Pre & Postop Instructions

• All women ages 40 years + will need a routine mammogram before surgery
• Removal & replacement of implants will require an ultrasound and/or MRI to determine condition of implants as instructed by your surgeon
• If results are not received at least 2 – 3 weeks in advance, surgery will be postponed at your expense

• No smoking (ideally 12 weeks before and after surgery)
• No dental work: teeth cleaning & filings
• No cosmetic injections
• No laser hair removal treatments
• No body tattoos
• Remove body piercings, including nipples

• Consent forms due
• Outstanding accounts due
• Organise a support person to pick you up and stay with you 24 hours after surgery

• Implant sizes are finalised
• Discontinue ALL non-prescription medication (including multivitamins and herbal products)
• Discontinue ALL diet medications- including shakes, thermogenic products, and duromine (phentermine)
• No blood thinning medications, including: Aspirin, Ibuprofen (e.g. Nurofen), Non-Steroidal Anti-inflammatory, Vitamin E, Gingko Biloba or Fish Oil
• No illegal drugs
• You CAN continue to take the contraceptive pill

• No alcohol
• Report any signs of infections, colds, rashes, or skin sores
• If you have ANY respiratory symptoms – notify the clinic
• No spray tanning/ remove ALL traces of tan to prevent infection
• If you require a medical certificate: email the clinic with exact days. For example: 24.3.2021 – 24.04.2021

• Remove acrylic nails, nail polish/shellac off 1 finger each hand
• Eyelash extensions may be left on
• Wash your hair
• Follow fasting instructions given to you by the hospital: NO eating or drinking anything after midnight. Regular prescription morning medication may be taken with a small sip of water

• Shower with the preop wash
  Apply wash to your entire chest, abdomen, underarms
  Apply from the neck down, do not use on face or genitals
  Clean in circular motions for 5 minutes using gentle pressure
  Turn the water off. Leave the product on the skin for 5 minutes
  Rinse thoroughly
  Do not use any other wash over the area
  Pat dry with a clean, soft towel
• Do not apply anything to the skin: lotion, powder, deodorant, perfume
• Remove all jewellery and piercings
• Wear clean, loose and comfortable clothes, ideally a button up or zip up top
• Brush your teeth
• No contact lenses
• Visit a bathroom prior to admission to theatre
• Bring a pillow in the car to hold against your chest on the drive home

• No showering for 5 days. After 5 days, avoid wetting the dressings, dry with a hairdryer on a low heat setting. If dressings get overly wet, you will need a dressing change earlier
• Do not massage your breasts
• Do not put anything on your breasts: ice, heat, creams etc
• You may experience nauseas and vomiting following the general anaesthetic. You will be prescribed anti-nausea medication that will help manage this.
• It is important to maintain a good oral intake of food and fluids as the analgesia (pain medication) can cause bloating and constipation.
• Maximise resting in the first week of healing; you should not be performing any excessive exercise or activity which elevates your heart rate or causes you to break a sweat for the first 3 weeks of healing.
• Do not drink alcohol for 1 week or until your antibiotic course is complete
• Do not drive for 1 week
• You may resume all supplements ceased after 2 weeks
• No smoking for at least 6 weeks; significant wound healing compromise can occur if you continue smoking.
• It is normal to hear strange gurgling, sloshing sounds in the breast pocket
• Numbness and altered sensation is normal; Nerve channels can take up to 6 weeks to heal.
• Bruising may occur as the surgery involves manipulation of the muscles and skin across your chest. We recommend taking arnica tablets post and even leading up to surgery if you are prone to bruising.
• Breasts should be treated as separate surgeries: one may heal faster than the other, they may appear uneven in early recovery, trust the process. It will take 3 months before the swelling starts to subside. You should allow up to 1 year to see the final results of your surgery.
• No sun exposure on the breast area for the first three months. Protect your incisions from sun exposure for the first 12-24 months by using appropriate SPF. Sunlight can lead to hyperpigmentation (darkening) of scars.

• Textured Implants: Don’t lift arms above shoulder height for 2 weeks
• Motiva / Smooth Implants: Don’t lift arms above shoulder height for 4 weeks
• No hugging for 6 weeks
• Don’t lift or push anything heavier than 5kg for 6 weeks
• After 6 weeks this can be increased by 5kg per week as comfort permits

• Week 0 – 1: Sleep and rest in an upright position on 2-3 pillows
• Week 2 – 3: You may sleep flat on your back
• Weeks 3 +You may sleep on your side
• No stomach sleeping for 6 months

• 0 – 6 weeks: wear your post operative bra 24/7 – it should feel firm, but it’s not a sports bra and should not feel as tight as one. You must continue wearing your post operative bra until your week 6  with Dr Chinsee.
• 6 – 12 weeks: wear a firm fitting, sports bra with NO underwire or padding during the day and your postop bra at night
• After 3 months: no bra, padded bras, strapless bras, bras with underwire may be worn for SHORT periods of time. You must wear a supportive and firming fitting sports bra if you are exercising. You must wear your post op bra at night for a minimum of 12 months at night time. However, we recommend wearing your bra as much as you can indefinitely. Your implants will keep their shape and last longer if you wear a bra the majority of the time.
• If you have Motiva implants you are required to wear your postop bra for 3 months

• No exercise (including dancing) or submerging your body under water for 6 weeks, no exceptions
• Week 1: Gentle walking only – the pace you would walk around a shopping center
• Week 6 (pending review): light exercise, gym work, running, swimming, dancing. You must wear a supportive and firming fitting sports bra if you are exercising.
• 3 Months: contact sports: surfing, horse riding, netball, scuba diving, gun range, ski diving, roller coasters, bowling. You must wear a supportive and firming fitting sports bra if you are exercising.
• 6 Months: Crossfit style exercising, MMA fighting, pole dancing. You must wear a supportive and firming fitting sports bra if you are exercising.
• Sexual intercourse: may be resumed after 2 weeks, however if you are resuming prior to 6 weeks your post op bra must remain on, refrain from any strenuous exercising that could disrupt healing (ie. bouncing, grabbing and handling of the breasts). No mouth to nipple contact for 3 months to prevent infection.

ARM MOVEMENTS

• If you have MENTOR implants, you can lift your arms above your head after 2 weeks
• If you have MOTIVA or SMOOTH implants, you can lift your arms above your head after 4 weeks
• Work within your limits, if something feels uncomfortable or hurts – stop

• Cosmetic Injections: resumed after 2 weeks
• Dental Work: resumed after 6 weeks – advise your dentist you have implants as you may require prophylactic antibiotics to prevent infection
• Laser Hair Removal: body resumed after 6 weeks, no laying on your stomach for at least 6 months, underarms resumed after 3 months
• Tattoos: body tattoos resumed after 6 weeks, breast/ torso resumed after 6 months
• Piercings: body piercings resumed after 6 weeks, NO nipple piercings due to infection risk
• Massage: resumed as comfort permits, no laying on your stomach for at least 6 months
• Fake Tanning: resumed after 6 weeks. Cover incisions and nipples with tape for at least 3 months to prevent infection
• Sauna: 6 weeks after surgery (provided incisions have healed)
• Cool Sculpting/ Body Sculpting: stomach resumed after 3 months, body resumed after 6 weeks, no laying on your stomach for at least 6 months

ALL patients will require a dressing change at week 1, 2, and 3

Dressing Changes In Clinic:

All dressing changes are performed by one of our Registered Nurses.

Dressing Changes At Your GP

• Your Dressing Change Letter to give to your GP is in your post operative instructions on the first page of this weblink– please make sure you read this letter yourself! Unfortunately some GPs do not read the instructions properly
• You will have a Virtual Appointment with your surgeon at Week 1

View Your Dressing Change Letter

Additional Information

• In summer we see an increase in infections due to the heat. If you get HOT or SWEATY you will need to arrange an earlier dressing change; it is not uncommon for mastopexy patients to require dressing changes every second day
• Some patients may have an external suture knot underneath one or both breasts: this will need to be trimmed at the base at Week 2
• You MAY experience some discomfort at your week 1 dressing change, take your pain medication prior to reduce this
• Breast Lift Patients: (with or without implants) require areola stitch removal at Week two
• All patients will have scheduled postoperative appointments with their doctor at six weeks, three months, six months (optional), and twelve months (optional). We recommend booking these in advance!

Book Your Dressing Changes & Postop Appointments

After the first three weeks of in clinic or GP dressing changes, and pending there are no wound breakdowns or infections, you will be responsible for ensuring all your incisions remain clean, dry and supported.

You will need to either purchase from a chemist or Inigo Cosmetic the appropriate dressing change consumables to wear from week four up until your review with Dr Ian Chinsee at week six.

Dressing change instructions:

• Wash hands thoroughly
• Remove dressings in the shower, rinse with tepid water
• Pat dry with a clean towel
• Snap a pic and email through to us for review: info@inigocosmetic.com.au
• For breast augmentation patients:  Once dry, place a thin layer of Stratamed to dry, this may take a couple of minutes to dry.
• For breast augmentation with mastopexy (breast lift or Mastopexy (breast lift) only: Apply steri strips over all incisions and then place hypafix directly over steristrips. Change tape every five days, or as required (changing it too often may irritate the skin)
• Continue use until your six week appointment
• If you notice any discharge or redness contact the clinic ASAP

Each week you will repeat this until your review with Dr Ian Chinsee at week six. You can shower normally, and blow dry the hypafix with cool air in-between. Don’t begin using your scar therapy products until you have approval from Dr Ian Chinsee at week six.

For information on scarring and how to care for your incisions after 6 weeks refer to our Surgery & Scarring Guide

Scarring After Surgery – The Complete Guide

• ANTIBIOTIC: Cephalexin 500mg 4 times per day(every 6 hours) until finished

• PAIN RELIEF: Paracetamol 1000mg 4 times per day (every 6 hours) up to 10 days
• ANTI-INFLAMMATORY: Celecoxib 200mg 2 times per day (every 12 hours) up to 10 days

• STRONG PAIN RELIEF: Oxycodone 5 or 10mg every 4 hours IF needed
• ANTI-NAUSEA: Ondansetron 4mg every 4 hours IF needed

• It is important to take the antibiotics as prescribed until finished to decrease risk of wound infection and implant rejection
• We recommend that you take paracetamol REGULARLY with the antibiotics for at least the first 5 days
• Paracetamol & Celecoxib work together in different ways to give you pain relief so it’s important to take them for this initial period, you can continue to take them for up to 10 days IF required
• Oxycodone is an opioid pain killer. You should take this type of medication ONLY if you have severe pain AFTER taking paracetamol & celecoxib
• Do NOT take the oxycodone on its own without taking regular paracetamol & celecoxib as they all work in different ways to control pain

• Oxycodone can cause constipation: ensure a high fibre diet with plenty of water. You may ask the pharmacist for a stool softener
• Oxycodone can impair your function (driving) when you first start taking it. If you don’t usually take oxycodone, please be aware this may affect you more
• Antibiotics and oxycodone may cause nausea. Take both with food. Don’t take these medications together (try to space out by 30mins or so). An ondansetron wafer may relief nausea