BR Notes

Breast Reduction Notes, Questions, & Lists To Help You On Your BR Journey

I have added a little more information to my nearly 10 pages of notes, questions, and lists that have helped to put my mind at ease as my BR surgery date approaches. I’d like to share my notes with others who are considering a BR or who are waiting for their BR surgery date to arrive. I printed the following off and took it with me to my last PS appointment, and it proved to be extremely valuable. A big “Thank You” goes out to all the lovely ladies who have shared the information below in bits and pieces so that other women, like me, can become familiar with what has helped them through their BR journey. I will continue to add to this and update it as I learn more and as I recover from my own BR, however I feel it's too long to re-post here in my review repeatedly so I probably will not post this list again until after my BR and a substantial amount of notes have been added.

Following are my personal notes, compiled from researching information about breast reduction surgery and from reading multiple forums (mainly realself.com ) as my own BR surgery date approaches. Nothing should override your PS’s instructions. Some of these apply only to me personally, based on my lifestyle or on information I have already received from my PS. I thought others who are preparing for their own BR surgery might want to have a look at this, so decided to share it even though it is a work in progress and certainly is not as complete as it could be. As my BR surgery date approaches, I will continue to add more to this. If you have already had your BR, please feel free to share any suggestions you might have! I would LOVE to hear them!

There are MANY questions that should be asked before selecting a PS, and I did not include any of those here because I have already selected my PS.

BREAST REDUCTION NOTES:

• Before BR Surgery: Questions To Ask
• What To Bring To BR Surgery, & What To Ask Before Discharge
• Breast Reduction Recovery Tips
• After BR Surgery: Necessary Items to have on hand
• Bras For After Surgery
• Food Suggestions
• Links


QUESTIONS TO ASK BEFORE SURGERY:

I am taking the following medications, vitamins, and herbs. What do I need to stop taking PRE OP? How long should I stop taking them before surgery?

• ______________________
• ______________________
• ______________________
• ______________________
• ______________________

*In addition to medications that should be avoided, find out your PS’s guidelines for avoiding alcohol, caffeine, and smoking. I’m not a smoker, but I stopped drinking alcohol & coffee 6 weeks before my surgery to minimize my caffeine intake.

I am planning on taking the following medications, vitamins, and herbs POST OP. Do you approve of all of these? Can all of them be started when I arrive home from my BR surgery?

• ______________________
• ______________________
• ______________________
• ______________________
• ______________________
• ______________________
• ______________________
• ______________________


• What are my choices of surgery locations? Which location will minimize my exposure to germs?

• What method of anesthesia will be used?

• Will I be intubated?

• Will a catheter be used?

• Do you use compression socks during surgery?

• Can I have anti-nausea medication or a patch to minimize nausea when I wake up after the surgery?

• Will I be sent home on antibiotics?

• What pain medications will you prescribe?

• Will I be able to fill the prescriptions before the date of my surgery?

• Should an antibacterial wash such as Hibiclense when showering prior to my surgery date?

• Should I avoid shaving the night before my surgery?

• Should I avoid the use of deodorant and lotions the night before my surgery?

DISCUSS DESIRED BREAST SIZE IN DETAIL WITH PS to be sure that my ideal breast size has been communicated. Discuss the size PS is hoping for and reasons for his preference of that size. I made an additional appointment with my PS in between our initial consultation and my surgery date, specifically to give me an opportunity to clearly communicate my desired size and to find out what he felt I could be safely taken down to. This was a very productive meeting and extremely reassuring. It put my PS & I on the same page as far as my desired size. This conversation put the emphasis on what I think is proportioned and beautiful & would fit my lifestyle, rather than what my PS personally thinks is proportioned and beautiful. He thanked me for coming in and stating so clearly what I was hoping for, and asked his nurse to note the details of this conversation in my file.

I am not having a FNG, so I do not need to inquire about a FNG. If your PS recommends a FNG, learn EVERYTHING you can about it before proceeding.

• Discuss BR method & scar pattern PS will use
• What will my nipple/areola size be? Where will the nipple be placed?

• Will more grams be removed from my larger breast? How much more do you estimate?

• How many grams do you estimate you will remove from each breast?

• Is that amount based on medical limitations (to preserve nipples, for insurance purposes, etc.) or on your personal opinion of what looks proportioned?

What method of closure will be used externally?
• Stitches?
• Glue?
• Tape?

• If stitches are used, how long before stitch removal?

• How long will the tape be worn?

• Do I need to purchase additional tape for application at home?

• Will there be drains?

• If so, how long before drain removal?

• How do you avoid dog ears?

• How long should I wait to shower after surgery?

• Should I use paper tape or silicone tape to minimize scars, and if so, for how many months?

• When should I switch from paper tape to silicone tape or silicone spray? (I plan on using paper tape, then silicone tape or spray to reduce scars, as long as my PS approves).

• When should I start massaging my scars? What should I massage with?

• Do you recommend Kelo-Coat (a silicone scar treatment gel) or bioCorneum (a silicone cream with SPF that forms a clear, flexible "sheet" over the scars), Bio Oil, Palmer’s Vitamin E Skin Therapy Oil, or any other product be applied to my scars?

• Can I use ice on my breasts Post Op?
• If so, should I avoid putting the ice over the incision areas?
• How long/how often should I ice for?

• I’m currently running/walking 20 miles per week. This often creates rubs/injuries from my sports bra. Should I stop exercising prior to my BR to eliminate any possible rubs before surgery?

• How much walking is ok after BR surgery? Aside from short walks for up to 10 minutes of each hour when I’m awake, how far is too far? *My PS recommends short walks every hour you are awake, however not all PS’s recommend this.

• When will I get information from the lab about the breast tissue that was sent away for analysis?

• In the event a revision needs to be done, how do you handle revisions, and at what cost to me?


BRING TO THE SURGICAL CENTER:

• Any pre-op paperwork that needs to be turned in, ID & insurance card, copay
• Written list of current medications, dates meds were stopped, etc.
• Thoughts to share with the PS while being marked
• Slip on shoes (easier for nurses/husband to help me into)
• Yoga pants/sweats
• Button or zip up top/ hoody
• 1 or 2 pillows for the drive home
• Lip moisturizer
• Hair scrunchy to put my hair up
• Cough drops
• Bag or container in case you throw up during the ride home
• Phone or camera for photos if desired
• A big hug & some sweet words for the kind soul that will be waiting for me while I’m in surgery, driving me home, and probably had to deal with my anxiety the night before as well


ASK BEFORE LEAVING SURGERY CENTER (I will probably ask my husband to ask the following for me):

• Do I have all the prescriptions I need? When should first dose be taken?

• Can I have additional anti-nausea meds?

• Can I purchase an extra surgical bra?

• What should I watch for so I know if I am developing an infection?

• What should I watch for so I know if I am developing a hematoma?


AFTER BREAST REDUCTION
• Recovery Tips
• Items To Have On Hand
• Bras For After Surgery
• Food Suggestions


RECOVERY TIPS

• Drink LOTS of water (and honey lemon tea)
• Take a stool softener upon arriving home from the surgery center if PS approves to help counteract effects of medications.
• NO LIFTING
• Rest, rest, rest
• Minimize arm movement and do not reach over your head, do not sleep with 1 arm up
• Wear a supportive garment at all times until PS clears you not to do so
• Sleep on your back, at an incline
• Minimize salt intake
• No aspirin or alcohol until cleared to have by PS
• No Driving until cleared to do so by PS and completely off medications that may affect your skills
• Ideally have significant other, relative or close friend stay with you for the first 72 hours or more
• If you must pick something up from the ground, do lunges or Squat instead of bending to minimize blood pressure in your breasts initially (& minimize pressure on sutures, glue, etc.)
• Walk around for a few minutes of every hour while awake if able to do so comfortably to minimize chance of blood clots (this is my PS suggestion, but other PS may not recommend this, so check with yours).
• REMIND YOURSELF that you only have one opportunity to recover from this, and how you handle your recovery affects the final shape and health of the beautiful, smaller breasts you waited so long for… so do NOT overdo it. Rest, do not lift, let the house get messy and let the laundry build up if need be. Follow PS’s instructions and timelines. Never hesitate to contact PS’s office for answers about concerns.

Create a chart/written list of what my PS has already approved, his comments, doses, times, etc. regarding the following medications, vitamins, & herbs as far as what to take upon arriving home (since I’ll probably be a little foggy from the surgery meds, best to have it written out):

My Prescription Medications & Vitamins, Herbs, etc.:
• ______________________
• ______________________
• ______________________
• ______________________
• ______________________
• Multivitamin
• additional C
• Arnica Montana
• Bromelain
• MSM
• Stool softener
• Laxative


ITEMS TO HAVE ON HAND FOR USE POST-OP

• Digital thermometer to monitor temperature
• Hibiclense
• Stool softener
• Laxative
• Benadryl (diphenhydramine) on hand for any allergic reaction or to ease itching
• Paper tape or silicone tape to minimize scars
• Bottled water (have bottle caps twisted off on a few bottles if you will be alone)
• Gauze pads, nonstick gauze pads, etc.
• Extra surgical brassieres or brassieres that PS has approved
• Reading material
• Laptop/access to internet
• Front closure pajamas
• Wedge pillow, extra pillows to make the bed more comfortable, or consider a recliner
• Priority items and comfort items set up next to your resting area
• Gel ice packs or frozen veggies IF your PS approves the use of ice
• Alarm, set to stay on schedule taking prescriptions, a chart to check off what has been taken
• Plastic chair or stool to place in the shower for the first few showers
• Prepared meals/snacks
• Moisturizer of choice for massaging scars (Bio Oil, Palmer’s Vitamin E Skin Therapy Oil, etc.)
• Patience & understanding for your significant other who is helping you through your recovery
• Have a few thank you cards/blank cards on hand, so that you can write a sweet note to any of the individuals who are helping you through your recovery. I’m sure at some point I’ll get a little bitchy/frustrated and may need to hand out an “I’m Sorry”.

BROMELAIN is a pineapple enzyme that can reduce swelling and pain. According to what I have been reading, Bromelain should not be taken before surgery, as it can act as a blood thinner and cause additional bleeding. Bromelain should be taken on an empty stomach in order for it to act as a preventative for hypertrophic scarring, although this may cause an upset stomach and diarrhea. I plan on taking Bromelain, and my PS has approved it for use after my BR.

Arnica Montana is an herb that can reduce swelling and bruising. I plan on taking Arnica Montana for 3-4 months post op, & some people start taking it prior to their BR surgery. My PS has encouraged me to take Arnica Montana both before and after my BR. They stock Arnica Montana in their office and give it to patients who have had facial surgery. Some PS’s DO NOT want to taking Arnica Montana before surgery, as some PS’s feel it can cause increased bleeding, so definitely get your PS’s ok before taking it.

MSM: I’ve been taking MSM on and off for years, so I plan on taking MSM. My understanding is that MSM is vital for the repair of connective tissue, and acts as an antioxidant. There is a lot of information available about MSM, so if you are curious about it, do a search for information on MSM and educate yourself about the MSM purity test. MSM can cause transient headaches because it is a detoxifier. You need to drink a lot of water with it, and if you want to help avoid the headaches, take smaller amounts initially and then build up to the recommended dose over time.


BRAS FOR AFTER SURGERY:

After looking at many bras available for wearing after surgery, reading suggestions for bras that were comfortable and soft, and after discussing some of them with a nurse at my PS’s office, I’ll probably look into getting the following for use as soon as my PS says it is ok to switch out of my surgical bra:

Marena Surgical Bra http://marenagroup.com/garmentstore/product/tabid/199/p-16-surgical-bra-2-elastic-band.aspx
Thanks to Kimmers at RealSelf.com for suggesting this one!

After my BR surgery, I will also look at Walmart and Target for inexpensive sports bras that will not rub my incision lines. The nurse at my PS’s office recommended picking up a few inexpensive jog bras for the days when you have swelling, as your size may fluctuate as you recover from your BR.

My PS recommends waiting a minimum of 3 months, preferably 6 months, before investing money in new bras. Ask your PS for their recommendation.

Most PS’s recommend that you do not wear ANY underwire bras for a lengthy period of time after BR. Check with yours to see what they recommend.


FOOD SUGGESTIONS - Foods I would like to have on hand post op:

I will prepare snack sized portions of many of the following on the day before my surgery

• Fresh lemons (to make lemon tea)
• Minute Maid frozen lemonade
• Cantaloupes
• Bananas
• Greens, salads
• Greek yogurt
• Apples
• Apple sauce
• Oranges
• Peaches
• Tuna
• Veggies
• Brown rice
• Eggs (hard boiled)
• Cottage cheese
• Rice pudding
• Jello


LINKS - Links to sites I have found useful while researching BR’s:

RealSelf.com Breast Reduction Forum and Reviews is a great place to gather information and emotional support both leading up to and following your BR: http://www.realself.com/breast-reduction/forum

Kimmers “13 things I wish I’d known before I had Breast Reduction surgery” on realself.com: http://www.realself.com/forum/13-before-breast-reduction-lift-surgery

Got Small Boobies is great blog with honest, candidly written blogs that is regularly updated: www.gotsmallboobies.wordpress.com

Breasthealthonline.org has forums and information about BR's: http://www.breasthealthonline.org/cgi-bin/mwf/forum_show.pl

RealSelf is such a useful tool. I have found that conversing with the other lades on realself has really done wonders for my comfort level discussing my breasts and having them examined, which has allowed me to communicate much more openly with my PS. So, thank you for this, ladies. It’s really great to be able to talk about this stuff here and not feel like you are obsessing over it lol. My husband has been REALLY wonderful about all the time I’ve been spending looking at boobies, reading about boobies, typing messages about boobies, and talking to him about boobies, but it’s just not the same as talking to other woman who are facing this surgery or have had this surgery. It’s such a comfort to be able to relate to other women about this stuff.

So, due to all my fretting about wanting to have my breasts made as small as possible, and worrying about my PS wanting to reduce me to only to a size he thought would look proportioned, I made an appointment to speak with my PS. At my initial consultation, after I expressed my desire for small boobies, we came to an agreement on a C- as the goal. I am so SO glad I met with him, instead of worrying about what size he would be willing to aim for over the next month. I told him I made this appointment to discuss the size we had agreed to at my initial consultation. I reminded him that I am a runner, a rider, and that I am certain my breasts will grow when I go through menopause. I told him that if I thought I could convince him to give me A’s, I would lol! I asked him if we could shoot for B+’s instead of C’s. He explained that a fuller breast helps to balance out the scars that you end up with, and that a fuller breast presents a more natural appearance compared to a smaller breast. I reiterated that I have spent the last month doing a lot of research, and I am absolutely certain that I would like to be smaller rather than larger. He examined me again, and again commented that I have extremely dense, heavy breast tissue, and that I need this reduction. Said he will probably end up taking nearly twice as much tissue from my right breast compared to my left breast, due to it being larger (I figured that). He said absolutely, he will take me down to a B+ if it can safely be done, which he expects it can. He told his nurse to note this conversation in my file, and he told both his nurse & I to remind him of my size wishes in pre-op before he marks me. One of his nurses then spent a lengthy amount of time explaining the procedure and answering all of my questions. She described what the breast shape could look like immediately post op; she said often the breast shape is boxy, but this is what helps to maintain perky breasts over time. She said within the few months after BR, your breast settles down into a more natural shape. She explained how they close the skin externally, and described what it will look like. She said the tape & glue will remain on my breasts for about 3 weeks. I already knew this from reading online, however it was nice that she spent time preparing me for what my breasts will look like post-op. She will be present for the surgery and will be there when I wake up, so It was reassuring to meet her.

I asked about taking Arnica Montana, and they said they are big believers in it, and they actually keep Arnica Montana at the office and give it to all of their facial surgery clients. They encouraged me to start taking it before my surgery. This made me very happy, as I was hoping I would be able to take Arnica Montana before my surgery as well as post-op.

My PS is a big believer in walking frequently during your recovery, with the caveat that he does NOT want you to sweat. I’m planning on walking only for the first 3 months, because I’ve read so much about how the internal stitches need time to heal completely before bouncing your boobies around for the best long term results. When I go running, I typically run 3-5 miles, and I’m pretty sure I will not be up to that at 4 weeks post op.

I printed the list/notes that is listed above in one of my updates (although, OF COURSE it’s a little longer now!), and I took it with me to my PS's office for my most recent appointment. It was very helpful to mark the questions/concerns I wanted to make sure I went over with my PS. Thankfully, my PS did not think I was crazy when I pulled that list out of my purse! The nurse told me to print out a fresh copy and bring it with me on my surgery date, and she'll make notes on it in addition to the papers and instructions they normally send you home with.

I cannot adequately express how happy I am that my PS was so responsive to my personal preference for small breasts, even though my size desire clashes with his professional opinion that my breasts should be larger. I am so pleased with my PS and his staff. So far, they have done such a great job answering all of my questions and concerns, and I find their availability to be a great confidence builder. I feel like now I can relax for the next month while waiting for my surgery date, because all of my concerns so far have been fully addressed by my PS and his staff. That office has their [RS bleep] together!!

Counting down the days!! Hope everyone who is in recovery is resting LOTS and doing well. Good luck to those of you who have surgery dates coming up soon! Wishing you all the best. For those of you waiting, like me, hang in there. We can do this!

The more I read about other women's experiences, the more excited I am to get my BR. I can't wait! 1 more month!