Breast Augmentation

Conveniently located to serve Seattle and Bellevue

SHOPPING LIST

• One Surgical Bra (provided to you by RP Plastic Surgery)
• Prescriptions: Fill prescriptions prior to your surgery date.
• Stool Softeners or Mild Laxative: (Colace preferred) to help with constipation associated with narcotic pain relievers.
• Tylenol: alternative to narcotic pain medication if pain is not severe. Do NOT take NSAIDs.

WEEKS BEFORE SURGERY

• Work and Recovery Arrangements. Make any arrangements to be off from work or other strenuous activities while you are recovering from surgery. Have extra help available, particularly if caring for small children.
• Smoking. Tobacco, cigarettes, and nicotine consumption will cause poor wound healing, longer healing times, and excessive scarring. We advise discontinuing these products more than 4 weeks prior to surgery.

3 WEEKS BEFORE SURGERY

• Surgery Preop Appointment. You will come in for your preop appointment where you will review the surgery plan with your surgeon and go over logistical surgery details with your patient coordinator. Bring your questions as well as any individuals that will be part of your support and healing.
• Diet/Supplement Restrictions. Avoid foods, drinks and herbal supplements than can increase risk of bleeding and bruising. Avoid aspirin, Ibuprofen, Naproxen, Motrin, blood thinners, vitamin E, omega-3, fish oil, and alcohol. Also see Medications to Avoid list in your pre-op packet. Use Tylenol in place of other over the counter pain medications.
• Fill Prescriptions. These may include antibiotics and/or pain medication for after surgery. Make sure you understand how and when to take all medications. We suggest keeping a note pad to keep track of the medications you have taken.

WEEK BEFORE SURGERY

• Review Instructions with Caregiver. Confirm who will be driving you to and from the surgical center and who will stay with you for at least 24 hours after surgery.
• Arnica. If provided, start your Arnica tablets two days before surgery. One in the AM and one in the PM and continue until the bottle is finished. (optional)

NIGHT BEFORE SURGERY

• DO NOT EAT OR DRINK ANYTHING AFTER MIDNIGHT OR SURGERY WILL BE RESCHEDULED.
• Set Up Home Recovery Area. This may include pillows, blankets, books, television, and anything else to assist with a comfortable recovery.
• Bathing. You can shower with plain anti-bacterial soap (Dial, Dove, etc.) but do not apply lotion, perfume, hair product, etc.

DAY OF SURGERY

• Dress Comfortably. Dress in comfortable, clean, and loose-fitting clothes. Shirts that can be buttoned or zipped up are preferred and slip-on shoes.
• Arrival to Facility. Arrive to your designated surgery location at the time stated in your pre-operative packet. Remember to bring a form of identification.
• Do NOT wear any makeup, jewelry, cosmetic creams (lotion), hair products, deodorant, sunscreen, and remove all piercings.

POST-OPERATIVE INSTRUCTIONS FOR BREAST AUGMENTATION

NIGHT OF SURGERY

• Sleep. You must sleep on your stomach for the first two weeks after your surgery. Putting a few pillows under your pelvis to allow your hips to be flexed may help with further comfort.
• Movement is Important. Make sure you are up and walking around immediately after your surgery. When lying down in bed or on the couch, make sure you are moving your legs and ankles. Take deep breaths frequently to keep your lungs clear.

MEDICATIONS

• Pain. You will be prescribed a pain medication for post-operative pain control. If your discomfort after surgery is not strong you are welcomed to take Tylenol in place of the prescribed medication. Do not exceed 4,000 mg of Tylenol in any 24-hour time period. Take medication with food to minimize risk of nausea.
• Nausea. If you are experiencing nausea, which is common after general anesthesia as well as a known side effect of some stronger pain medications, we advise that you take your nausea medication. You may have been given Scopolamine patch that is placed behind your ear. This will deliver anti-nausea medication for three (3) days after its placement.
• Constipation. You will experience constipation if taking narcotic pain relievers. Miralax or other over the counter laxatives are recommended. Do not wait to take until you are constipated. Begin treatment with narcotic use.
• Medications to Avoid. Take only those medications approved or prescribed by your surgeon.

NUTRITION

• Diet. A light low-fat diet is best after surgery. You may start a regular diet the day after your surgery as long as you are not feeling nauseated or vomiting. Start with liquids for the first few hours after surgery and then slowly advance to more solid foods.
• Hydration. Stay hydrated by drinking 8 -10 glasses of water a day. Avoid alcohol while you are still taking pain medications.

ACTIVITY

• Movement is Important. Normal daily activity can be resumed a few days after surgery. Make sure to get out of bed and maintain movement (walking around) immediately after your surgery. When lying down in bed or on the couch, make sure you are moving your legs and ankles. Take deep breaths frequently to keep your lungs clear.
• Sleep. Sleep on your back with your head elevated about 30-40 degrees (2-3 pillows). Do not sleep on your side. Keeping your body more upright will minimize swelling. Continue this for two (2) weeks.
• Exercise. Light physical activity may be resumed 4-5 weeks after surgery. Remember to start easy and build back up to your previous exercise levels. At 6-8 weeks or when further instructed by your surgeon, more intense exercise can be started. Just know that swelling may transiently be worse with exercise.
• Arm Movement. Limit your arm use to daily activities such as brushing your teeth, eating, and combing/shampooing your hair. Avoid rigorous movement and do not lift more than 5lbs, bending, straining, or intense cardio activity for the first 4 weeks. Let pain be your limiting factor. If it hurts, please do not do it.
• Driving. DO NOT operate a vehicle or make important decisions until you have been off pain medications for 24 hours.
• Return to work. Most patients require approximately 5-7 days off work depending on their job responsibilities. Returning to work with a light schedule initially, working from home or even part-time can be beneficial as well.
• Sleeping. It is advised for the first few weeks to sleep on your back to avoid putting too much pressure on the breasts.

BATHING

• Showering. You may shower with assistance 72 hours (3 days) after your surgery. Incisions are covered with Steri-Strip dressings and require no attention. Replace garment after your shower.
• Hot Tubs/Baths/Swimming Pools. No tub baths or Jacuzzi until your incisions have healed, and approved by your surgeon, which is usually around 4 weeks. It is best to wait one month for hot tubs as they tend to have more bacteria than regular chlorinated swimming pools.

HOW TO TAKE CARE OF YOUR INCISIONS

• Incisions. Your incisions are covered with a waterproof dressing. No dressing changes or incision care is required. After your first postop visit, the dressing will be removed, and tape will be applied. Additional tape is provided so you can continue a planned scar regimen.
• Stitches. All stitches are dissolvable.
• Scar ointment. Scars are small and hidden in the breast crease. They may take up to a year to fully heal. After your incisions have completely healed and when your doctor has told you it is safe, you can begin to use silicone-based ointment or strips (Silagen preferred) on your scars to improve healing.

WHAT TO EXPECT

• Bruising. You can expect to have bruising. Most bruising will resolve after about 2-3 weeks. The bruise will go from a purplish color to a yellow/green shade as it starts to resolve.
• Swelling. You can expect swelling particularly in the top half of the breasts. This can take 3-4 weeks to improve, and the swelling is responsible for the feeling that the implants are high. As the swelling resolves, it seems as though the implants drop into a lower position.
• Itching. Itching at the incision sites is normal for a few days. You may take Benadryl to help with this.
• Pain. It is normal to experience tightness, pressure, soreness, itchiness, and fatigue for several days to weeks following surgery as your skin and muscle adjust to your breast implants.
• Implant Position. Implants may appear higher in position, firm, and uneven due to swelling during the healing process. After 4-6 weeks the implants should show a more final result with significantly reduced swelling.
• Sensory Changes in Skin. You may feel reduced or heightened sensation in the nipples, incision sites, and breast tissue which is normal. You can expect return of normal sensation after a few weeks to months.
• Crackles/Sloshing Sounds. Air and fluid are left behind as a normal part of the surgery and it takes time for it to be resorbed by your body. These sounds are normal after a breast augmentation and will resolve in 5-7 days.
• Purchasing new bras. We advise waiting 8 – 12 weeks before purchasing your new size bra. During this waiting period swelling will go down and you will be able to better measure your bra size. In the interim, a sports bra from Walmart or Target is a reasonable investment.

DO NOT’S

• DO NOT apply hydrogen peroxide and/or anything else to incision sites. Keep postop dressings in place until follow-up.
• DO NOT soak in baths, Jacuzzis or hot tubs until all incisions have fully healed.
• DO NOT take Aspirin, Ibuprofen, Naproxen, or other blood thinners until your surgeon advises you it is safe.
• DO NOT apply heating pads or ice packs to the treated areas unless otherwise instructed by your surgeon.

EMERGENCY SITUATIONS

WHEN TO CALL DR PARIKH @ 206-963-6724

• Signs of Infection. Spreading redness, worsening swelling, increased drainage, or drainage of pus, worsening pain and warmth at incision site. Temperature over 101 degrees Fahrenheit.
• Excessive Bleeding. If the dressings are saturated with bright red blood and you are having to make very frequent dressing changes.
• Other Emergency Situations. Shortness of breath or difficulty breathing, chest pain, lightheadedness that does not quickly resolve, severe vomiting, pain or asymmetric swelling in your legs.

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