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          Post Operative Checklist

          1. Have your significant other, parent or good friend there to take care of you for the first 48 to 72 hours. It is very important to have someone to wake you for medications, help you to the bathroom, prepare food for you and make sure that you eat it, and to be there in the event of an unforeseen emergency.
          2. Take your pain medications. There is simply no reason to suffer. Studies have proven that patients who are in pain and have a lot of stress can expect to significantly increase their healing time. Take care of yourself.
          3. Take your antibiotics on time; you do not want an infection. Finish your entire course and do not skip pills.
          4. Be sure to follow your surgeon's advice on icing and be sure to change out the cold packs often. Keeping the area cold can really help diminish the swelling and discomfort, especially in the first 48 hours. Do not place ice or a cold compress directly on skin. If your surgeon says no icing — no icing. Abide by your surgeon's rules.
          5. Try to eat something, even if it consists of a few bites. You need your energy, because your body is working overtime to heal itself. Taking medications on an empty stomach can cause nausea and dizziness.
          6. It is very important to drink plenty of water. Your body needs water to help flush out the residual anesthesia and pain meds, especially after you stop taking them. Plus, your body will retain more fluid if you don't drink enough water, resulting in more bloat and increased swelling. Also, your medications can cause constipation, and being dehydrated can only make things worse.
          7. Remember that swelling is normal, as is bloating. If you accept it and continue to drink water and eat a balanced diet, all will subside in its own time with a lot less stress.
          8. Some patients recommend Daikon (a root vegetable) to help with constipation that is brought on by pain medications. It also helps flush out the system. Daikon may be best after you are finished with your medications. Mild stool softeners like Colace are really effective, but please ask your surgeon first.
          9. Sleep with your chest elevated for at least 10 days.
          10. Have pillows alongside of you as well as in back of you to support your arms and assist you in trying to roll over on your stomach or sides. You may wish to add a small pillow at the lower back for sleeping.
          11. Take your temperature regularly. An elevated temperature could mean an infection.
          12. Take your antibiotics ON TIME. Don't forget if you are taking birth control pills that some antibiotics can interfere, so in the event that you do have sex, use another form of protection as well.
          13. When you get tired, sleep. Sleeping gives your body more time and energy to direct towards healing.
          14. Get up and walk around when you are able, but don't overdo it. Too much too soon spells disaster.
          15. If you were fortunate enough to have quit smoking, please do not start again. Smoking narrows blood vessels and decreases the amount of hemoglobin to the wound. This can result in wound closure problems and necrosis (death) of skin cells and tissue.
          16. Keep moist towelettes or baby wipes near the bed. These are great for freshening up without much effort.
          17. Keep the ringer on your phone turned off in your room. A constantly ringing phone will keep you from getting much-needed rest.
          18. Have a whistle, walkie-talkie or intercom system on hand so that you can alert your caregiver if you need them for any reason.
          19. Ask your surgeon about silicone gel sheeting, Steri-Strips from 3M, Mederma scar gel or whatever else your surgeon may recommend for helping scars.
          20. Remember to take your after photos or day-by-day photos if you are keeping track. Have your caretaker take several photos during your recovery. You may not remember having them taken or may even get aggravated with a camera in your face when you don't feel well, but you will appreciate it later if you are keeping close documentation.
          21. Remember to write in your journal daily because you will forget later due to the amnesiac properties of the anesthesia. Use a miniature tape recorder to keep track of your experience, if you prefer.
          22. No walking around without a support garment unless your surgeon specifically told you not to wear one. Your breasts will need support during this time for several reasons: breast shape, scar stretching, pain and trauma to the healing breasts.
          23. If you have online friends, have someone post or email them after your surgery or they are going to worry about you.
          24. Make sure you don't take any products that contain aspirin — and don't drink any alcohol — for at least two to three weeks after surgery.
          25. Have your friends stop by when you are feeling better. Get some fresh air if you can; it will do you good. Just don't overdo it.
          26. Remember, you will have scars and they will look worse before they look better. Please don't be depressed because of the scars. Your breasts will continue to change over the next few weeks and months, and the scars will be less visible. The scars are at their reddest in the first three to four months. Depression and stressing out over every little thing is NOT good for proper recovery.
          27. You shouldn't ride any roller coasters or other types of amusement park rides. If G forces can cause aortal tears, they can cause internal tearing and bleeding in freshly healing tissues. Also refrain from horseback riding and contact sports for several weeks. Be sure to ask your surgeon when you can continue these activities.
          28. If you have topical arnica montana gels, take care not to get the product on your incisions. Arnica montana can irritate your wounds and cause inflammation.
          29. Many surgeons recommend that you continue taking vitamin C during your recovery. Ask your surgeon if he or she approves.
          30. No lifting objects over 5 to 7 pounds. This includes children and pets.
          31. No bending over. Bending over increases pressure on your wounds and may cause hemorrhaging. Squat down, if you must, but do be careful. This is why it is important to place things at hip level beforehand or have a caretaker.
          32. If you suspect you may need to pick things up, perhaps buy a "reacher" marketed for this very purpose.
          33. No raising your arms way over your head. Ask your surgeon when it is safe to do so.
          34. One of our visitors suggests tying a long string to the ceiling fan light/fan cords.
          35. Be careful with your significant other and children, and tell them to be careful. Being hit in the breast after surgery can cause bleeding, suture popping and pain.
          36. Sleeping upright can cause back cramping. Try hot water bottles or heating pads to alleviate this, but remove them when you sleep as they can cause burns. Also, keep heat away from your breasts unless otherwise instructed.
          37. Watch for suspicious swelling and discolorations that could be a hematoma. Learn the difference between a hematoma and a bruise.
          38. Make a chart of when to take your meds or use the med chart we have provided. Some are taken 1 every four hours, some are taken four a day. Don't confuse the instructions. A pill case will help you keep your medications in order.
          39. Place a waterproof, non-slip stool or plastic chair in the shower when you are finally allowed to shower.
          40. After you shower, place a towel on the closed toilet seat and sit down to dry yourself. If you are dizzy from your pain medications, you may fall and hurt yourself.
          41. If you are expecting your period and it does not come, do not worry. The medications, trauma and anesthesia will probably disrupt your cycle. This goes for it coming at an inopportune time as well, such as surgery day. Just have your feminine supplies on hand and expect it when you least expect it, or not at all.
          42. You are probably going to be depressed a few days after your surgery or at some point during your recovery. This is very normal. Just warn your loved ones beforehand and keep your chin up. Your body has been put through a trauma, albeit a planned trauma, and will make you pay for it in its own subtle ways. Depression may rear its ugly head with crying sessions, feelings of unattractiveness, self doubt, regret and general sadness. This, too, will pass.
          43. Do not be afraid to contact your surgeon if you feel there is something wrong. Surgeons are accustomed to talking with patients who have questions or just need reassurance.
          44. Go to your postoperative appointments. These are important so that your surgeon can gauge your progress and assess any further needs you may have to improve your results or experience. It's also when you can share your thoughts, express concerns or ask advice.
          45. Most importantly, relax. Don't stress. Being stress-free is very important for your recovery.
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            Joseph A. Mele, MD, FACS

            130 La Casa Via
            Building 2, Suite 206
            Walnut Creek, CA 94598
            (925) 943-6353
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          • 95 Scripps Drive
            Sacramento, CA 95825
            (916) 929-1833

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            A.J. Khalil, MD

            A.J. Khalil, MD
            436 North Roxbury Dr
            Suite #207
            Beverly Hills, CA 90210
            (323) 856-1941
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