Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Pre-Op Instructions

Breast Restoration - Patient Surgery Guide

Patient Surgery Guide - Pre-operative Instructions


Two or more weeks before surgery



Do not take any aspirin containing medication including cold formulas for at least two weeks prior to surgery. Please refer to the Medication List link for some frequently used medications that contain aspirin or an anti-inflammatory. These compounds have a tendency to decrease the average clotting capacity and increase bleeding during surgery. Tylenol may be used instead as it does not have these untoward effects.



Smoking compromises blood flow by causing spasm of blood vessels and significantly increases the risk of flap complications and wound healing problems. Therefore, DO NOT SMOKE for at least three weeks before and six weeks after surgery. This also applies to second hand smoke; therefore do not stay in the room with cigarette smokers.


Donating Blood

The amount of blood loss during the surgery varies, and only 30% of patients will require a blood transfusion. This of course is greater in patients undergoing restoration of both breasts. Therefore, we recommend that patients donate two units of blood prior to surgery. Preferably, the blood should be donated at least one week prior to surgery, and each unit is available for 35 days after donation.  



Iron supplementation should be started as soon as possible prior to surgery especially when donating blood. Red cells contain a large portion of the body's iron stores. Therefore, supplementation should be started immediately and continued for at least 2 weeks after surgery. There are several iron supplements available without a prescription. All may cause some gastric distress or constipation, although individual reactions may differ. You may tolerate one product better than another. Taking iron supplements with food decreases such symptoms. All are better absorbed on an empty stomach, taken with orange or grapefruit juice or vitamin C. Avoid taking supplements with milk or calcium supplements, which decrease iron absorption. Some examples are:

Ferrous Sulfate: usually the least expensive form, well absorbed, can cause gastric distress or constipation (eg. Slow Fe R, Feosol R, Fer-In-Sol R)

Ferrous Gluconate: slightly more expensive and causes less gastric distress (eg. Fergon R)

Ferrous Fumarate: similar to ferrous gluconate (eg. Ferro-Sequels R), contains stool softener.


Surgical Garments

During your initial visit, measurements will be taken for a postoperative surgical bra and a girdle. The bra hooks in the front for easy dressing changes and flap monitoring. The girdle has zippers on the sides to make it easier to put on over the abdominal inicion. We have found that these garments provide support, and therefore decrease post-opertive pain. They are ordered through our office, and will be available for you to try during your visit the day before surgery. The girdle should be worn for at least four weeks after surgery.


One Week Before Surgery


Pre-operative Labs

Preoperative lab work must be obtained and reviewed prior to surgery.


Hibiclens Soap for Body

Use Hibiclens (over-the-counter antibacterial skin cleanser) in the shower instead of soap for three days prior to surgery. Apply the minimum amount of Hibiclens necessary to cover the skin from shoulders to thighs and wash gently. Rinse again thoroughly. (be careful not to get the product on your face, eyes, or ears). You do not need a prescription for this. Once you have completed your visit the day before the surgery, if you need to shower, do so only with water no soap to keep the markings in place.


Notification of Illnesses

Notify our office promptly if cold, fever, or any illness appears before surgery. Call in any allergies, medications, or conditions - you may have forgotten to tell us about.


The Day Before Surgery


Office Visit the Day Before Surgery

You will have an office visit the day before the surgery to review the planned procedure, answer final questions, and perform pre-operative markings and photographs.


The Night Before Surgery

Do not eat or drink anything after midnight the night before surgery. This includes gum, candy and water. Failure to comply with these instructions may result in cancellation or delay of your operation. If you are diabetic and take insulin you will be instructed how to take your medication and discuss this with your anesthesiologist during the preoperative visit.

For more information, please contact the Methodist Institute for Reconstructive Surgery at 713-441-6102.