Congratulations on your decision to have a breast augmentation! This information sheet is designed to give you some general guidelines on what to expect before and after your surgery.

PRE-OP

1. Make sure you have all of your questions and concerns answered by Dr. Healy or his staff before your surgery. There is no such thing as a dumb question. We want you to have the best information available to help you make the best decisions for yourself.
2. Don't take any aspirin, ibuprofen, motrin, advil or medications that contain these substances for two weeks prior to your surgery. These medicines affect the platelets in your blood and cause excessive bruising and swelling and can lead to bleeding complications.
3. Make arrangements to have somebody drive you to and from the hospital on the day of surgery and to your follow-up appointments for the first few days after surgery. You’ll need some extra help around the house for the first several days after surgery as well.
4. Pick up all of your prescriptions before your surgery date if possible. You should receive your prescriptions when you come for your pre-op visit.
5. Get a good nights rest before your surgery. It’s normal to be a little nervous prior to your procedure but try to get some rest.
6. Don’t eat or drink anything for at least 6 hours before your surgery time.

DAY OF SURGERY

1. You will need to be at the hospital 2 hours before your scheduled surgery time.
2. You can park at the hospital parking garage. Bring your parking ticket to the registration desk so it can be validated.
3. Check in at the registration desk at the hospital or surgery center. You will need a photo ID. The hospital fee is included in the price of your surgery. Dr. Healy's office will pay the hospital fee prior to your registration.
4. Wear loose fitting clothing to the hospital preferably with a shirt that buttons in the front. You will not feel like raising your arms above your head to put on regular clothes.
5. You will change into a gown and a nurse will start an IV.
6. Dr. Healy will see you in the holding area before your surgery. Any last minute questions can be addressed at this time. Dr. Healy will do some measuring and marking on your breasts.
7. The anesthesiologist will meet you and review your health history and talk to you about the anesthesia plan.
8. The actual surgery time will be about 1.5 to 2 hours. After surgery you will be taken to the recovery room. You will stay there for about 1-2 hours as you wake up from the anesthesia. Once you are awake, your pain is controlled and you feel comfortable you will be discharged from this area.
9. Your escort can wait for you during the surgery or they can leave their phone number with the nurse and they will be called when it is time for you to go home.

POST-OP

1. You will be sleepy after your surgery. Go home and rest. Take your medicines as directed.
2. You can eat or drink whatever you want after surgery. You might be a little nauseated from the anesthesia (take your nausea medicine) and at the very least make sure you drink plenty of fluids to keep yourself hydrated.
3. Your chest will be wrapped with an Ace bandage after surgery. Leave this on until your post-op visit with Dr. Healy.
4. You can walk around the house the day of your surgery and if you feel up to it you could go out that evening.
5. You will have some pain and this is expected. Take the pain medicine and the valium for the pain. If you have a pain pump you will probably require less narcotics for pain control but you will still need some. Do not drink any alcohol when you are taking the pain medicine.
6. Your first post-op visit will usually be the following day with Dr. Healy. At this visit the Ace bandage will be removed and you will be placed into a post-surgical bra. You will want to buy some sports bras that open in the front. For the first 6 weeks you should not wear an underwire or push-up bra. This is to prevent the underwire from rubbing along the incisions and to allow the implants to settle into their position.
7. Don’t be surprised if your implants are higher than expected. The muscles contract and pull the implants into a higher position right after surgery. As the muscles relax and get used to the implants, they will settle into their normal position. This usually takes a few days but can take up to a few months.

COMMONLY ASKED QUESTIONS

1. When can I go back to work?
   This depends on what type of work you do. In general plan to be off of work for 1 week. It may take a little longer for some patients especially if your job is physically demanding.
2. When can I exercise?
   You can walk the day of your surgery and gradually increase your distance and time each day. You can't do any strenuous exercise (running, aerobics, weight lifting) for 6 weeks. Even though you will feel good after a couple of days it takes 6 weeks for the tissues to heal. When you start exercising again the key is to go slow and listen to your body. If you're having a lot of pain with exercise you need to slow down.
3. When can I shower?
   In general you can shower 24 hours after your surgery. If you have a pain pump you may want to wait until the catheters come out- usually 2-3 days after surgery. No soaking in a tub or pool for at least 2 weeks.
4. When can I drive?
   Usually around 1 week after surgery. If you are taking the narcotic pain medicine you cannot drive. You will be considered under the influence and could cause injury to yourself and others. Have someone else drive you until you no longer are taking the narcotic pain medicine.
5. When can I have sex?
   Usually after 1 week. Be cautious and listen to your body.
6. What can I do to make the scars look better?
   Keeping the wound clean with soap and water and just being patient is the best treatment. The final appearance of your scars may take up to 1 year. Despite what you hear and read, vitamin E does not help the scars look better and may actually make them look worse. There is no scientific proof that any of the other ointments and creams you read about make any difference in your scar appearance.
7. Will my implants last forever?
   No, your implants are mechanical devices that will wear out over time. The average "life expectancy" of implants is around 13 years. Some may last for 30 years with no problems, others may develop problems within months. The manufacturers warranty the implants and will replace them free of charge if they leak or rupture. You should receive a card with the implant information and a warranty booklet after your surgery.
8. What is capsular contracture?
   Your body will form scar tissue around the implants. Usually this does not cause any problems. Rarely the scar tissue will contract around the implant making it feel firm or hard. Even more rarely you may experience pain or the implant position may shift due to the capsular contracture. If this is severe enough you may require additional surgery to remove the scar tissue around the implants.
9. What are the signs of an infection?
   Usually you will get a fever, develop redness around the incision or over the breast and may get drainage from the incision. It is important to take all of your antibiotics to help minimize the risk of infection. If you feel you have an infection notify Dr. Healy's office.
10. How often will I need to see Dr. Healy after my surgery?
    In general you will see Dr. Healy the day after your surgery, 1 week after surgery, 1,3,and 6 months after surgery and then on a yearly basis. Some patients may require more frequent visits depending on their post-operative course. All of your post-op visits are included in the price of your surgery.
11. When should I get a mammogram?
    The American Cancer Society recommends that women start to get routine mammograms at age 40. If you have a strong family history of breast cancer or other risk factors, you may need to start earlier. Discuss this with your primary care doctor. When you do get a mammogram inform the technician that you have implants so they can modify the technique to get the most accurate study.

Hopefully this information has been helpful and not overwhelming to you. We want your surgery to be a very positive experience in your life and will do our best to make sure that happens. Never hesitate to call and ask any questions you might have. Our goal is to "exceed your expectations" in every aspect of your surgery.

For breast augmentation in Hawaii contact board certified plastic surgeon, Dr Jeff Healy. Located in Aiea just outside of Honolulu serving surrounding cities in Oahu Hawaii.