Home/Discharge Instructions for Immediate Breast Reconstruction Expander/Implant After Bilateral Mastectomy:
NOTE: These instructions were given to me explicitly from MY Plastic Surgeon, for MY individual post-op care according to MY medical history and needs. If you have any medical concerns or questions, DO NOT take advice from the internet, CALL YOUR ATTENDING PHYSICIAN!
I have included the photo, on the left, to give an idea of the extent of this surgery, the mastectomy. The photo is NOT of me, it is courtesy of Breastfree.org which is a terrific site for persons choosing to forego any reconstructive surgery after mastectomy.
My particular scars would be about the same size and length with the only exception that I opted to have immediate reconstruction which included tissue expanders, my chest would have slightly “filled” areas where the breasts were and will “grow” larger as the expanders reach full capacity.
…Continuing with the Discharge Instructions:
- Rest the first 24 hours. Take prescribed pain meds and antibiotics as instructed. START your oral antibiotic with your first meal at home and continue until gone.
- Keep your elbows to your sides, (T-Rex.)
- DO NOT move your pectoralis major muscles by raising your arms for 2 weeks after surgery. This will contract the muscle sitting over the expander/implant and could cause shifting.
- Immediately after surgery, apply ice packs to the surgical area, 20 minutes on and 20 minutes off until midnight. You can resume the following morning, 20 minutes on every 1-2 hours for comfort. You can continue to use ice packs up to 72 hours after surgery.
- JP Drains: Strip the drain tubes 2 x daily, empty the drains every six hours and record the output of each drain separately. Clean the sites twice daily and apply antibiotic ointment around the tube at the exit site of the skin. Bring the drain-flow sheet to your follow-up appointment.
- It is imperative that the recording of the drains is accurate, serious complications could arise if one cheats in the reporting or does not empty, strip, or clean the area of the drains as prescribed.
- Surgical Compression Garment: Must be worn 24 hours per day for several weeks following the surgery. My doctor supplied the Jobst Surgical Vest for me and put it on me after the operations were complete.
- AFTER 24 HOURS: Clean the incisions twice daily. Remove the compression bra, dressings, tape, gauze, yellow gauze, but leave the Steri-strips on the incisions in place. Gently clean the incisions between the Steri-strips with cotton ball or gauze and 1/3 peroxide and 2/3 water, no rubbing or scrubbing. Pat dry, apply a thin layer of Bacitracin antibiotic ointment over the incisions and place gauze over the site, DO NOT USE TAPE! Slip into your *compression garment.
- *For me, it was a worthwhile investment to buy another surgical vest, making it so much easier to always have a clean one for after showering, sure, you have to wash one every day, but, for me, that’s cheaper than buying 3 or more of them, they are on the expensive side!
- AFTER 48 HOURS: You can shower, OR you can wait until another 24 hours after the pain pump is removed. (Pain pump is removed 4 days after surgery.) While you shower, you must wear something around your neck to hold up the JP Drains(I used some crafting string.)
- Pain Pump Removal: On day 4 after surgery, you will remove the pain pump.
- Remove the clear tape and Steri-strips holding the tubing. Take a deep breath and as you slowly blow-out, pull the tubing from the body in one, fluid, smooth movement. Apply Bacitracin antibiotic ointment and a Bandage to the entry points. DO NOT SHOWER for 24 hours after removal. You can throw the pain pump and the tubing away.
- I did remove the pain pump at home, by myself, well, with a little help from my husband, however, when he held one of the tubes to pull it out, he was pulling rather f-a-s-t! I told him to slow down! I actually became scared because there was tape and Steri-strips and I was just frightened, so I phoned my Plastic Surgeon. She was at one of her children’s soccer games, but spoke with me and walked me through removing the pump.
This picture is not of me, it is of a patient at the Cosmetic Surgery Forums, but, it looks similar to what my post-op situation was, except, I did not have such large breast mounds! What you are seeing in the photo is the pain pump, the 2 wires in-between her breasts, the JP Drains are those hoses coming out of her upper sides, and the bulbs attached to her pants.
- No Aerobic activity, or strenuous activity, including vigorous housework, for 4-6 weeks after the procedure, until released to do so.
- Follow-up with your doctor within one week of surgery!