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Breast Reduction
Your Procedure
You have had a breast reduction, or "reduction mammaplasty".
Pre-operatively
Prior to a breast reduction, please visit your family doctor. During your pre-operative physical discuss any medications that you are currently taking, including Vitamins. Some medications increase bleeding and should be avoided for at least ten days before surgery (i.e. Aspirin, Coumadin, Plavix, Ginger or Gingko supplements). Have nothing to eat or drink after midnight on the night before surgery. Plan to shower the night prior and the morning of your surgery with a chlorhexidine sponge. As this is daycare surgery you will need a responsible adult to take you home and stay with you that night.
IF you are over 40, or have any significant personal history that puts you at risk for breast cancer, you should have an updated mammogram within the last year leading up to your consultation.
What to Expect
A bit of bleeding on the dressing is normal. Most swelling is resolved within 4-6 weeks. You may tire easily for the first few weeks after surgery. In order to protect incisions and promote healing, vigorous activity must be limited for four to six weeks after surgery. Avoid heavy lifting, stretching and strenuous exercise. You may need to prepare to have assistance with duties around the house (i.e. lifting children/groceries or vacuuming).
Time off work varies between one and six weeks, depending on your occupation. Nipples may be numb immediately after surgery and then may become more or less sensitive than preoperatively. Depending on the style of incisions, you may notice puckering at the suture lines. Occasionally the dissolving sutures form a little pimple in the skin that may burst, sometimes 4 weeks after surgery, but can easily be treated by applying Polysporin. Puckering should resolve within three to four months.
Approximately two weeks after surgery, when incisions have healed completely, scar management will be discussed and an information sheet will be provided at your post-operative appointment.
Surgical Site Care
Purchase and bring with you a medium support bra with cup shape and without underwire or a loose sports bra with a front closure (if possible). Wearing a shirt that opens in the front may be easiest. Choose a size that is a bit bigger than what you hope to be after surgery, as it will also hold dressings and can be tightened if needed.
Starting the day after your surgery you may need to apply clean 4x4 gauze dressings to your incisions every day, for the first 10 to 14 days (i.e. after showering/bathing). This dressing will absorb small amounts of blood and/or clear fluid discharged from the incisions for the first few days. Replace wet/soiled gauze as needed (you may need to change the dressing a few times per day).
Small gaps/openings in the incision lines may occur; keep these areas clean and dry. The sutures are under the skin surface and will dissolve themselves. You may remove your dressings and shower three days after surgery. Steri-strips (thin tapes) or Prineo (a light purple colored mesh) will remain in place 2-3 weeks and are designed to get wet in the shower. You may use soap and water, rinse, and use a soft towel to pat dry.
Activity and Care at Home
The surgery will be performed under general anaesthetic therefore you must not operate motor vehicles, boats, power tools or machinery for the first 24 hours. You may drive when you have full control of the motor vehicle and are not taking any narcotic medication - this is usually about a week after surgery.
Your bra should be worn both day and night, for the initial two weeks then be worn daytime only for the next two to four weeks. Supporting your breasts with the bra minimizes tenderness and scarring. After three months you may wear a bra with underwire if desired. Generally, you may resume full activities at 4 weeks some people may require 6 weeks.
You can sleep on your back right away, on your side after 2 weeks, and on your stomach after 4 weeks, if desired.
Medications and Pain Management
Your breasts will be firm, swollen and bruised for several days. To manage pain, take Ibuprofen (Advil) and plain Tylenol every 6 hours for the first 48 hours. If that is not sufficient, then take the prescription medication. Do not take more Tylenol or ibuprofen than is recommended on the bottle in 24 hours. Sleeping with your arms elevated on pillows minimizes tugging on incisions and may, therefore, ease discomfort. Ice or cool compresses may help in the first couple of days, but do not leave ice on for longer than 10 minutes at a time.
What to watch for / when to call / who to call
If any of the following occur, please call the office:
Increasing pain rather than decreasing pain.
Increased swelling or redness around the wound, especially if only on one side.
Fever and chills.
Foul odour and/or increased drainage from incisions.
Excessive bleeding that is not controlled with pressure.
Swelling or excessive bruising that occurs only on one side.
Shortness of breath or pain in your calf.
If it is after hours the message will instruct you how to reach the doctor on call for problems that cannot wait for the office to open. Even if you plan to go to the emergency please call the surgeon as this may save you considerable time.
Follow-up
Your post-operative visits should be pre-scheduled at the time of surgical booking. If you are unsure of your follow up dates, please contact our office. Patients are usually seen for their first post-operative appointment about 7- 10 days after surgery.