Breast Reduction

1. Try and arrange to have either a friend or family member to pick you up and to stay with you for the first 24/48 hours in order to help you get settled in around the house.

2. Everyone recovers from their anaesthetic differently. Some people feel no side effects while others are more noticeably affected, feeling tired and even sick for the first couple of days.

3. Eat lightly with small meals throughout the day to minimise sickness. If necessary, cut food into small bite sized pieces to facilitate chewing and digestion. Salty foods can contribute to fluid retention and swelling so limit these in the first 7 to10 days. In order to avoid constipation, eat plenty of fresh vegetables and dried fruits. Overall, try to eat a balanced diet to ensure your body is getting all the important nutrients it needs in the immediate postoperative healing period.

4. Drink plenty of fluids in the form of water and fresh juices, in the first few days after surgery. Avoid caffeine and carbonated drinks in the first few days. Dairy products in the first 72 hours after surgery can upset your stomach and make you feel sick and therefore it would be sensible to keep these to a minimum.

5. Do wear comfortable front opening and loose clothing at night and in the day, that do not need to be pulled over your head.

6. Please rest as much as possible after returning home. Although you can gently walk about and do light duties, please avoid any excessive stretching or lifting during the first 7 to 10 days. You may return to light work duties after this time and commence light lower limb exercise after two weeks. Upper arm exercises and swimming can begin after four to six weeks. When exercising always try and wear a good sports bra.

7. Driving is allowed after 1 week (not permitted prior to this, mainly due to seat belt irritation over your chest).

8. Sexual activity involving the breasts can be commenced at around 4 weeks although at this stage only very gentle handling of the breasts is advised. More vigorous handling can be commenced only after 2 months! In general use common sense! If it hurts then don’t do it!

9. Although the majority of patients have only slight to moderate amount of pain, for the occasional patient, breast reduction surgery can sometimes be quite painful. The first week is usually the worst, after which the pain gradually subsides. Sometimes it may be that the pain is limited to mainly one side. This should not alarm you as healing can proceed differently in each side. Should you experience any pain, then take one or two pain relieving tablets (such as paracetamol OR anti-inflammatory tablets) as required up to 4hourly. If the pain does not subside or is unbearable then please contact us for advice.

10. Continue to avoid smoking and alcohol for the first week after surgery. Do not allow anyone to smoke in your presence.

11. It is important that you check your nipples four times daily for the initial 72 hours. The Practice Nurse will explain and demonstrate how and what to look for upon discharge.

12. Your breasts will be somewhat swollen and sometimes bruised postoperatively. This usually settles in about two to three weeks. Sometimes swelling may be slightly different between the two sides. This is normal. However if a great difference develops between the two sides then please contact us for advice.

13. Following Breast Reduction surgery the breasts may appear to be placed quite high up and look irregular. This is normal. During the first two months postoperatively the breast will gradually lower and settle from the effects of gravity into a more natural position. Do not be alarmed if one side settles quicker than the other, as this sometimes occurs.

14. You may recommence any regular medication that you normally take (i.e. blood pressure tablets) as soon as you are able to drink, unless specifically instructed not to or is mentioned in the DON’TS section of your information booklet. Please continue your Arnica as suggested in the accompanying instructions.

15. After your surgery you will notice a light white dressing across the lower half of your breasts. This is part of a triple layer dressing designed to protect the wound from any intrusion or infection. Occasionally from the outside, you may be able to notice some bloody staining underneath the dressing. This is usually some blood which has seeped from the wound, but is still contained within the dressing. If however the outside of the dressing actually feels dry to touch, then ignore this as it is of no consequence and will dry on its own. It will be dealt with and cleaned when you come back for your follow up appointment.

16. The dressing must be kept dry and undisturbed for a period of about 10 days. Therefore you are allowed to bathe up to your waist during this time and wet wash above this point. THIS DRESSING MUST REMAIN DRY AND UNDISTURBED UNTIL YOUR FOLLOW UP CHECK AT TWO WEEKS. If the dressing peels away at the sides please replace by applying a small sticky dressing over this area.

17. At about 10 days your dressing will be removed and the wound inspected and lightly cleaned. There are no stitches to remove, as these are internal and dissolvable.

18. A light crust may form on the suture line but please do not disturb this.

19. Following removal of your dressing you will be allowed to shower but NOT bathe. Remember to dab dry the wound with a clean towel. Do not rub the wound. Bathing can recommence after a further two weeks. Although internal, your stitches take about six to eight weeks to dissolve. Before that time if a small stitch should become visible or palpable, do not pull on it. Please phone and arrange for an appointment as it can easily be removed in the consulting room.

20. Very occasionally a small area along the scar may become red and inflamed. This usually represents a small dissolving stitch which has becomes superficial and is irritating the skin. If this occurs then you need to phone our office where we will arrange to clean this and dress it for you and give you advice regarding care. Although this event represents a slight “hiccup” in your healing progress it always heals and settles with time.

21. Bruising and swelling are variable but can last up to four or six weeks. It is important therefore that a firm support bra (no underwire) is worn continuously day and night, during the first six weeks and which will help contain some of the swelling.

22. During the first six weeks you should try and sleep on your back or on your side, and avoid sleeping face down which could put pressure directly on the breasts. Under wire or boned bras may be worn after six weeks. Local massage to the scar is usually begun at around 4 weeks. You will be instructed to massage the scar and nipples at your follow up visit at about 4 weeks. Please do not begin until shown how to do this.

23. Use your normal body lotion creams to facilitate this action but avoid preparations containing Vitamin E unless specifically instructed. A silicone gel sheet which will be provided for you and or Bio Oil (available at Boots chemists) can also be used to improve the quality of the ensuing scars. You will be instructed on how to use these at your first follow up visit.

24. The sensation to the nipples and the skin of the lower half of the breast may be diminished following surgery. Alternatively this may be hypersensitive or even feel like a burning sensation. In any case this is due to nerve trauma from surgery. Usually this recovers although it may take anywhere up to 2 years for this to occur. In the first few months postoperatively it is quite common for patients to experience intermittent, brief, shooting type pains throughout the breast. This is due to nerve regeneration taking place to repair the sensation and therefore there is no need for alarm.

You should contact us if any of the following occur:

a) Fever greater than 100 Fahrenheit or 38.5 Celsius.

b) Pain not relieved by two pain relieving tablets.

c) Significant swelling of either breast.

d) Significant discharge from the wound sites after 72 hours.