Dr. Marga is a board certified Plastic Surgeon with additional training as a Certified Lymphedema Therapist. She is the Founder of the National Institute of Lymphology and serves as a Medical Advisor to the Norton School. Dr. Marga promotes the the highest standard of lymphedema care for surgical patients nationwide.
Getting Ready for Breast Reconstruction Surgery
To get ready for breast reconstructive surgery is to love yourself…
Maintain a healthy diet and avoid any excess weight gain. Please do not "grow" fat for your breast reconstruction procedure. If you are overweight (BMI > 30), we recommend a structured weight loss program (Weight Watchers™) in addition to a daily, physician-approved exercise program – typically 30 minutes of aerobic exercise daily. We encourage you not to lose more than 2 pounds per week and that you discuss your individual diet and exercise regime with your primary care physician before you get started. Yoga is a wonderful compliment to your daily activities. Meditation, relaxing to music, or getting routine massages are highly encouraged.
You should visit with your primary care provider to discuss your intentions to proceed with breast reconstruction. We will request pre-operative blood work, a chest x-ray and a pre-operative electrocardiogram (ECG) the results of which should be FAX'd to us at least 14 days prior to surgery. If you have had chemotherapy, are age 55 or older, have a history of high blood pressure or profound family history of heart disease, we will request that you have a stress echocardiogram and a cardiology consultation for pre-operative clearance. We recommend that you do this sooner rather than later as these evaluations may require several coordinated physician appointments.
Please let us know if you have a personal or family history of blood clots either deep venous thromboses of the extremities or pulmonary emoboli as this will influence your personalized care plan.
We will review your medications with you prior to surgery. Please refrain from elective aspirin and non-steroidal anti-inflammatory medications 3 weeks prior to surgery.
DISCONTINUE ANY HERBAL MEDICATIONS 4 WEEKS PRIOR TO AND 4 WEEKS FOLLOWING SURGERY AS SOME HERBALS HAVE BEEN ASSOCIATED WITH ABNORMAL BLOOD CLOTTING.
Please discontinue TAMOXIFEN 3 weeks prior to and 3 weeks following surgery.
AVOID PRIMARY AND SECONDARY CIGARETTE SMOKE FOR 3 MONTHS PRIOR TO AND 3 MONTHS FOLLOWING SURGERY AS TOBACCO EXPOSURE HAS BEEN ASSOCIATED WITH SEVERE WOUND HEALING PROBLEMS.
You will need a pre-operative CT Scan or MRI of the abdomen or gluteal region typically at your Stage I Hospital if you elect to have a perforator flap breast reconstruction. Please notify us immediately if you are allergic to IV contrast dye used for CT scans as we will need to secure a MRI, potentially at a separate medical facility. MRI scans are more difficult to schedule and we would like to help make this appointment as close to your OR date as possible given your travel requirements.
Dr. Marga will see you in the office at 5 pm on the evening prior to surgery to address any last minute questions or concerns. She will place your pre-operative markings at that time. Be prepared to have your photograph taken at that time.
On the evening prior to surgery, do not eat or drink anything after midnight. Please shower with Hibiclens™ or Dial™ antibacterial soap. Please avoid the use of these agents on the face or around the eyes or ears. Hibiclens™ can be purchased over-the-counter at your local pharmacy. You can take your normal medications with a sip of water on the morning of surgery as approved by Dr. Marga.
The following are some recommendations to follow regarding your hospital stay:
Wear something comfortable to the hospital that is easy for you to get off and on. We highly recommend wearing something that either has a zip or button front. A post-surgical bra will be issued at the hospital. Please do not wear any jewelry, nail polish or hairpins. Please leave all valuables at home. All make-up will need to be removed. If you wear dentures or contact lens, these will also be removed at the hospital, so be prepared.
If you take insulin, please do not take it the day of surgery, but bring it with you to the hospital. You will have an "Accu-check" on admission. The Anesthesiologist will decide if you need to take your insulin, and at what dose, at that time.
Please bring copies of your reports to include lab work, chest x-ray and heart tracing with you on the morning of surgery.
Dr. Marga typically obtains your informed consent and request for surgery on the morning of surgery such that you will have additional time to consider any last minute questions or concerns.
Please call us immediately if you are ill the week before your surgery. Fever, coughing, flu-like symptoms or pain while urinating may be reasons to reschedule your surgery.
If you have any questions or concerns, please feel free to contact our office at 866-446-0962.