Breast Implant Exchange with Fat Grafting
Print Card
- Dr. Brown:
- Gown – XL, XL Length
- Gloves – 8 Indicator glove, 7.5 Biogel glove
- Dr. Chandler:
- Gown – L
- Gloves – 5.5, 6 only if 5.5 not available
- Sean Kirby PA-C:
- Gown – XL
- Gloves – 7.5 Indicator Glove, 7 Nonlatex Glove
- Pre-operative Medications (prescribed pre-op)
- Night before:
- Scopolamine patch placed behind ear
- Shower with Hibiclens for couple days before surgery 4% topical chlorhexidine soap.
- In pre-op holding ~1 hour before surgery:
- Tylenol 975mg PO x1
- Gabapentin 600mg PO x1
- Celebrex 400mg PO x1
- Night before:
- Intra-operative Medications
- Ancef 2 grams IV (ok if allergic to Penicillins)
- Vancomycin 1g IV (if allergic to Ancef)
- Infiltration Solution (PHARMACY TO PREPARE, IN PRE-OP ORDERS)
- NS or LR 500 mL
- Ropivicaine (Naropin) 300mg
- Clonidine 0.3mg
- Dexamethasone 4mg
- Liposuction Tumescent Solution for Fat Graft harvesting:
- LR 1L + 2g Epinephrine (2 amps of 1:1000)
- Warm in towel warmer
- Ancef 1g and Vancomycin 1g reconstituted into 10mL syringes to “squirt” from off the field to on the field – into the fat graft solution before Dr. Brown injects the fat.
- Post-operative Medications (Prescribed pre-op)
- Tylenol 650mg PO q6 hours scheduled
- Methocarbamol 1500mg PO q6 hours scheduled
- Gabapentin 300mg PO PO q6 hours scheduled (if not too expensive)
- Cephalexin 500mg PO q6 hours scheduled for 4 doses starting after surgery
- Celebrex 200mg PO BID scheduled (if not too expensive)
- Pericolace 1 tab PO BID scheduled
- Phenergan 25mg PO q8 hours PRN nausea
- Oxycodone 5mg tabs, 1-3 tabs PO q4 hours PRN pain
- Ibuprofen 600mg PO q6 hours scheduled, starting 48 hours after surgery
- Anesthesia
- Anesthesia choice
- Patient Position
- Supine. Able to sit up 90 degrees (make sure bed can do this)
- Bra underneath patient with folded chux pads on top (see photo below).
- Facility provides bra for insurance cases.
- Dr. Brown provides bra for cosmetic cases.
- Bed Attachments
- Arm boards, Ulnar nerve pads, Kerlex
- Patient Warming
- Lower Body Bair Hugger
- DVT Prophylaxis
- Bilateral SCDs in OR. ON and working BEFORE induction of anesthesia.
- Foley Catheter
- No
- Instrument Sets
- Breast & Body
- Need Tebbetts double ended breast retractor & Long skinny breast retractor
- Small Volume Fat grafting equipment (all in Breast & Body instrument set)
- Infiltration/Infusion cannula
- Small liposuction cannulas
- Small collection cannister
- Small fat injection cannula
- Breast & Body
- Surgical Packs
- Breast
- Surgical Prep
- Chloraprep x 4
- Irrigation Solutions
- Standard irrigation solution (PHARMACY TO PREPARE, IN PRE-OP ORDER SET)
- NS 1L
- Ancef 2g
- Gentamicin 160mg
- Betadine Paint (10% Povidone-Iodine) 100mL
- Standard irrigation solution (PHARMACY TO PREPARE, IN PRE-OP ORDER SET)
- Blades
- 10 x 2
- 11 x 2
- Bovie
- Short Protected ENT tip x 1
- Long Proctected tip x 1
- Cut pure 40
- Coag fulgarate 40
- Suture
- 3-0 Monocryl Large cutting x 2
- 3-0 v-Loc (absorbable) Long, Large Cutting x 2
- 2-0 PDS large taper x 2
- 5-0 Fast Gut Large, Cutting x 2
- 2-0 Nylon large cutting x 2
- Drains
- 10mm perforated flat JP drain on tracer (if available), 100mL bulb suction
- Additional Supplies
- Marking pen x 4
- Paper Ruler
- Implant funnel (Dr. Brown to bring, do not open)
- Breast Implants and sizers that were ordered.
- Facility to order and purchase if an insurance case.
- Dr. Brown to order and purchase if cosmetic case.
- Infusion tubing (to pump in tumescent fluid)
- Liposuction tubing
- Infusion/Peristaltic Pump (to pump in tumescent fluid)
- 60mL Toomey syringes x 4
- Davol Sputum Catch or Leukins Trap
- Dressing
- Mastisol
- Wide Long Steri strips
- Kerlex fluffed in a bra
Print Card