Preparing for Breast Reduction Surgery

Once your surgeon has recommended cosmetic breast surgery for you, there are some preparations
you’ll need to make before the surgery. Preparation requirements and recommendations will vary
from surgeon to surgeon, but familiarity with common guidelines can give you some idea of what
to expect during the surgery process. Of course, you will need to rely on your own surgeon to give you
specific instructions.

Lab Tests You May Need
If you are younger and healthy, you may not be required to
undergo any lab tests. On the other hand, your plastic surgeon may
require that you have a full physical examination in order to receive
pre-operative medical clearance for surgery. This practice may vary
among surgeons, but if you are older, say over 40, your surgeon will
ask that you have lab tests. Similarly, if your medical history includes
conditions such as diabetes or thyroid problems, for example, the
surgeon will require lab tests. If these tests are requested, the plastic
surgeon will refer you to your family physician or referring doctor
for testing.

Pregnancy Test
Regardless of age, you will need to demonstrate that you are not
pregnant; undergoing surgery while pregnant could be harmful to
your fetus. You may opt for a blood pregnancy test or a urine pregnancy
test. Often, a surgeon will request a blood pregnancy test during
your consultation and an additional urine pregnancy test on the day
of surgery.

If you are over age 40, you’ll likely be asked to have a mammogram.
A mammogram is a low-powered x-ray used to examine the entire
inner structure of the breast. It’s used to screen for a variety of breast
maladies, the most common of which is breast cancer. If your surgeon
does recommend a mammogram for you, he or she will refer you to a
radiologist who is specially trained in mammography.

A radiology technologist will most likely perform your actual
screening. During your mammogram, each breast will be inserted
both horizontally and obliquely into the mammogram machine so
that pictures may be taken from both angles. This will ensure that
your breasts are thoroughly assessed for potential problems. After the
mammogram, the radiologist will review your results. He or she may
share them with you immediately or send them to your referring surgeon.

Complete Blood Count (CBC)
The complete blood count (CBC) and blood chemistry tests both
require blood to be drawn from a vein in either your arm or hand. The
CBC is a screening and diagnostic test for a variety of diseases. It will
also tell the surgeon whether you are anemic; anemia is caused by having too few red blood cells. Symptoms of anemia include feeling
tired, weak, and short of breath. Anyone who is anemic would not be
a good candidate for the stress of surgery.

Before surgery, I squeezed
into 36 DD bra. My bra
straps dug into my shoulders.
My back hurt. I had rashes.
After surgery, I was a 36 C.
I am much happier now.
— Mildred, 37

The CBC also indicates whether problems exist with such things
as fluid volume, loss of blood, abnormal blood cells, infection,
allergies, and clotting ability. The blood chemistry test screens for
problems with levels of potassium, sodium, creatinine, fasting glucose.

Electrocardiogram (EKG or ECG)
You may be asked to have an electrocardiogram, most commonly
called an EKG or ECG. The purpose of the ECG is to record the electrical
activity of your heart and screen for heart disease. This is a painless
procedure in which electrodes are affixed to your chest, arms and legs.
It may also include a stress test where you may be expected to perform
some sort of physical activity, such as walking or running on a treadmill.

Chest X-ray
Your surgeon may request a chest x-ray, as well. The purpose of
a chest x-ray is to screen for any lung masses or abnormalities as well
as to look at the heart.

Other Preparations for Surgery

Quit Smoking
Whatever your age, one consideration is non-negotiable when it
comes to preparing for your surgery: You must quit smoking! Nicotine
causes problems with circulation; so, as you can imagine, healing from surgery will pose a problem if you have nicotine in your system. As
mentioned earlier, if you smoke, you must stop before and after your
surgery. You will need to quit smoking two to three weeks before your
surgery and should not smoke until at least two three weeks after
surgery. Remember, you won’t be able to rely on any of the popular
smoking cessation aids that contain nicotine—no nicotine gum,
lozenges or patches. Talk with your surgeon about the best method of
quitting for you.

Medication and Diet Restrictions
You’ll need to avoid all products containing aspirin for two weeks
prior to your surgery date and for one week afterwards. Aspirin thins
blood and could cause you to bleed excessively during surgery. To
decrease the risk of bleeding complications during surgery, you also
need to avoid Vitamin E, fish oil, and Omega 3 for the same reason.

Drugs which May Cause Blood Thinning
Advil BC Powder Doan’s Pills Indocin
Aleve BC Cold Powder (Regular &
Alka Seltzer Bufferin Dolobid Norgesic
Anacin Children’s Aspirin Dristan Norgesic Forte
Anaprox Clinoril Feldene Pepto-Bismol
Ansaid Coricidin Florinal (tabs & liquid)
Ascriptin Coumadin Goody’s Headache Percodan
Aspergum Darvon Powders & Tabs Persantine
Aspercream Darvon with ASA Ibuprofen  
Aspirin Disalcid Tabs & Caps    

After surgery, you will be able to take pain relievers which do not
contain aspirin.
Make sure you speak with your surgeon and receive a complete
list of blood thinning drugs to avoid during your surgery preparation
weeks. If in doubt, do not take a drug during this time period
without clearing it with your surgeon first. Even "just one" of the
wrong medication can make a difference.

Avoid Alcoholic Beverages
Alcohol also thins the blood. Be sure to quit drinking alcohol a
few weeks in advance to decrease your risk of related complications
during surgery. And, of course, you’ll want to make sure that you are
eating as healthfully as possible to best prepare your body for surgery.

Arranging for Care after Surgery
Prior to your procedure, you will need to arrange for a reliable
friend or relative to transport you home from the hospital or surgical
center a couple of hours after your surgery. You will still be experiencing
some of the effects of your anesthesia and will not be able to drive
yourself home.

Also, you will need care for 24-48 hours upon your homecoming.
Ask someone with whom you feel comfortable to stay with you
during this time to help you with basic tasks. Be aware that, if you
have young children, you will not be able to care for them for awhile,
so you will need to make other arrangements for them, as well. You
will not be able to care for them or carry them for at least one week
because you’ll need time to heal. (If you do care for them too soon,
you run the risk of being accidentally hit in the chest by them.) A high
level of physical activity early on could be painful and even cause
bleeding to occur.

Iam so much smaller on
top now after my breast
reduction. Most people
think I have lost weight.
The change is dramatic.
No more back pain. I can
buy clothes that fit.
— Alicia, 31

Preparing for Your Return Home
Think ahead to what you will need available to you immediately
after your surgery. Prepare to have several items on hand when
you come home, especially a variety of fluids, crackers, and your
medications filled in advance. Immediately after your procedure, your
surgeon most likely will recommend that you restrict your diet to
liquids and slowly advance to solid food since some people do
experience nausea after anesthesia. All items you will need after
surgery should be located as conveniently as possible. This way, when
you arrive home after your procedure, you can actually relax!

The Day before Your Procedure
On the day before your surgery, you’ll need to be mindful of a
few important details. First of all, this is not the day to run that
marathon you’ve been training for during the past eight months.
Vigorous exercise is not recommended this close to your surgery date.
And, consider showering with antimicrobial soap, paying special attention
to wash the areas to be operated on in particular with it. This will help
prepare those areas for surgery. Make sure you get plenty of rest the
evening before surgery, as well, even though you will no doubt be
almost too excited to sleep.

Remember, no food or drink, except water, after midnight. Why
is this important? If you have eaten just prior to surgery, it is possible
that the contents of your stomach could come up, causing choking.
Or, you could aspirate food particles into your lungs, causing a
condition known as aspiration pneumonia.

The Day of Your Procedure
Your surgeon will likely give you instructions to follow. Those
instructions will probably include some of the following.

Questions to Ask Your
Surgeon on How to
Prepare for Your

  • What kind of pregnancy test
    will I be required to take? When?
  • Do you need a letter from my
    general practitioner or OBGYN
    giving me clearance for surgery?
  • Do I need a mammorgram?
  • What method do you
    recommend that I use to
    quit smoking since I’m not
    allowed to use any kind of
    nicotine replacement?

You’ll probably want to take advantage of the fact that you are
allowed to bathe on the day of your surgery because you won’t be able
to shower for a few days after your procedure. So, feel free to bathe the
day of, but remember that you cannot use any products, such as oils,
lotions, make-up—not even deodorant. Again, make sure you wash
your surgical areas with antimicrobial soap to cleanse your body and
prepare it for your procedure.

Remove Nail Polish
You’ll also need to remove nail polish from at least one of your
fingernails on each hand so that your medical team can monitor the
color of your nails and ensure that your blood is well oxygenated
during surgery. A probe that measures the amount of oxygen in blood
also will be placed on your fingers before surgery.

No Food Today
Remember, no food or liquids today. If your surgeon makes an exception
and allows you to continue to take your current medication on
the day of your procedure, take the tiniest sip of water possible with
it. And, when you are brushing your teeth, remember not to swallow
any water while rinsing your mouth.

What to Wear
Choose function over form. Wear loose-fitting clothing that opens in
the front. Be comfortable right down to your toes by wearing shoes
that can be slipped off easily. Make sure you leave the jewelry at home

Table of Contents
Previous: Chapter 3. Your Consultation

Next: Chapter 5. Your Breast Reduction Procedure

*Patient Results May Vary
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