Tony L. Weaver, DO, FACS
Board-Certified Plastic & Reconstructive Surgeon
Office Phone: 256-817-6153
Text Line (Non-Urgent Questions): 256-434-7520
“I will restore you to health and heal your wounds,” declares the Lord.
— Jeremiah 30:17


GENERAL EXPECTATIONS
It is normal to experience:

• Swelling, bruising, and tightness of the upper arms
• Mild to moderate discomfort
• Temporary numbness or altered sensation along the incision lines
• Drainage from incision sites in the first 24–48 hours

Swelling may persist for several weeks and can fluctuate throughout the day. Final contour results evolve over 3–6 months.

ACTIVITY

• First 48 hours: Rest with arms elevated above heart level when possible on at least 2 -3 pillows
• Weeks 0–2:
  • No lifting greater than 5–10 pounds
  • Avoid reaching overhead or stretching the arms
  • Gentle hand, wrist, and elbow motion encouraged
• Weeks 2–6:
  • Gradual return to light daily activities
  • No strenuous exercise, weightlifting, or upper-body workouts
• After 6 weeks:
  • Resume unrestricted activity only after clearance

🚫 Do NOT perform push-ups, pull-ups, rowing, or resistance training until cleared.


COMPRESSION GARMENTS

• Wear your arm compression garment continuously (24/7) for the first 2–3 weeks, except for showering
• Afterward, wear during the day for an additional 2–3 weeks as directed
• Compression helps control swelling, supports healing, and improves contour

INCISION & WOUND CARE

• Keep incisions clean and dry
• Showering is typically permitted 48 hours after surgery unless otherwise instructed
• Allow soap and water to gently run over incisions—do not scrub
• Pat dry and reapply dressings as instructed
• No soaking (baths, pools, hot tubs) for 4 weeks

DRAINS (IF APPLICABLE)

• Empty drains 2–3 times daily and record output
• Secure drains to clothing to prevent tension
• Drains are usually removed when output is minimal, typically within 5–10 days

MEDICATIONS
PAIN CONTROL – MULTIMODAL APPROACH 
Pain following surgery is expected and is best managed using a multimodal regimen to minimize opioid use while maintaining comfort.

1. Ibuprofen (Motrin) 800 mg
   • Take every 8 hours with food, scheduled for the first 5–7 days, then as needed.
   • Avoid taking other NSAIDs concurrently.
2. Methocarbamol (Robaxin) 750–1500 mg
   • Take every 8 hours as needed for muscle tightness, chest wall discomfort, or spasms.
   • May cause drowsiness—use caution when standing or walking.
3. Percocet 5/325 mg
   • Take only for breakthrough pain not controlled with ibuprofen and Robaxin.
   • Use the lowest effective dose for the shortest duration possible.
   • Do not drive, operate machinery, or consume alcohol while taking this medication.
4. Gabapentin 100 mg
   • May take three times daily for nerve-related pain (burning, tingling, hypersensitivity).
   • Most beneficial in the first 48–72 hours after surgery.
   • Discontinue if excessive sedation or dizziness occurs.
5. Phenergan
   • Take as needed for nausea or vomiting, particularly if using opioid medication.
   • May cause drowsiness.

🚫 Avoid aspirin, NSAIDs, or supplements unless approved.


SWELLING & BRUISING

• Swelling is normal and may be asymmetric
• Elevation and compression are key
• Bruising typically resolves over 2–3 weeks

SLEEPING

• Sleep on your back
• Keep arms elevated on pillows
• Avoid pressure on incisions

DIET & HYDRATION

• Maintain a high-protein diet
• Stay well hydrated
• Avoid alcohol for at least 2 weeks
• No smoking or nicotine products—this significantly increases wound complications

WARNING SIGNS – CALL IMMEDIATELY IF YOU EXPERIENCE:

• Fever > 101°F
• Increasing redness, warmth, or pus at incision sites
• Sudden swelling or severe pain in one arm
• Shortness of breath or chest pain
• Excessive bleeding soaking through dressings
• Separation of the incision

FOLLOW-UP

• First post-operative visit: as instructed 
• Additional visits will be scheduled to monitor healing and scar progression

SCAR MANAGEMENT

• Scars will appear red and firm initially—this is normal
• Once incisions are fully healed:
  • Begin silicone gel or silicone sheets
  • Gentle scar massage may be recommended
• Scar maturation occurs over 6–12 months

IMPORTANT REMINDERS

• Results improve over time—patience is essential
• Minor asymmetries and residual swelling are common early
• Strict adherence to instructions directly affects outcomes

If you have questions or concerns, contact our office immediately.Weaver Plastic Surgery
📞 256-817-6153

Tony L. Weaver, DO, FACS
Board-Certified Plastic & Reconstructive Surgeon
Office Phone: 256-817-6153
Text Line (Non-Urgent Questions): 256-434-7520
​
“I will restore you to health and heal your wounds,” declares the Lord.
— Jeremiah 30:17



1. Activity & General Care

• Rest for the first 48 hours, then gradually increase light activity as tolerated.
  
  
• Avoid lifting more than 8 lbs (about a gallon of milk) for the first 2 weeks.
  
  
• No strenuous exercise, pushing, pulling, or overhead arm movements until cleared by Dr. Weaver.
  
  
• Sleep on your back with your head and upper body elevated (2–3 pillows or in a recliner) to reduce swelling.
  
  

2. Incision & Dressing Care

• Leave all dressings in place until your first office visit – do not remove or change them unless instructed.
  
  
• Keep the surgical area clean and dry.
  
  
• You may take a sponge bath or sit in a shallow tub bath (water below the waist) – do NOT get breasts, dressings, or drains wet.
  
  
• You may wear deodorant, but avoid getting it on or near the incisions.
  
  
• First shower will be after your initial post-op visit when Dr. Weaver removes your dressing
  
  

3. Jackson-Pratt (JP) Drain TeachingYour JP drains remove fluid to help healing and prevent infection or seroma. You may have one or more drains. Each drain must be cared for individually.
A. How to Secure the Drain

• Attach the bulb to your clothing with a safety pin or lanyard so it doesn’t pull on your skin.
  
  
  
• Keep tubing loose with gentle loops to avoid kinking.
  
  
  

B. How to “Strip” the Tubing (Twice Daily or If You See Clots)

1. Wash hands with soap and water.
   
   
   
2. Hold the tubing near where it comes out of your skin with one hand.
   
   
   
3. With the other hand, pinch the tubing using an alcohol pad and slide your fingers down toward the bulb, squeezing any clots along the way.
   
   
   
4. This keeps the line open and fluid flowing.
   
   
   

C. How to Empty the JP Bulb (see separate post)

1. Wash your hands.
   
   
2. Open the plug on top of the bulb.
   
   
3. Pour fluid into a clean measuring cup.
   
   
4. Record the amount and color in your drain log (see chart below).
   
   
5. To “recharge” suction:
   
   
   
   • Squeeze the bulb flat with one hand.
     
     
   • While still squeezed, close the plug securely.
     
     
   • The bulb should stay collapsed – this means suction is working.
     
     
     

D. Drain Output Goals

• Measure and record each drain separately at least twice a day (morning and evening).
  
  
• Drain removal is usually considered when output is <30 mL over 24 hours for 2 days in a row.
  
  

4. Drain Output LogBring this to every appointment. Keep a record of the drain volume every 6 hours or as needed. 




5. Pain Management

• Take prescribed pain medications as directed.
  
  
  

6. When to Call Dr. Weaver Immediately

• Fever over 101.5°F
  
  
  
• Increasing redness, swelling, or warmth around the incision
  
  
  
• Sudden firmness or swelling in one breast
  
  
  
• Drain not holding suction or drainage stops suddenly before removal
  
  
  
• Cloudy, foul-smelling, or pus-like fluid
  
  
  
• Severe pain unrelieved by medication
  
  
  
• Shortness of breath or chest pain – Call 911
  
  
  

7. Follow-Up

• Keep your scheduled first post-op appointment – bring your drain log.
  
  
  
• At that visit, Dr. Weaver will check healing, possibly remove drains, and clear you for your first shower.
  
  
  

PAIN CONTROL – MULTIMODAL APPROACHPain following breast reduction is expected and is best managed using a multimodal regimen to minimize opioid use while maintaining comfort.

1. Ibuprofen (Motrin) 800 mg
   • Take every 8 hours with food, scheduled for the first 5–7 days, then as needed.
   • Avoid taking other NSAIDs concurrently.
2. Methocarbamol (Robaxin) 750–1500 mg
   • Take every 8 hours as needed for muscle tightness, chest wall discomfort, or spasms.
   • May cause drowsiness—use caution when standing or walking.
3. Percocet 5/325 mg
   • Take only for breakthrough pain not controlled with ibuprofen and Robaxin.
   • Use the lowest effective dose for the shortest duration possible.
   • Do not drive, operate machinery, or consume alcohol while taking this medication.
4. Gabapentin 100 mg
   • May take three times daily for nerve-related pain (burning, tingling, hypersensitivity).
   • Most beneficial in the first 48–72 hours after surgery.
   • Discontinue if excessive sedation or dizziness occurs.
5. Phenergan
   • Take as needed for nausea or vomiting, particularly if using opioid medication.
   • May cause drowsiness.

Your safety is our top priority.
If you have questions or concerns, call 256-817-6153. After hours, your call will be routed to Dr. Weaver or the on-call provider.