Self-Care Following 1-Stage Breast Reconstruction With a Permanent Implant
Conveniently located to serve the areas of Lake Forest, Glenview and Grayslake, IL
This packet will help you learn about breast reconstruction in 1 stage with a permanent implant. The information is meant to be used in addition to talks with your physicians and nurses. Some of the information may not apply to you. Be sure to ask your plastic surgeon or nurse about what might be different in your situation.
Topics included are:
- What to expect after surgery
- Caring for your incision
- Comfort measures
- Exercise
- Clothing tips
- Completion of your breast reconstruction
Contents
What to expect after surgery
After your surgery, you will have a large gauze dressing over your incision. The dressing is held in place by a surgical bra. The dressing and bra will be put on while you are in the operating room.
One or 2 small plastic drains may be placed near your incision line. These drains collect fluid that normally develops under your skin after surgery. They will usually stay in place for 1 to 2 weeks. You will be taught how to care for your drain(s) before leaving the hospital. The drain(s) will be removed by your physician when the amount of drainage is less than 30 cc (about 1 fluid ounce) in 24 hours. Most patients describe the drain removal as a slight pulling or stinging sensation that lasts only a few minutes. You will not need pain medicine for the drain removal. After your drain(s) are removed, some fluid may continue to leak from the site.
Cover the area with a gauze pad and change the pad if it becomes damp. This drainage is normal and can be expected for 24 to 48 hours, after which time the site is usually healed.
Some discomfort is normal after surgery. You may have a stinging sensation along the incision line and your drain site(s) may itch. You may also notice some tenderness along your lower rib cage. These sensations gradually decrease after surgery. You may take pain medication when you need it. Be sure to ask for it so you will be as comfortable and active as possible.
Other common sensations after your surgery include:
- Numbness under the arm and over the chest
- Warmth in the arm
- A feeling of water trickling down the arm
These sensations are caused by the nerves being cut or moved during the mastectomy. They will gradually lessen as the months go by, but some degree of numbness may be permanent.
Caring for your incision
While you are in the hospital, your physician or nurse will examine your reconstructed breast every day and change the dressing as needed. We encourage you to look at your chest during the dressing changes so you are familiar with how it looks. When you are ready, you can care for your incision with help from your nurse. This will help prepare you to care for yourself at home.
At first, the size of your reconstructed breast may be different than your natural breast. There may be lumps and bumps, swelling or bruising of the breast skin. This is normal.
The incision line across the breast mound is closed with stitches (sutures). You may see some redness and some slight bloodstains on the gauze pad. You may also feel tenderness around the incision. These are normal signs after surgery. After examining the area, the nurse may place a fresh gauze pad over your suture line.
When you leave the hospital, your stitches will still be in place. They will be covered with a gauze pad. You can wear the surgical bra or any support bra that does not have an underwire and does not press on the implant.
You should replace the dressings daily after surgery for 3 to 4 days. You may shower 48 hours after surgery. We recommend daily showers to help keep the suture line clean. Do not take tub baths until your incision is fully healed. Soaking the area may increase your risk of infection. Before entering the shower, remove your bra and the gauze pad. Wash with lukewarm water and a plain non-perfumed soap. Gently clean your incision line and skin. Rinse well. The shower stream should not be directed at your reconstructed breast. Pat the incision line dry with a clean towel, but do not rub it.
Only use an electric razor to shave under your arm on the side of the surgery. Also, deodorant could cause an infection, so do not use it until after you put your bra on. Do not use deodorant on the side of the surgery if you have any break in your skin. After your shower, inspect the incision line and drain site carefully. To do this, stand in front of a mirror in a room with good lighting.
Call your plastic surgeon or nurse immediately if you have any of these symptoms:
- New skin redness
- New drainage from the incision
- Temperature more than 101 F
When you have finished the inspection, place a clean gauze pad over the incision line. You should wear the bra 24 hours a day. For additional gauze pads and surgical bras, call our office.
Comfort measures
As you heal, there are a few things you can do at
home to feel more comfortable. Warm showers, acetaminophen (Tylenol®) or ibuprofen (Motrin®, taken with food), may help ease the tightness and discomfort. A non-perfumed moisturizer put on once or twice a day can be soothing. Do not put the lotion directly on the incision for the first 6 weeks. Never apply a heating pad or warm compress directly on the breast mound. It is possible to burn your skin because your sensations have changed. Your nurse will also show you stretching exercises you should do at home.
Exercise
Regular exercise after your surgery is good for you, but there are some exercises you should not do. Do not do high-impact aerobics, jog, lift weights or swim until your physician approves. Avoid exercises that build up your chest muscles (pectoralis). Do the simple exercises at home that are shown in your exercise booklet. These exercises will improve your comfort and flexibility.
Clothing tips
When you leave the hospital, you will be wearing a surgical bra.
After the drains are removed, you may choose to wear your own bra. It should:
- Be comfortable
- Not be too tight
- Not have an underwire
Completion of your breast reconstruction
If it is indicated, the surgeon will discuss surgery on the other breast to make it match the shape and size of your reconstructed breast. This surgery is done to make the natural and new breasts look alike. This surgery is up to you. You may want to have it, decide whether to have it later or choose not to have it at all.
If you decide to have a nipple reconstruction, it is usually done about 3 months after the permanent implant is placed. Surgery on the other breast may also be done at this time.
Nipple reconstruction can be done either in the hospital or in your surgeon’s office. If your reconstructed nipple/ areola needs to be darkened, tattooing of the area can be done in the office.
Do not hesitate to seek help or get support from your plastic surgeon or nurse. If you have questions or concerns, please contact us.
