Why is preparation so important?

The success of breast surgery—whether augmentation, mastopexy, reduction, or reconstruction—is not determined solely in the operating room. A significant part of the outcome depends on the patient’s condition prior to surgery: overall health, quality of wound healing, absence of medications that increase bleeding, abstinence from tobacco, and stable weight. And the immediate recovery—the first 72 hours—determines how the patient feels in the weeks that follow.

This article outlines what we at Mallorca Medical Group discuss with each patient before any breast surgery. It is not a substitute for a personal consultation with the surgeon—which is where the individual plan is established—but it helps ensure that all questions are answered and the way forward is clear.

Four weeks earlier: what can't be improvised

Tobacco Suspension

It is the factor that has the greatest impact on the outcome and, yet, the one that is most underestimated. Tobacco use compromises blood flow to the skin and tissues, impedes healing, increases the risk of necrosis of the areola-nipple complex in mastopexy and breast reduction surgeries, and significantly increases the risk of scarring complications. At Mallorca Medical Group, smoking must be stopped at least 4 weeks before surgery and avoided for 4 weeks afterward. Vaping and e-cigarettes are also prohibited: nicotine—not smoke—is the critical factor.

Medication Review

Some medications and supplements increase the risk of surgical bleeding. The patient should bring a complete list of her regular medications to the appointment. The surgeon and anesthesiologist will decide which ones to discontinue and how far in advance. As a general guideline:

• Aspirin and NSAIDs (ibuprofen, naproxen): Discontinue use 7–10 days beforehand, as directed by your doctor
• Anticoagulants (Sintrom, apixaban, dabigatran): Never stop taking them on your own; always have your doctor adjust the dosage.
• Supplements: Vitamin E, omega-3, ginkgo, ginseng, high-dose garlic, and cranberry can increase bleeding. Stop taking them 2 weeks beforehand.
• Hormonal contraceptives: may be continued, with thromboembolism prophylaxis if indicated

Preoperative Tests

For standard breast surgery, the protocol typically includes:

A week earlier

This week is for clearing up any remaining questions and organizing the logistics for the next steps. Here are some practical details:

• Arrange for someone to assist you during the first 48–72 hours after discharge: someone who can help you with basic tasks (getting dressed, personal hygiene, eating, getting up)
• Purchase the postoperative medications prescribed by your surgeon so you will have them at home when you return from the hospital (pain medication, antibiotics if prescribed).
• Get your home ready: sleep in a semi-upright position for the first few nights (extra pillows), set up a resting area with everything within reach, and wear comfortable, loose-fitting clothing
• If you work, arrange for sick leave: the type of surgery determines the duration (breast augmentation: 7–10 days for sedentary work; breast reduction and mastopexy: 10–14 days; reconstruction: longer)
• Arrange for transportation from the hospital: never drive after general anesthesia

The day before and the day of the surgery

Hygiene and Fasting

The day before, take a full shower using an antiseptic soap that will be prescribed to you (chlorhexidine or similar), paying special attention to the chest area. Do not apply creams, perfumes, or deodorants on the morning of the surgery. Fast completely starting at midnight the night before: do not eat or drink anything (not even water) unless otherwise instructed.

What to Bring to the Hospital

For standard breast surgery requiring an overnight stay, please bring:

• Documents: National ID card, private health insurance card (if applicable), complete preoperative reports
• Comfortable, open-front clothing for the trip home: a button-down shirt, loose-fitting pants, and slip-on shoes
• Postoperative bra (your surgeon will have recommended a specific style)
• Basic personal items: toothbrush and toothpaste, hair ties, cell phone with charger
• NO jewelry, NO contact lenses (glasses if you wear them), NO nail polish

The First 72 Hours: What to Expect

At the hospital (first 24 hours)

After the surgery, you will be taken to your room wearing a postoperative bra or compression bandage. The predominant sensation during the first few hours is a feeling of pressure in the chest, rather than sharp pain. Intravenous pain medication is administered, and, depending on your progress, oral medication may also be prescribed. You can usually get up to use the restroom with assistance during the first few hours; it is advisable to get moving early to prevent blood clots. A gradual transition to a liquid and soft diet is recommended if you do not experience nausea.

Check-in and Return Home

Patients are typically discharged the next day (24 hours) after breast augmentation with implants, and 24–48 hours after a mastopexy, reduction, or reconstruction. You’ll go home wearing your postoperative bra, with written care instructions, medication, and directions on when to return for a follow-up visit. It’s best to go straight home, without making any stops, and to rest.

The First 72 Hours at Home

• Position: Sleep in a semi-seated position (using pillows or a wedge); do not sleep on your stomach or on your side during the first few nights
• Hygiene: Showering is usually permitted on the 2nd or 3rd day, as directed, taking care around the scars. DO NOT bathe in a tub or swim in a pool for the first 3 weeks
• Physical Activity: Walk around the house regularly; don't stay still. DO NOT lift your arms above your head or carry heavy objects
• Medication: Take pain relievers as prescribed; don't wait until you feel pain; take antibiotics until the full course is completed
• Brace: 24 hours a day for 4 weeks, then only during the day for 2 more weeks
• Warning signs: pain that does not subside with pain medication, a fever higher than 38 °C, sudden asymmetrical swelling, bleeding through the dressing, or redness of the scar. Contact the clinic immediately.

When will you be able to return to normal life?

The general guidelines for recovery times after breast augmentation with implants—the fastest cases—are as follows: sedentary work, 7–10 days; driving, 10–14 days (depending on how comfortable you feel); gentle gym workouts and light cardio, 4 weeks; and chest exercises, 6–8 weeks. For breast lifts, reductions, and reconstructions, recovery times are extended by an additional 2–4 weeks. Your surgeon will provide you with a personalized recovery schedule.