strap for 2 weeks, than bra during the day plus strap at night for 2 more weeks (total 4 weeks). Be sure the garments lie smoothly against your skin. Make sure the band/strap is high in the front and low in the back.
8. Change the gauze pads as needed, but do not remove the steri-strips from your incisions.

Prevention of Capsular Contracture and Scar Management
1. Massage your breasts as instructed beginning one week post op as instructed on first visit.
2. Apply Mederma to scars as directed starting 3 weeks post op. This will be discussed at your 2nd post op visit.

Restrictions and Precautions
1. ABSOLUTELY NO SMOKING, SECOND HAND SMOKE OR CAFFEINE FOR 2 WEEKS POST OP.
2. Avoid lifting and strenuous exercise (for 1 month post op, at least).
3. No underwire bras for at least 3 months
4. Always inform your Dentist or any Physician that you have breast implants as special prophylaxis may be necessary prior to any medical/dental procedure.


Breast Implant Removal Post Operative Instructions

1. Keep your breasts dry until the sutures are removed in two weeks.
2. Call Dr. Marble immediately if you develop a fever, redness around your breasts or wounds,
drainage or increasing pain.
3. Take your antibiotics as prescribed.
4. Keep your sports bra and ace bandage on for 24 hours per day for the first two weeks.
5. Take 1,000 milligrams of Vitamin C twice daily. This will reduce your scarring.
6. Massage your breasts as instructed beginning two weeks post-op.
7. Avoid lifting and strenuous exercises for at least one month after surgery.
8. Wash under your arms with soap and water daily.
9. ABSOLUTELY NO SMOKING OR CAFFEINE for two weeks post-op.
10. May shower after one week.


Breast Reconstruction with Placement of Implants Post Operative Instructions

1. Take your antibiotics as prescribed.
2. Take 500 Milligrams of Vitamin C twice daily.
3. Ice is needed for swelling. Make sure you have a tee shirt or towel between you and the ice to avoid frostbite,
4. Take Arnica for bruising topically and/or orally.
5. Empty drains twice daily or if ½ full.
6. Cleanse drain sites next to skin with hydrogen peroxide and then apply Bacitracin.
7. Re-apply gauze under drain sites – fold two 4x4’s in half. Snip on fold to create pocket for tubing, then tape.
8. No showering or any other moisture on the incisions for 24 hours after suture and drain removal, usually between 7 and 14 days.
9. Call Dr. Marble immediately if you develop a fever, redness around breasts or wounds, drainage, or increased pain.
10. Wear your garments as directed: bra/binder until further notice. Be sure that the garments lie smoothly against your skin.
11. Change the gauze pads as needed, but do not remove the steristrips from the incisions.
12. You will be instructed on your first post op visit on further instructions such as heat and massage therapy.
13. Absolutely no smoking, second hand smoke or caffeine post op!
14. Avoid lifting and strenuous exercise (upper body) until further notice.
15. No underwire bras for at least 3 months.
16. Always inform your Dentist or any Physician that you have implants as antibiotic may be prescribed prior to any medical or dental procedure.


Breast Reconstruction with Placement of Implants Post Operative Instructions DRAIN CARE

1. Keep wounds and drain sites dry.
2. Change your dressings and perform drain care twice daily as you were taught by the doctor and nurse at the hospital:
a. Remove all gauze. Be sure that your steri-strips are allowed to air-dry prior to applying fresh gauze. Failure to allow the steri-strips to dry will result in yeast infection which will cause wound healing problems.
b. Empty drain bulbs; Cleanse drain site with hydrogen peroxide and apply Bacitracin twice daily.
c. Apply fresh dry gauze over all your wounds.
d. Replace the surgical bra, binder and ace bandage.


Breast Reduction/Mastopexy Post Operative Instructions

Immediate Post-op Instructions and Restrictions:
1. Keep wounds and drain sites dry;
2. Change your dressings and perform drain care twice daily as you were taught by the doctor and nurse at the hospital;
a. Remove all gauze. Be sure that your steri-strips are allowed to air-dry prior to applying fresh gauze. Failure to allow the steri-strips to dry will result in yeast infection which will cause wound healing problems.
b. Empty drain bulbs;
c. Apply fresh dry gauze over all your wounds;
d. Replace the surgical bra, binder and ace bandage;
3. Take your antibiotic and pain medication as prescribed. In addition, take 500 mg of Vitamin C orally twice a day for 2 weeks. Ice packs as directed over your dressing will help with pain and swelling;
4. You may take Arnica tablets to aid in resolution of bruising and swelling. Arnica gel or lotion can be applied to bruised and swollen areas as well, but avoid contact with your incisions and drain sites. You may purchase Arnica at Dr. Marble’s office or at a nutrition store;
5. Walk frequently, at least every 2 hours to avoid blood clots in your legs. Use the spirometer that you received in the hospital for breathing exercise;
6. Limit the use or your arms. Don’t lift greater than 10 pounds or do any upper extremity work for at least 4 weeks;
7. A clear yellow or bloody drainage is normal. Call the office if you develop a fever, increasing redness or purulent drainage (pus) from your wounds;

5-7 Days Post Op
You will have a follow-up visit in the office with Dr. Marble’s Medical Assistant. The sutures around your nipple and under your breasts will be removed as well as the drains. You will be given new instructions regarding wound care and heat application. Activity restrictions/limitations will also be reviewed and reinforced. Signs/symptoms of infection or potential other problems will be discussed. You may shower 24 hours AFTER this visit. Be sure your wounds, including steri-strips are completely dry prior to dressing. Failure to do so will result in yeast infections which will delay wound healing. Call us if you develop itching or redness around the steri –strips. Bring a comfortable sports bra with a low riding band (i.e. one that rests on the upper abdomen rather than up under your breasts) to this visit. A bra with hooks/and or zipper in the front is preferable. Your nipples may be painful/and or sensitive as healing progresses. This will resolve over the next few months. Also you may have a small open area at the intersection of your incisions under each breast. This also will eventually resolve. You will be given instructions regarding the care of these areas should they occur.

2 Weeks Post Op
You will have another follow-up visit. The remaining sutures (your vertical incisions) will be removed at this time. You will be given new instructions regarding activity restrictions, bra usage and wound care.

3 Weeks Post Op
You will begin massaging your healed incisions with Mederma twice daily. You will be given instructions regarding the care of any remaining unhealed areas and your restrictions will be modified as indicated.

In Addition To All Of The Above
For the first 8 weeks, or until your wounds are healed completely PLEASE avoid caffeine, smoking (either 1st or 2nd hand smoke), weight reduction diets and vigorous exercise. Also do not drink alcohol while you are taking narcotic pain medication.