PRE-OPERATIVE CONSULTATION

Before deciding on a breast reduction, you must meet with our surgeon for a pre-consultation. During this meeting, you will discuss your expectations, and the surgeon will evaluate what will yield the best results for you. You will also receive a thorough overview of your options, and the risks associated with each surgical option. The surgeon will ask about your health to ensure you are suitable for surgery.

Based on your expectations and the surgeon’s recommendations, you will plan your surgery together. You are welcome to bring another person to the pre-consultation, as there is a lot of information to consider.

According to the law, you must have a 7-day reflection period after the pre-consultation before you can give your final consent to cosmetic surgery.



EXPECTATIONS

In a breast reduction at Caolín, the surgery is tailored to your individual shape and desires.

After the surgery, your breasts will be swollen and tight, but this will subside over the first 3-9 months, after which they will attain a natural and soft shape.

It is important to be aware that the results of cosmetic surgery are not permanent. The natural aging process and the rate of body aging are influenced by both genetic factors and lifestyle factors such as smoking, sun exposure, and weight changes.

Additionally, it is important to understand that surgery always carries a risk of complications, and the result may not always match your or the surgeon’s expectations completely.

If you are significantly overweight or underweight, there is an increased risk of complications with anesthesia and wound healing. If your BMI is over 30, we may not be able to offer you surgery.

PREPARATION

Before the surgery, you must:

Stop taking medication containing acetylsalicylic acid such as Magnyl, Aspirin, Ibuprofen, and

Treo one week before the surgery.
Avoid natural medicines, especially fish oil, ginger, and vitamin D, as they can increase the risk of bleeding. Stop all natural medicines three weeks before the surgery.

Any blood-thinning medication may need to be paused. This will be discussed with the surgeon during the pre-consultation.

Smoking must be paused least 4 weeks before and 6 weeks after the surgery. Smoking can negatively affect the cosmetic outcome, increase the risk of infection, and is generally bad for your health. We often choose not to offer surgery to active smokers.

It is a good idea to shop and prepare meals before the surgery, so you can focus on your recovery afterward.

On the day of the surgery, you should take a shower with thorough cleansing of your body and hair. Avoid using body lotion or other products on the area to be operated on. Wear loose, comfortable clothing, preferably a zip-up blouse, loose fitting pants, and flat shoes. Remove all jewelry and any piercings and leave them at home.



MAMMOGRAPHY

If you are over 40 years old or have a family history of breast cancer, a mammogram is recommended before the surgery.



ANESTHESIA

The surgery is performed under general anesthesia. You must fast for 6 hours before the surgery (no eating, chewing gum, smoking, or similar). You may drink clear fluids like water and sugary drinks in small amounts until 2 hours before the surgery; do not drink milk, juice, etc.

It is crucial to adhere to the fasting rules, as anesthesia can be dangerous if you are not fasting, and the surgery is canceled, if you are not fasting.



SURGERY

On the day of the surgery, arrive at the clinic at the scheduled time. A nurse will greet you and you will be shown to your room, change clothes, and have an intravenous line placed. The anesthesiologist will discuss the anesthesia with you, and finally, you will meet with the surgeon, who will ensure you feel comfortable and well-informed. The surgeon will also mark the area to be operated on.

The surgery will be performed under general anesthesia and will last 1-2 hours. Excess breast glandular and fat tissue will be removed and sent for routine examination to ensure there are no pathological changes in the tissue. The placement of scars and the extent of the surgery will depend on what you and the surgeon have determined to be best for you, based on your desired shape and placement of your breasts.

In some cases, the surgeon may place one or two drains (small plastic tubes) to remove any blood and wound discharge from the healing areas. To reduce the risk of infection, you will receive antibiotics during the surgery.

The wounds will be sutured with self-dissolving sutures, and tape will be applied over the wounds along with an absorbing dressing. Finally, you will be given a bra to wear.



AFTER THE SURGERY

After the surgery, you will be taken to the recovery room where the nurse will monitor you. You will receive something to drink and eat and pain reliefers if needed. Depending on the extent of the surgery, you may be discharged after a few hours.

Before you go home, the plastic surgeon and nurse will review the post-operative precautions with you and answer any questions you may have to ensure you feel comfortable.

You should arrange for someone to pick you up, as you will not be able to drive yourself.

DAYS AFTER THE SURGERY

Since the surgery was performed under general anesthesia, you will be tired and sluggish on the first day, and you may experience nausea and dizziness. We recommend having an adult at your side for the first 24 hours.

It is important to take it easy for the first days after the surgery and generally listen to your body’s signals to reduce the risk of bleeding and swelling. Make sure to stay well-hydrated and consume a sensible protein-rich diet.



PAIN

After the surgery, your breasts will often feel tight and firm, especially in the first few days, which is normal. The breasts may continue to feel tight, swollen, and have slightly uneven shapes during the first few weeks. Additionally, you may experience itching, tingling, and burning in the scars.

It is important to take the prescribed medication. The medication will reduce pain, but you should expect some discomfort during the first 3-4 days.
Many people experience stabbing and sharp pain in the operated area. This is normal and occurs because the nerves are re-establishing connections. These sensations can last for up to 1 year after the surgery.

You will be prescribed Paracetamol tablets and Ibuprofen tablets to be taken together 4 times a day. Additionally, you will receive a stronger painkiller, a synthetic morphine tablet, which you can take if you experience severe pain.

The nurse will thoroughly review the medication with you before you leave, and you will also receive written material describing everything.



DRAINS

If drains are placed during the surgery, they are often removed before you are discharged. If they are not removed, you will be given detailed instructions on how to care for them and when they are to be removed.



ACTIVITY

In the initial days after the surgery, getting out of bed might be difficult, so having someone to assist you is a good idea. It is important to get up and move around quickly to reduce the risk of blood clots. Engage in light activity, such as short walks, but take breaks when needed. For the first 1-2 weeks, avoid any strain on the wounds.

You must avoid vigorous exercise for the first 6-12 weeks after the surgery, but it is important to keep your body active with light activities, like short walks.
We recommend that you do not lift more than 2 kg per arm for the first 6 weeks after the surgery and avoid lifting your elbows above shoulder height during this period. However, remember to move your shoulders to avoid stiffness.

You must avoid driving until you can handle the vehicle safely and no longer need strong painkillers. Always use a seatbelt, whether you are driving or a passenger.



SLEEPING POSITION

We recommend lying on your back for about 4 weeks after the surgery. You may lie slightly on your side, possibly with a pillow behind your back.



WORK

You can resume sedentary work after 1 week. Physical work should be avoided for 2-4 weeks before resuming.



BATHING

You can take a shower 24 hours after the surgery or when there is no longer any discharge from the wounds (unless you have drains). Before showering, remove the compressive bandage and the absorbing dressing. The brown plaster must remain until your follow-up appointment. It can withstand water. Take a gentle shower, rinse the wounds to wash away soap residues (do not wash or scrub the wounds), and pat dry with a clean towel before putting the compressive bandage back on.

You should avoid taking baths, swimming in the sea, or going to a swimming pool and sauna until the stitches are removed and the wounds are fully healed.



BLEEDING

There may be some discharge from the wounds in the first few days, which is normal. You will be given extra dressings for this purpose.

However, it is important to monitor for bleeding from the breast in the first few days. Should bleeding occur, which is a rare complication, the breast may become hard and swollen. If this happens, contact the clinic for an evaluation.



BRA

After the surgery, you will be given a supportive bra to wear for 6 weeks. You can remove the bra when you shower or when it needs washing.

Underwire bras must not be used until after 3 months.

You may purchase an extra bra from the clinic if you want more to alternate between.



SCARS

The scars from the surgery will typically be red and swollen but will improve over 6-24 months. Over time, scars usually become narrow and lighter I color, but in some cases, they may become wide and darkly pigmented.

You may apply a soothing cream to the scars once they are completely healed. Avoid smoking, as it increases the risk of infection, slow healing, and unsightly scars.



CONTACTING THE CLINIC

You will be given a phone number upon discharge so you can contact the clinic 24/7 in case of an emergency.

Additionally, you can expect a call from a nurse the day after your surgery to ensure you are doing well and to answer any questions.



FOLLOW-UP

After 10-14 days, you will return for a follow-up with the nurse. The dressings will be removed, and the wounds will be checked. You will not need to have sutures removed as they are self-dissolving.

New tape will be applied and given to you, which you should change every 10-12 days for about 3 months after the surgery. The tape helps to keep the scars narrow, flat, and level with the rest of the skin.

We will discuss how to manage the scars, any pain, etc. You will be offered a follow-up appointment with the plastic surgeon 3-6 months after the surgery. If you have any issues before then, you are always welcome to contact us.

COMPLICATIONS

Infection: Infections are very rare. Symptoms typically appear after a week and include redness, warmth, swelling, throbbing pain, and possibly fever. If an infection occurs, you will be treated with antibiotics.

Swelling and Bruising: This is expected and will subside over the first few months.

Unattractive Scarring: Scarring can vary greatly from person to person. Most scars become nice and white over time, but some people may develop red and thick scars, known as hypertrophic scarring. This process can take several years.

Bleeding: In very rare cases, bleeding may occur in the operated area. If this happens, it may require another surgery and could affect the result.

Sensory Changes: Sensory disturbances may occur in the skin in the operated area. This usually resolves after 6-9 months, but in some cases, it may be permanent.

Asymmetry: Many people naturally have slight asymmetry in their breasts. In some cases, this asymmetry can be corrected during the surgery, but there is a risk of uneven results. Poor skin quality increases the risk of skin laxity developing over time and the asymmetry not being uniform between the breasts.

Small Wounds: If the sutures are tight, varying degrees of small wounds or defects may appear in the scar. These often heal within a few weeks.

Pain: Some people experience a stabbing and shooting sensation in one or both breasts long after the surgery. This is normal and due to the nerves reconnecting. These sensations may last up to 1 to 1½ years after the surgery.

Fluid Accumulation: In rare cases, fluid may accumulate in the operated area. If this occurs, it may be necessary to drain the fluid with a thin needle.

Tissue Death: This means that parts of the skin lose their blood supply and die. If this occurs, it may require surgical removal or waiting for the body to heal the area from within, as assessed by the surgeon. The risk is higher if you are overweight or smoke.