TYPICAL POST-OPERATIVE SYMPTOMS
Typical symptoms of breast reconstruction and signs to watch for following breast reconstruction with free tissue transfer include the following:
Tightness in the chest or donor site (abdomen, buttocks or thigh) and stiffness; tingling, burning or intermittent shooting pain: These are normal experiences as the skin, muscles, tissue and sensory nerves heal. Pain medication and muscle relaxants will help you cope with any discomfort. If you have drains, you may experience additional localized discomfort. Consistent sharp pain should be reported to our office immediately.
Shiny skin or any itchy feeling: Swelling can cause the breasts or skin at the donor site to appear shiny. As the healing process advances, you may also find a mild to severe itchy feeling of the breasts or at donor site incision. An antihistamine like Benadryl can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact our office immediately.
Asymmetry, the breasts look different, or heal differently. Breasts may look or feel quite different from one another in the days following surgery. This is normal; no two breasts are perfectly symmetrical in nature or following breast reconstruction surgery.
SURGERY AND HOSPITAL STAY
The procedure itself can take from 6 hours for reconstruction of one breast to 8-12 hours for bilateral reconstruction.
You will be admitted to the intensive care unit for monitoring of the flap and will be at strict bedrest for 2-3 days with your head elevated and knees propped. You will be required to lay on your back without side sleeping or moving side to side.
You will remain on intravenous fluids for three days and will be allowed to begin eating the day after surgery.
You will be on an intravenous pain pump for 1-2 days, then pain medication by mouth.
Typically patients will be allowed out of bed on postoperative day 4 and will be allowed to shower and be discharged later in the day.
You will most likely experience difficulty standing fully upright if your donor site is from the abdominal region: Standing upright could greatly affect your results and could cause serious injury.
AFTER YOUR RELEASE FROM THE HOSPITAL
FOUR TO TEN DAYS FOLLOWING SURGERY
During this time you will progress with each day that passes. Ease into your daily activities. You will receive clearance to begin driving or return to work at your post-operative visit.
- You will continue to sleep on your back
- Cleanse wounds gently with peroxide and you may shower. Take a warm, not hot shower. Do not take a bath. Limit your shower to 10 minutes. Do not rub your incisions. Apply a fragrance free moisturizer to breast and surrounding skin, however not on your incisions.
- Take antibiotic medications and supplements as directed. Take pain medication and muscle relaxants only as needed. You may wish to switch from prescriptive pain medication to acetaminophen or ibuprofen.
- Maintain daily walking. Walking is essential every day to prevent the formation of blood clots. You will begin to be standing upright at this time. In addition, you may begin stretching and range of motion exercises.
- Maintain a healthy diet. Do not smoke. Do not consume alcohol.
TWO TO FOUR WEEKS FOLLOWING SURGERY
As you resume your normal daily activities, you must continue proper care and healing.
- Continue wound care as directed.
- Ease into light weight-bearing exercise (nothing more than one to two pounds). However no twisting or lifting anything over your head. No tennis, golf, softball or other sports with similar swinging motions. Avoid aerobic exercise that may cause a lot of bounce.
- Do not smoke. While incisions may have sealed, smoking deprives your body of necessary oxygen that can result in poorly healed, wide, raised scars.
- No under wire bras for 6 weeks. You may sleep without a bra; however a camisole with built-in shelf support can be comfortable and provides added support as you continue to heal.
- You may sleep flat. However do not sleep on your stomach. If you are a side sleeper, a soft pillow under your mid-back and shoulders may offer more comfort and support than a single pillow under your head.
- Practice good sun protection. Do not expose your breasts or donor site to direct sunlight. If you are outdoors, apply at least an SPF 30 to the chest area at least 30 minutes prior to sun exposure. Your chest region, breast skin and donor site are highly susceptible to sunburn or the formation of irregular, darkened pigmentation.
SIX WEEKS FOLLOWING SURGERY
Healing will progress and your breasts will settle into a more final shape and position.
- You may ease into your regular fitness routine. However realize that your upper body may require some time to return to prior strength. Lift nothing heavier than 5 pounds for a minimum of 8 weeks after surgery.
- You may resume wearing underwire bras, although these are usually not necessary.
- Discomfort or tightness and tingling will resolve. Any lingering nipple sensitivity or lack of sensation should begin to greatly improve.
- No need to resume smoking. You have now gone 10 weeks (4 weeks prior to surgery and 6 weeks following) without a cigarette. For your long-term health, there is no need to resume smoking.
- Nipple and Areola reconstruction can be scheduled as advised by Dr. Ma or Dr. Boutros.
YOUR 1st YEAR
- Your scars will continue to refine. If they become raised, red or thickened, or appear to widen, contact our office. Early intervention is important to achieving well-healed scars. Scars are generally refined to fine incision lines one year after surgery.
- A one-year post surgery follow-up is required. However you may call our office at any time with your concerns or for needed follow-up.
Your body will change with age. The appearance of your breasts will change too. You may wish to undergo revisional surgery again in the future to help maintain your appearance throughout life. Contact our office with any of your questions or concerns, at any time.