Tissue Expander Reconstruction
- You may have drains in place after the surgery. You will be shown how to care for the drains. Cover the drains’ entry site with a split gauze. Record drainage and empty the bulb every 12 hours. Strip the tubing by pinching one hand near the exit site and strip the tubing between the thumb and index finger of the opposite hand. If the drain should accidentally fall out, cover the site with a dry gauze dressing. DO NOT attempt to push the drain back- this will result in infection.
- Bring the record of the drainage amounts with you to your next appointment.
- The drain operates by vacuum. If the bulb is not compressed, the drain will not function properly. Please make sure to keep the collection bulb compressed.
- Please bring the card recording the drainage amounts to the office for each appointment.
- You may shower with in 24 hours after surgery. Please remove the garment and the dressings over the incision but leave the steri-strips (paper tapes) in place. This will keep the incision from widening. Do NOT submerge the incision for at least 6 weeks. Baths and hot tubs can be resumed once all areas are completely healed. NEVER use a heating pad on the abdomen or breast, burns can easily occur. A blow drier set on a “cool” setting is helpful in drying the areas after a shower. Place a hand at the site to make sure that the air stream remains cool.
- Affix the drain to a “belt” while showering- (and old housecoat cord or old pair of panty hose tied in a loop around the neck or a belt around the waist works well for this purpose)
- Expect significant tightness and occasional muscle spasms in the chest or back area. This soreness will decrease slowly over the next several weeks. Some tightness with certain activities may persist for months. Numbness at the surgical site is expected. Be careful in adjusting the temperature of water in the shower. Heating pads should NEVER be used in the areas in order to prevent burns.
- Cover the incision with gauze, “Light Days” feminine napkins or nursing pads, allowing the bra, garment or light tape to hold them in place. This is recommended as long as there is drainage and to prevent irritation of the incisions. We prefer that you wear the surgical bra provided day and night (except to shower) for the first 4-6 weeks. You can wash the bra in the washer on a gentle cycle and line dry it. Under wire bras should be avoided for the first 3-6 months. The stays can be removed from old bras by clipping the cuff and removing the wire.
- Driving may be resumed once one’s reaction times, reflexes, and abilities are back to “normal”. One cannot drive while taking narcotic pain relievers. This usually requires up to 7 to 10 days for most people to be safe behind the wheel.
- Ice packs (bags of frozen peas or corn work well for this purpose) may be used on the sides or underneath the breast for the first 1-3 days post-op. This may provide some additional comfort and help decrease swelling. Never put ice directly on the skin, as this might cause frostbite.
- Expect pieces of yellow fatty material or clots of old blood to be present occasionally in the drain bulb or tubing. This is not problematic. DO NOT disassemble the drain to remove this material.
- One should continue antibiotics orally as long as the drain remains in place. Please use the refills as needed
- Avoid heavy lifting for at least 6 weeks after surgery. A 10-15 pound weight limit is advisable initially. Strenuous activity should be limited for 6-8 weeks post-operatively. To avoid wound healing problems and disruption of wounds on need to be mindful of one’s activities. Be aware that it takes 42 days for most wounds to achieve 70% of the strength of intact skin. Even though you may feel “healed” in 2-4 weeks, the wounds are not as strong as you think.
- Activity should be gauged to how one feels. Early ambulation is strongly encouraged. More strenuous activity can resume in 2 weeks. Elevation of the heart rate and blood pressure should be avoided for the first 2 weeks to minimize swelling and bruising. After 2 weeks, one can increase one’s pace in walking but should not resume jogging, aerobics, or high impact activities for at least 6 weeks post-op.
- It is not uncommon that an occasional dissolving suture will surface along the wound presenting as a small open area. This is frequently misinterpreted as “infection”. Removal of the offending suture will usually result in rapid healing. We will do this for you as needed in the office.
- Temperature elevations from 100-101 degrees in the first 2-4 days are usually due to collapse of the small air passages in the lungs after general anesthesia. This usually dose not represent infection in most cases unless accompanied by other signs and symptoms such as redness, unusual drainage, increasing pain etc. This usually improved with deep breaths, increased activity and occasionally forcing a cough to re-expand the lungs.
- All pain medication can cause nausea when taken on an empty stomach. Please take every does with food to avoid this problem. A choice of pain medications has been provided. Please choose one and do not change unless a problem occurs with a particular medication or you wish to step down to a lesser strength narcotic. ALL pain medications cause constipation. Please use laxative or stool softeners as needed.
- Early and frequent walking is necessary to prevent the risk of blood clots that could pass to the heart or lungs resulting in a pulmonary embolus. Significant pain and swelling in the leg or sudden onset of shortness of breath are very important symptoms that demand immediate attention.
- The sutures that were used are absorbable. We will snip off the knots during a post-op visit.
- Please leave the steri-strips on the incisions as long as possible; eventually they will come off by themselves. This will help prevent the scar from widening.
- If you develop increased redness, warmth, pain, or temperature in excess of 101 degrees, please call our office and have your pharmacy’s phone number available.
- Resumption of sexual activity is dictated by ones’ physical comfort level.
- Deodorant can be used however one should not get this into the incisions.
- Please keep in mind that the final appearance of the tissue expander reconstruction will not be evident for a few months. This is a work in progress. Your patience is appreciated!
If you have any questions that our office has not covered, please call us.