Instructions for Care After Breast Reconstruction With a Tissue Expander
Conveniently located to serve the areas of Lake Forest, Glenview and Grayslake, IL
As you recover from your breast reconstruction surgery at home, it is important to follow these instructions.
Contents
Pain medications
You may have pain for a few weeks after surgery. Take acetaminophen (Tylenol®) and/or ibuprofen (anti- inflammatory medication) to relieve your pain.
Ibuprofen is best taken with food. If the pain medications are causing a burning sensation or pain in your stomach, stop taking them and call your physician. You may take naproxen (Aleve®) as an alternative to ibuprofen.
If your pain is not controlled by acetaminophen and/or ibuprofen, add the narcotic medication (e.g., tramadol or oxycodone) that your physician ordered.
You may also be prescribed a muscle relaxant, such as diazepam (Valium®) or cyclobenzaprine (Flexeril®). You may use this for muscle cramping or spasm-type pain. You may take thee muscle relaxant in addition to the medications listed above.
If you are prescribed antibiotics, take them until they are finished or your physician tells you to stop.
If you have severe pain that is not relieved with the medicine that has been recommended for you, call your physician or go to the nearest Emergency Department.
Your surgeon or nurse may ask you to keep a record of your pain and the medications that you take at home. You can do this in the “Notes” section at the end of this booklet.
Pain medication may cause constipation. To help your bowels stay regular:
- Drink more liquids
- Get regular exercise (a 15 minute walk is a good start)
- Take a stool softener such as docusate sodium (Colace®) if your doctor tells you to do so
If you need to continue your pain medication at home and require a refill of a prescription, please notify the Plastic Surgery Clinic Monday through Friday, 8 am to 4:30 pm, at 224.271.4250. It may take 1 business day to get a refill. Do not wait until your pills are gone to request a refill.
What to eat and drink
You should resume your normal diet gradually. It may take time for your appetite to come back. This is normal. You may return to eating a regular diet once you are at home.
If you find it hard to eat enough calories, try eating smaller servings at each meal. Add nutritious snacks between meals. Try high-protein, high-calorie shakes, or commercial supplements such as Ensure® or BOOST®.
Drink plenty of nonalcoholic liquids.
Clothing and bandage tips
Once you leave the hospital, bandages are not required over your incisions except over your drain site. If there are tape strips on your incision, leave them in place.
If you are sent home in a surgical bra, continue to wear it as much as possible until your follow-up appointment. You may remove it to shower and launder it.
If you are not sent home in a surgical bra, do not wear a bra until cleared by your surgeon.
Try to wear clothes that button up or have zippers in the front.
Try not to lift your arms over your head to put on T-shirts or sweaters during the first week after surgery.
To care for your drains
You will have 1 to 4 drains placed during surgery.
The drains help keep fluids from building up under your skin causing swelling and pain. The drainage tube goes through your skin near the surgical incision and is held in place by a stitch. The fluid will drain into the attached bulb.
Nurses will provide detailed instruction during your hospital stay on how to care for the drains.
The drains will be covered by a clear plastic dressing. If the dressing falls off, call the office for a replacement at 224.271.4250.
Wash your hands well with soap and warm water for at least 30 seconds before emptying a drain.
Empty the bulb container at least 2 times a day, in the morning and before you go to bed. Empty it more often if needed, whenever it is at least 1/3 full.
Record the output from your drains each time on the Drainage Record Sheet and bring it with you to each follow-up appointment.
Drains are usually removed 10 to 20 days after your surgery. If you empty less than 30 mL of fluid from the bulb container for 2 days in a row, call your surgeon’s office to see if the drain should be removed.
If a drain falls out, cover the site with a gauze bandage. Call the office during normal business hours.
Activity guidelines
Showering
You may shower 48 hours after surgery. It is OK for water to touch the incision and drain dressings. Do not take a bath, swim or get into a whirlpool until cleared by your surgeon.
Sleeping
For the first week after surgery, you may be more comfortable sleeping with a few extra pillows under your head and shoulders to help with swelling. However, this is not necessary. Extra pillows in bed to keep pressure off the surgical site may help.
Do not place ice packs on your incisions.
Daily activities
You are encouraged to begin walking and resuming light daily activities as soon as possible. To prevent blood clots in your legs, it is important to get out of your chair or bed every hour and walk around for a few minutes. You do not need to do this during your normal sleeping hours. Do not push, pull or lift anything heavier than
8 pounds (about the weight of a gallon of milk) until cleared by your surgeon.
Exercising
You may begin range of motion exercises as directed by your surgeon. Do not plan to do any strenuous activity or exercise (running, weight lifting, aerobics) for 6 weeks after surgery. When you have been cleared by your surgeon to start exercising, ease yourself back in. Some stretching or pulling sensations are OK. Do not push through pain.
Driving
Do not drive while taking narcotic pain medication or muscle relaxants. You may drive when you feel comfortable behind the wheel with a seat belt on. For most women, this is at least a week after surgery.
Sexual activity
Do not engage in any sexual activity for at least 2 to 3 weeks. Only begin when you are completely comfortable.
What else to expect
Some pain and discomfort should be expected for 3 to 4 weeks. However, it should gradually get better after the first 2 or 3 days. This pain should be manageable and not severe.
You may have stinging sensations along your incision line and your drain sites. You may also notice tenderness along your lower rib cage or a feeling as if you are wearing a very tight bra. These sensations will improve.
Other common sensations include numbness under your arm and over your chest; and warmth, chafing, pins and needles, or other sensations in your arm. These sensations are caused by nerves being cut or stretched during the mastectomy. They will gradually get better as the months go by, but some degree of numbness may be permanent.
You may notice bruising to your skin and incision sites. You may also notice a lumpy or bumpy appearance and may feel hard ridges or areas under your skin.
When to call the office
Call the office anytime of the day or night if you have:
- A temperature over 100.5 F for 2 readings taken 4 hours apart (you do not need to take your temperature unless you feel hot)
- An increase in redness, swelling, or significantly more pain around or under your incisions
- Pain that is not relieved by your medication
- Persistent diarrhea, nausea or vomiting
- Drainage that becomes cloudy or has a foul smell
- A bulb container that fills with blood or drainage that collects quickly after it is emptied
Call the office during daytime hours if:
- You need a prescription refill
- Your drain bulb will not stay compressed
- Your drainage tube falls out
- The suture comes out that is holding the tube in place
