Roderick P. Zickler, M.D.
These are general instructions for patients having had breast augmentation surgery with implants. Specific individual instructions may have been given to you in addition to these, but generally most patients who have had implants need to remember the following things.
Use your pain medication and the antibiotic prescribed for you as directed. Usually the antibiotic that we give is a precautionary measure. If it causes nausea, rash, or yeast infection or other problems, please call the office (423/968-2732) and let us know what the problem is and stop taking your antibiotic. The antibiotic you received in the Operating Room should be satisfactory and we will usually not add an additional antibiotic if you need to quit.
There is usually a tape dressing over the incision on the underside of your breast. This can be removed at two to three days when you feel good enough to get in the shower. Once this dressing is removed it does not need to be replaced. The stitch line at two to three days should be healed well enough to keep germs out. If you wish to apply a dressing over this, you certainly can but it should not be necessary. Please call our office if there is any leakage or drainage from the incision, usually at two to three days when the dressing is removed there should be none.
The upper pole breast binder is used to help keep the implants from “riding up” in the early postop period. We ask that this be worn for approximately two to three weeks until the implant capsule is formed. This will be much more comfortable if it is worn over top of a cotton T-shirt or camisole to keep the strap from digging into the skin at the front of your armpit. It may be removed for showers or if you choose to throw the garment in the washing machine. Otherwise, the garment should stay in place if at all possible.
Overhead lifting and reaching should be avoided as much as possible for the first three weeks after surgery. You may use a curling iron or wash your own hair but should refrain from doing activities which require your elbows above your shoulders. This changes the position of your pectoral muscles and can cause the implant to ride up somewhat or become uneven compared to the other side. Wear shirts with buttons or front opening, limit the use of sweaters or brassieres that you need to pull on over your head.
Usually, initially after implant surgery a bra is not necessary. If you feel that you need to wear one, a sports bra is recommended, certainly nothing with under wires which would tend to push the breasts up. Something with a clasp in front is much desired over a one piece sports bra that needs to get pulled on over you head for reasons already discussed. You may wear the upper pole breast restraint (breast binder) over top of a sports bra if that is comfortable.
If you required a drain tube, Dr. Zickler will have to discuss that with you, but basically you should refrain from showering until the drain tube is removed. It should be emptied once a day by removing the small stopper from the bulb, squeezing it empty while upside down and replace the stopper. The fluid can be discarded. Generally the tubes will be removed when the drainage is less than 30 cc per day. This is the lowest line on the drainage bulb when it is completely uncompressed.
If mastopexy (breast lift) has been performed at the same time as augmentation, Dr. Zickler may have some specific suggestions for you; however, the skin tape should probably stay in place until seen by Dr. Zickler in his office as they are generally put on to support the skin and minimize stretching or swelling of the skin flaps due to the breast implants.
If there are any other questions, problems or concerns please call the office day or night (423/968-2732). If this is after hours, the answering service will get in touch with Dr. Zickler promptly and he will answer your call. He would much rather know about any problem no matter how small immediately rather than have it cause a larger problem later on because it was not addressed promptly. If you have any questions about do’s or don’ts please call, but in general most restrictions, other than those listed above, are common sense.
Cosmetic Surgery Associates
Bristol Professional Park, Suite 205
350 Blountville Highway
Bristol, Tennessee 37620
Toll Free 1-800-231-3335
Fax (423) 968-7530