We specialize in state-of-the-art breast reconstruction techniques using your body’s own tissue without sacrificing important functional muscles.

Considered the most advanced in the world today, our procedures result in a breast that closely matches your own in shape and softness.

Post Surgery Instructions

You should be extremely proud of yourself once you return home.  You have made it through significant surgery and the first critical days of recovery.

In the weeks ahead, your focus will be on making a full recovery and a fresh start.  The goal is to have you feeling strong and full of life as soon as possible. To ensure your recovery goes well, it is important that you adhere strictly to the following guidelines regarding activity, medication, diet, drain and wound care.

Questions and Concerns

If you have any concerns or questions following your surgery, please contact your plastic surgery nurse.

For urgent concerns after hours or on weekends please call HSC paging at 787-2071 and ask to speak with the Plastic Surgery Resident on call or come to the Health Sciences Centre Emergency Department.

 

Monitoring Your Breast and Surgery Incisions

It is important to check your breast and all incisions daily for signs and symptoms of infection.   Please contact the clinic nurse or the plastics resident on-call immediately if you observe the following changes to your breast or incision:

  • Increased size
  • Increased firmness
  • Cool temperature to skin
  • Change in color
  • Incision line separation

Check your incision for:

  • Increased warmth or spreading redness of the skin near a site
  • Increased swelling
  • Increased pain or tenderness
  • Increased discharge at site (creamy yellow/green)
  • Foul smelling odor
  • Fever or chills
  • Elevated temperature greater than 38°C

Preventing Blood Clots

To prevent blood clotting it is important to do short periods of light activity like walking at least five or six times a day.   If blood clots develop in your legs, they can break off and travel to the heart or lungs and become potentially fatal.

Seek medical attention immediately if you experience:

  • Pain or swelling in your legs
  • Difficulty breathing or shortness in breath
  • Coughing up blood
  • Chest pain
  • Anxiety

Most sutures are dissolvable and do not require removal. The blue stitch on your breast will be removed at your first follow up appointment.  Your drain tubes are held in place with a suture that will be removed when your drain is ready to come out.

Dressings

Most patients require minimal dressings. You will receive a light non-stick dressing along the incision if you experience any oozing along the incision line. Dressings should be changed daily.

Bathing and Wound Care

You are normally allowed to shower four days after your surgery.  Do not soak in a bath. While showering, let the water run gently over your incisions and drain sites.  Do not allow the water to directly spray on the incisions.  Pat all incision lines dry.  If you have steri-strips on your incisions simply pat them dry and leave them intact until they fall off on their own.

You may be sent home with number of prescriptions.  It is important to avoid alcohol while taking any prescription medications.

Antibiotics are prescribed to treat or prevent infection.  Please follow instructions for use, and take them all until finished.

Pain Medication: Tylenol 3 is most commonly prescribed. As soon as you feel comfortable doing so, you may switch to extra-strength or regular Tylenol, to avoid the nausea and constipation commonly associated with Tylenol 3.

Iron supplements may be recommended to help you recover from blood loss.

Stool softeners: The combination of pain medication, iron pills and decreased mobility may leave you constipated.  We suggest an over-the-counter aid such as Senekit or Colace to maintain bowel regularity.

 

Drain Care

You will likely go home with drains in your breast and donor site. You must empty these drains twice a day and record the amount of output from each.

EXAMPLE Left breast Left abdomen Right abdomen
9 am 40cc 60cc 40cc
9 pm 25cc 20cc 30cc
—– —— ——–
DAILY TOTAL 65cc 80cc 70cc

Before you empty the container, you should milk the tubing to prevent clots from plugging the tube.  Use one hand to hold the tubing closest to your skin in a stable position.  With the other hand, gently pinch the tubing and slide your fingers down toward the drain canister. Open the lid of the drain and empty the contents into a measuring cup. Squeeze all the air out of the drain canister and then replace the cap.

Drainage tubes are ready to be removed when the amount coming out of them is less than 30cc in a 24 hour period.  Please call the nurse to arrange a time to come to the clinic to have the drains removed.

If a drain tube is accidentally pulled out from the site NEVER try to push the tube back into your body. If the drain canister is still holding suction please tape the tube in the exact position it is – don’t force it back.   If the drain canister is no longer holding suction, let the rest of the tube gently slide out (do not pull if it feels stuck) and apply a clean gauze bandage to the site.  Please call the clinic nurse or on-call resident for further instructions.

 

Activities of Daily Living

  • Do not lift anything heavier than a phone book for four weeks.
  • No driving for three weeks.
  • No sexual activity or strenuous exercise for at least four weeks.
  • Avoid smoking and exposure to second hand smoke for at least six weeks.
  • Avoid sun exposure for six months.

Time Off Work

Most patients may return to work four to six weeks following a breast reconstruction surgery, or two to four weeks following reconstruction with an implant. If your job requires physical exertion, more time may be needed.

Walking, Sitting, and Sleeping

Abdominal DIEP/SIEA flap patients:

  • Maintain a bent forward posture.
  • Sleep on your back with your head and knees elevated.
  • Rest with your head and knees elevated.
  • Do not lay on your side or back.
  • Continue to wear your compression bra and other garments except while showering.


Inner Thigh TUG flap patients:

  • Keep your knees together for four weeks.
  • Sleep flat on your back, with your knees together.
  • Sit in a reclined position, leaning back, to avoid any tension on your inner thigh incision.
  • Continue to wear your compression bra and other garments except while showering.


Buttock SGAP/IGAP patients:

    • Please lay flat on your back or stand straight.
    • Sleep flat on your back.
    • To avoid any tension on your buttock incision line – do not sit.
    • Continue to wear your compression bra and other garments except while showering.
    • Increase your daily walking (2-3 blocks).

General Instructions

  • There are no restrictions to shoulder movement. Start by lifting your arm above your head and work towards full movement. By week five, your shoulder movement should be back to normal.
  • Most patients may return to work four to six weeks following a breast reconstruction surgery, or two to four weeks following reconstruction with an implant. If your job requires physical exertion, more time may be needed.

Special Garments

Many patients experience a throbbing sensation in the first four to six weeks when they are not wearing their support garments. Increased tension on the incision may also cause your scars to stretch, so a properly supportive bra should be worn until your scar fully matures, which may take up to a year.

Exercise

Short, frequent walks are the best exercise for all patients. Walking at least five orsix times a day is also recommended to prevent blood clots. Strenuous exercise should be avoided for at least four weeks.

Diet

Your diet is an important part of recovery. A healthy balanced diet will provide your body with the energy and nutrients it needs to recover and stay healthy in the long term. A healthy diet contains a variety of foods including plenty of fruit and vegetables, fibre (wholegrain bread, rice, pasta and beans) and protein-rich foods like fish, eggs, lentils, dairy and meat.  It is also important to drink plenty of water every day.

You should avoid caffeine for at least three weeks, and also avoid alcohol while taking prescription medications.

For more information on diet visit the Canadian Cancer Society.

Sun Exposure

Please avoid sun exposure for at least six months.

What Else to Expect

It is normal to experience some swelling of the breast and donor site for one to three months.  Numbness in both the breast and the donor site may never completely go away.