Breast Reduction Post‑Op Instructions

Post-operative instructions. Breast reduction.

Day of surgery. I will meet you at the surgery center where you will have the chance to meet your team including the anesthesiologist. The anesthesiologist will review the documentation that I have provided with you to ensure accuracy and that we provide a smooth, safe anesthetic and recovery. Minimizing the risk of post-op nausea and wooziness starts in the pre-op area. You will be given an IV so that we can hydrate you and the anesthesiologist can give medications during the procedure.

During your surgery, you will have a breathing tube or a LMA that helps keep you safe during your operation. This can make you feel like you have a scratchy throat after surgery for a couple of days. A nice Throat Coat tea or Chloraseptic can help with the discomfort.

The shape of the breast created at the time of surgery is tight and flat along the bottom of the breast. This is intentional so that over the course of the first 3 months after surgery, the lower breast will soften and create that nice lower breast contour. If I created the perfect shape at the time of surgery, you would be a little droopy in 3 months.

I like to use long-acting local anesthetics during your surgery so that you have very little discomfort after surgery. Even with the block, you will still feel some pressure, but most patients have pain scores between 1 to 5 after breast surgery.

When your surgery is complete, the nurse will contact your family member to let them know your procedure is done and the time for pickup. If the surgery runs longer than anticipated, this is not a bad thing, though it can cause some anxiety in your family. Your breasts are unique and we must take our time to ensure that every little detail is accounted for. The work done during your surgery must last for the rest of your life.

Recovery. The typical downtime from a breast reduction is about one week, 3 to 7 days. Our post-operative dressings are very minimal. There will be some bruising and swelling, but you will be able to enjoy your new breast immediately after surgery. The downtime is also dependent on the demands of your job. If you swing a sledgehammer for work and your job requires heavy lifting, then downtime will be longer.

Evening after surgery, I recommend getting up and moving around at home. Surgery can increase your risk for blood clots in the legs and we want to ensure the blood is kept flowing. During the first evening, please ask for assistance from your loved one since you may not feel as stable as you normally do.

If you are a stomach or side sleeper, I recommend getting some wedge pillows or at least place a pillow behind your knees in order to help simplify sleeping on your back. I recommend sleeping flat on your back or slightly reclined with a few pillows or in a recliner in order to resist the temptation to roll over.

Follow-up schedule. 2 weeks after surgery: some bruising remains, but it is already starting to fade to yellow tones from purple. Not everyone bruises. I want to make sure you are comfortable, progressing well, that there are no signs of infection, and that you are having bowel movements. Nothing more frustrating than being sore from surgery and constipated. Trust me.

1 month after surgery, you feel great. Your incisions are healing well, but they will still look a little more red than the surrounding skin. We want to make sure that we are right on track.

3 months after surgery, you are enjoying the result of your surgery. The incisions are fading, but they will continue to improve all the way up to 1 year after surgery. Buy new bras or don't wear bras. Totally up to you.

6 months after surgery, feeling good, looking good. There are small nuances that we want to make sure are still progressing well.

One year after surgery. Why do I have to see the doctor? I want to see how you're doing. I want to see the fruits of our labor and see your mature, faint incisions, or try and find them anyway.

Incision care. During your first week, you do not need to apply anything. Once the skin glue or Steri-Strips fall off, apply vitamin E oil to the area twice daily. Once you get to 1 month post-surgery, you will switch to a silicone gel. Your incisions will never be as strong as what God gave you, but they will be maximum strength about 6 weeks after surgery. Out of an abundance of caution, you do not get back to full activity, sleeping on your stomach, etc. until 8 weeks post-surgery.

Medications for pain. Tylenol, 1,000 mg every 6 hours scheduled for 5 days. Do not wait for pain. Tylenol makes up the foundation of your pain management and will decrease the number of narcotics needed.

Ibuprofen 600 mg. Take one every 6 hours scheduled for 3 days. Do not wait for pain. Ibuprofen makes up the foundation of your pain management and will decrease the number of narcotics needed.

Gabapentin 100 mg every 8 hours scheduled for 14 days. Do not wait for pain. Tylenol makes up the foundation of your pain management and will decrease the amount of narcotics you will need.

Tramadol 50 mg to 100 mg every 4 to 6 hours as needed for pain for 3 days. It's okay to wait until you have pain. Tramadol is a long-acting narcotic that will begin to work in about 30 minutes and can last up to 6 hours. If you need it, use it.