PRE-OPERATIVE CONSULTATION


Before deciding on surgery, you will meet with our surgeon for a pre-examination. Here, you will discuss your expectations, and the surgeon will assess what will give you the best result. At the same time, you will receive a thorough review of your options and the risks always associated with surgery. The surgeon will also ask about your health to ensure that you are suitable for the procedure.

Based on your expectations and the surgeon's recommendations, you will plan your operation together.

You are very welcome to bring a relative to the pre-examination, as there is much information to consider. According to the law, you must have 7 days of reflection after the pre-examination before giving your final consent to the surgery.



EXPECTATIONS

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.

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.



ANESTHESIA


The operation can be performed under local or general anesthesia. This will be planned with the surgeon during the pre-examination.

If local anesthesia is chosen, you are awake during the procedure and can go home shortly afterward. When the surgery starts, you will receive local anesthesia in the entire area. You will feel the surgeon working but it should not be painful, just a bit uncomfortable.

If general anesthesia is chosen, you must fast for 6 hours before the surgery (this includes no eating, chewing gum, or smoking). You may drink water or clear juice up to 2 hours before the operation but avoid milk or other thick liquids.

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, you will arrive at the clinic at the agreed time. A nurse will greet you and guide you to the preparation area, where you will change into a surgical gown. An intravenous drip may be inserted into your hand, and the anesthetist will discuss the anesthesia with you. Finally, the surgeon will mark the areas for surgery and ensure you feel safe and informed.

During the operation, an incision is made on each side of the nipple in the areola. From this incision, the ducts that are tethered are cut over, so the nipple is no longer inverted but sits normally. The incision is sutured in depth with dissolvable sutures to reduce the risk of the tethering reforming. The skin is sewn with a thin nylon thread. A large bandage is placed to protect the area and minimize the risk of the tethering reforming.



AFTER THE SURGERY

If the surgery was performed under local anesthesia, you can go home immediately afterward. You may drive if you can safely operate the vehicle.

If the surgery was under general anesthesia, 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 SURGERY

If the surgery was performed under general anesthesia, you will feel tired and weak during the first 24 hours, and you may experience nausea and dizziness. We recommend that an adult stays with you for the first 24 hours.

It is important to rest during the first few days after the operation and generally listen to your body's signals to reduce the risk of bleeding and swelling. Ensure you drink plenty of fluids and eat a sensible diet.



PAIN

Most patients experience mild discomfort following a brow lift, but this can be managed with prescribed pain medication. It is normal to experience swelling and bruising, particularly around the nipples. These symptoms should subside gradually over the first 1-2 weeks.

You will be prescribed Paracetamol tablets and Ibuprofen tablets to be taken together 4 times a day. Additionally, you may 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.



ACTIVITY


For the first week after surgery, avoid strenuous activities that could raise your heart rate or blood pressure. This includes exercise, heavy lifting, or bending forward. Gentle walking is usually encouraged to promote circulation.



WORK

You may be able to resume light, sedentary work within a few days after surgery, but if your job involves physical activity, you should wait at least 2 weeks before returning. Swelling and bruising may persist for 1-2 weeks.



SLEEPING POSITION


You should sleep on your back for the first 2 weeks, as the nipples must not be subjected to pressure.



BATHING


You will have a nipple shield to prevent pressure on the nipple. The dressing should not get wet and must remain in place until your follow-up appointment with the nurse.
You can take a sponge bath or shower but avoid getting the dressing wet.



BLEEDING

Slight discharge, bruising, and swelling around the wound are entirely expected.

Minor bleeding can usually be stopped by resting and applying a firm, constant pressure with something cold for about 15 minutes.

Symptoms of bleeding include severe or sudden swelling, discoloration, and intense pain. If you experience this, you should contact the clinic.



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.



FOLLOW-UP


After 10-14 days, you will have a follow-up with the nurse at the clinic. The dressings will be removed, the wounds will be checked, and the threads will be removed if applicable. You may be called in for thread removal before or after this time.

New tape will be provided, which you should change every 10-12 days or if it becomes visibly dirty. The tape should be used for about 3 months. The tape helps keep the scar narrow, flat, and level with the rest of the skin.

We will discuss how you should proceed moving forward. You will be offered an appointment for follow-up with the plastic surgeon 3-6 months after the surgery. If you encounter any issues before then, you are always welcome to contact us.



CONTACTING THE CLINIC


At discharge, you will be given a phone number to contact the clinic 24/7 in case of an emergency. Additionally, a nurse will call you the day after your surgery to answer any questions and ensure that you are doing well.

COMPLICATIONS

Infection: Infections are very rare. Symptoms typically appear after 3-5 days and include redness, warmth, swelling, throbbing pain, and possibly fever. If an infection occurs, you will be treated with antibiotics.

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

Hematoma: A blood accumulation that can occur within the first 24 hours after the surgery.

Bruising and Swelling: This is completely normal and subsides over the first few weeks.

Reduced Sensation: Sensory disturbances and reduced sensation can occur in the operated area. This usually disappears within 6-9 months, but in some cases, it may be permanent.

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

Unevenness and Asymmetry: The skin may become uneven, and asymmetry can occur. Asymmetry is naturally common, and although the surgery can smooth it out, there is always a small risk of an uneven result. The worse the skin quality, the greater the risk that the skin will loosen again over time and the asymmetry may recur.

Breastfeeding: After the operation, you should expect not to be able to breastfeed. Therefore, it is a good idea to wait with the procedure until you no longer wish to have children or breastfeed.