Breast Augmentation Surgery Instructions

*FAILURE TO FOLLOW THESE INSTRUCTIONS MAY LEAD TO CANCELLATION OF SURGERY AND FURTHER FEES WILL APPLY

BEFORE YOUR SURGERY

Before taking any medication READ THIS!

1. No aspirin (ASA) or anti-inflammatory medicine. NOTHING containing aspirin like products* for two weeks before surgery since it interferes with normal blood clotting. Check the list at the end of these instructions for NSAID (Aspirin and Advil and other) products and if in doubt, call us or a pharmacist. Tylenol or Acetaminophen may be used.

2. Two weeks before surgery STOP talking birth control pills, hormone replacement and other hormones to reduce the risk of blood clot formation. Please use alternate methods of birth control.

3. Do not take Arnica Montana or Traumeel. There is no proven evidence that it helps with post op bruising and it may in fact cause post op bleeding.

4. Nutritional Supplements to AVOID include: Bilberry, Cayenne, Echinacea, Feverfew, Fish oil, Garlic, Ginger, Ginkgo Biloba, Ginseng, Kava Kava, Valerian, Licorice Root, Ma Huang, St. John’s Wort, Vitamin E, Yohimbe. or other herbs for 2 weeks prior to surgery (longer if possible) as they also may cause thinning of the blood.

5. Take at least 250 mg of Vitamin C daily for two weeks before and after surgery. The dosage is not critical.

6. Smokers must quit smoking before surgery – smoking dramatically increases the risk of major complications of surgery and anaesthesia such as severe respiratory complications, skin death and infection. If you need assistance, such as nicotine patch treatment, please ask your family physician.

7. No alcohol for 48 hours prior to surgery.

8. Report any signs of a cold, infection, boils or pustules appearing within 1 week before surgery.

9. You must have a responsible adult to drive you to your home, or hotel after surgery. If transport is needed a caregiver can be organized to assist you at an additional cost.

10. Have your prescriptions filled immediately after your pre-operative visit. It is also advised to get a stool softener, such as Senekot, as pain medications often cause constipation.

11. Gravol Suppositories may be helpful for nausea and vomiting post- operatively. Gravol can be purchased without a prescription.

12. Remove all jewelry, body piercings including both internal and external. Jewelry may cause injury while moving from one bed to another and burns may occur from cautery equipment used during surgery.

NOTHING TO EAT OR DRINK FROM MIDNIGHT THE NIGHT BEFORE SURGERY. No gum, candy, or water please.

SURGERY and PICK-UP TIMES are subject to CHANGE. We will attempt to give you notice IF POSSIBLE.

DAY OF SURGERY

1. No make-up. Do not use cream on face or body. Remove contact lenses. No nail polish on fingers nails and that includes gel and shellac.

2. Do not take medication of any kind (unless instructed by Dr. Gelfant). If you have high blood pressure medication you may take it in the morning but only with a small sip of water.

3. Wear comfortable, loose fitting clothes which do not have to be put on over your head. A top with a zipper up the front is best. No pantyhose, please.

4. You must have a responsible adult to drive for you after surgery. They must pick you up inside the surgery centre.

5. You must have a responsible adult spend the first night with you. Additional instructions and prescriptions can be given to the person calling for you. Such prescriptions should be filled promptly. If you have any questions before your operation, please call our office Monday through Thursday between 9am and 5pm and Fridays between 9am and 2pm.

AFTER YOUR SURGERY

1. Rest during the evening but try to get up walking as much as possible. You may need assistance to the bathroom.

2. AVOID hunching your shoulders forward. If you have mid back pain use a rolled up towel vertically under your spine when lying down. Range of motion exercises are very helpful in reducing muscle spasm. You should do these at least every hour until you go to sleep. Continue with the range of motion exercises the following day(s). The exercises are demonstrated on the website in a video. Review it before surgery and DO THEM Immediately after surgery and for the next few days.

3. Take medications according to instructions on bottle. If taking strong narcotics, or if other pain medications make you feel “spacey” or drowsy, have someone else give you your medicines according to the proper time intervals. Under such circumstances you could forget and take them too often

4. The period of greatest discomfort is usually the day after surgery, and starts to decrease about two to three days later.

5. Placing frozen peas or well- padded ice bags between and under the breasts often relieves discomfort significantly.

6. a) occasionally there may be an initial skin breakdown along the incision, there may be some fluid on dressing or tape. Do not be alarmed. Please notify us and we will discuss management.

b) If you develop a fever with a temperature of over 38 degrees C, call us. Infection is a very rare complication of surgery. A hot, extremely painful surgery site and increasing rather than decreasing pain after 2-3 days may be of concern.

7. Call 604-874-2078 (after hours we have an answering service) if you have:

a) severe pain not responding to pain medicine.
b) sudden onset of much more swelling and/or pain on one side than the other.
c) if any other question or problem arises

8. Avoid smoking after your operation to prevent coughing and possible bleeding, as well as skin loss.

9. You may drive a car with power steering after 3 days. Try a quick drive around the block with someone next to you in case of difficulty.

10. You will find sleeping on your back or side most comfortable. Getting in and out of bed the first few days may be difficult. You do not, however, have to avoid comfortable positions

11. Avoid prolonged exposure to sun and heat for 2 months.

12. Bathing: You may shower the second day following surgery. Do not leave wet bandages on. Tapes on the incision should be left in place.

13. “Massage”: We no longer recommend “massage” (implant displacement exercises) despite its continued use by some surgeons. There is no evidence it prevents capsular contracture

14. No alcohol while taking medication post-operatively.

The implants will be firm for the first few weeks following surgery. This does not mean contracture has started.

It is not unusual for the implant to be “high” for 2 to 6 weeks after surgery. You may be are asked to wear an elastic strap (endoscopic approach) 23 hours per day until Dr. Gelfant feels you may stop. You may adjust the strap with the Velcro closing to make it more comfortable.

WE WANT YOU TO BE AS COMFORTABLE AS POSSIBLE DURING YOUR HEALING PERIOD.

OFFICE VISITS

First Visit: The first day the office is open following surgery, or the day after.
Second Visit: 1 to 1- 1/2 weeks following surgery.
Subsequent Visits: Will be determined by Dr. Gelfant, usually four to six weeks later, then six months and one year after surgery.

ASA or anti-inflammatory containing drugs

(*i.e., Anacin, ASA, Bufferin, Calmine, Coricidin, Coryphen, Dolomine, Dristan Capsules, Entrophen, Herbopyrine, Instantine, Kalmex, Madelon, MED Tigol, Midol, Nervine, Nezgar Norgesic, Novasen, Novo AC&C, Pain AID, Robaxisal, 217, 222, 282, 292’s, Upsarin. Also AC with codeine, Asantine, Coryphen, Darvon products, Endodan, Fiorinal, Novopropoxyn, Oxycodan, Painex, Percodan, Phenaphen, Robaxisal, 692, Tecnal, 282’s, 292’s, Artrol, Trilisate, Diclofenac, (Apo-Diclo, ApoDiclo SR, Arthrotec, Diclofenac, Ect, Novo-Difenac, Novo-Difenac SR, Nu-Diclo, Taro Diclofenac, Voltaren, Voltaren SR), Diclofenac potassium,(Voltaren Rapide), Diflunisal (Apo-Diflunisal, Dolobid, Novo-Diflunasil, NuDiflunisal), Etodolac (Ultradol), Fenoprofen Calcium, (Nalfon), Floctafenine (Idarac), Flurbiprofen (Anacad, Apoflurbiprophen FC, Froben, Froben SR, Novo-Flurprofen, Nu-flurbiprofen), Ibuprofen (Actiprofen, Advil, Advil Cold and Sinus, Amersol, Apo-Ibuprofen, Exedrin, IB, Medipren, Motrin, Motrin IB, Novo- Profen, Nuprin, Nu-Ibuprofen, Sinus PR & Pain reliever with Ibuprofen), Indomethacin, Apo-Indomethacin, Indocid, Indocid SR, Indolec, Nov-Methacin, Nu-Indo, Pro-Indo, Rhodacine (Ketroprofen), Apo-Keto, Apo-Keto-E, Novo-Keto, Novo-Keto-Ec, Nu- Ketroprofen, Nu-Ketroprofen-E, Orudis, Orudis-E, Orudis-SR, Oruvail, (PMS- Ketoprofen, PMS-Ketoprofen-E, Rhodis, Rhodis-EC), Ketorolac tromethamine (Acular, Toradol), Magnesium Salicylate (Back-Ese-M, Doan’s Backache pills, Herbogesic), Mefenamic Acid (Ponstan) Nabumetone (Relafen), Naproxen (Apo-Naproxen, Naprosyn, Naprosyn-E, Naxen, Novo-Naprox, Nu-Naprox, PMS-Naproxen), Naproxen Sodium, anaprox, anaprox DS, Apo-Napro-Na, Naproxin-NA, Novo-Naprox Sodium, Synflex, Synflex DS. Oxyphenbutazone, Oxybutazone, Phenylbutazone, Alka Phenyl, Alka Phenylbutazone, Apo-Phenylbutazone, Butazolidin, Novo-Butazone, Phenylone Plus, Piroxicam, Feldene, Kenral-Piroxican, Nova-Pirocam, Nu-Pirox, PMSPiroxicam, Pro- Piroxicam, Rho-Piroxicam, Salsalate, Disalcid, Sodium Salicylate, Dodd’s, Dodd’s Extra Strength, Sulindac, Apo-Sulin, Clinoril, Nova-Sundac, Nu-Sulindac, Sulindac, Tenoxicam, Mobilflex, Tiaprofenicacid, Albert Tiafen, Apo-Tiaprofenic, Surgam, Surgam SR, Tolmetin sodium, Novo-Tolmetin, Tolectin