In preparation for consultation and surgery please learn as much as you can about all of your breast reconstruction options. It is very advisable to get more than one opinion and speak with women who have undergone breast reconstruction, especially DIEP and other perforator flap surgeries. When you come for your consultation please have some questions prepared so that you can fully understand the operations and the options available to you. We hope our website offers information helpful to you in making your own best personal decision in choosing breast reconstruction.
Preoperative (Before Surgery) Timeline
Six Months or More:
It is extremely advantageous to be in good physical condition prior to having surgery. If you are currently involved in an exercise routine please continue to exercise frequently. If you are not getting any or adequate exercise, please understand that any physical activity prior to surgery will serve you very well in your recovery. Even if you were only able to walk 20 minutes a day or take the stairs in your building, you will find that your recovery may be much quicker and much less painful. Please discuss an exercise program with your primary care physician.
Do Not Smoke. Avoid smoking for at least 6 months before and 6 weeks after surgery. This includes exposure to “second hand smoke”. Cigarette smoking causes blood vessel spasm and can diminish blood flow to your reconstruction. Tissue without blood supply heals poorly and can die completely.
You may be asked to see your primary care physician or a specialist prior to your surgery for surgical clearance. Please make sure your primary care physician knows that you will be undergoing an operation in the near future. We will be ordering some basic laboratory tests including blood tests, EKG, and sometimes a chest x-ray. We will also require you to have a highly sophisticated imaging study that maps your blood vessels using magnetic resonance imaging (MRI.)
Arrange for someone to stay with you in the immediate days after discharge and ideally for days following if possible. A visiting nurse service is usually a covered benefit of your insurance and we can arrange for this additional care if desired.
Most patients are able to return to work after 4 weeks. If your job requires physical exertion, more time may be required. Our office will assist you with leave of absence and/or temporary disability requests.
One week or more:
Lab work will generally be required before surgery. We will discuss this prior to or at your initial visit. All lab work required must be completed and reports faxed to hospital and office 9 days prior to surgery.
Notify us of any cold, fever, or if other illnesses occur in the days before surgery.
Two weeks before or more:
In general avoid aspirin containing compounds, ibuprofen, and herbal medications at least 2 weeks before surgery. You may take Tylenol as needed. Refer to the medication sheet in your information packet for more detail. Call if you have any additional questions about any medication that is not prescribed by The Center for Microsurgical Breast Reconstruction.
One and Two Days Before:
Wash from shoulders to thighs in the 2 days prior to surgery with Dial soap or preferably Hibiclens soap (do not use on your face). You do not need a prescription to purchase Hibiclens.
Sleeping pill night before surgery OK with prescription.
Postoperative (After Surgery) Instructions
What should I expect after surgery:
- Moderate swelling of the reconstructed breast and/or the buttock area will persist for 1-2 months
- Numbness in the reconstructed breast, donor area, and sometimes the upper, inner arm for 6-12 months
- Some emotional letdown after surgery is a normal part of your recovery
Please call us for:
- Persistent fever above 101.5
- Rapidly expanding swelling under the skin
- Spreading, bright pink color to the skin surrounding the surgical site(s)
- Pus in drain from the incision site
- Change in flap temperature or color
- Empty and record drain output 3 times daily on the sheet provided for you
- Dressings may be changed daily if present prior to discharge. Gauze and tape is removed and suture lines cleansed lightly with hydrogen peroxide prior to placement of fresh gauze and tape
- Only sponge bathing is allowed until all the drains have been removed
- Do not soak in tub for at least 2 weeks after surgery and pat the skin dry afterwards
- Take the antibiotic prescribed until completely gone
- Your prescribed pain medicine should be used on an as needed basis. As soon as you are comfortable doing so switch to extra-strength Tylenol or Ibuprofen, as narcotics may be causing nauseating and/or constipation
- We recommend taking over the counter aids such as senekot-S or Colace while recovering from surgery to maintain bowel regularity
- DO NOT drive until you have stopped all pain medications. For most driving is OK 2 weeks after surgery
- Light meals are better tolerated for the first week after surgery, but in general any food appeals to you is OK
- Avoid alcohol while taking prescription pain medication but it is acceptable in moderation once use of these medications are stopped
- Do not wear a bra for 3 weeks after discharge
- No driving for 2 weeks
- No sexual activity for at least 3 weeks
- No SMOKING
- No lifting of objects >5 lbs. for 3 weeks
- Daily walks are recommended
- Do no sleep on your side or abdomen for 3 weeks
- Flying or traveling as a passenger is OK after the first week
- Always use sun block if sun exposure is expected