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Tissue Flap Surgery for Breast Reconstruction: What to Expect at Home

Your Recovery

Breast reconstruction with a flap is surgery to rebuild the shape of your breast after you've had part or all of your breast removed because of cancer. Right after the surgery, you will probably feel weak, and you may feel pain for 2 to 3 weeks. You will be sore in the breast and in the area where the flap was taken. You may have a pulling or stretching feeling in those areas. You can expect to feel better and stronger each day, although you may need pain medicine for a week or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery.

You will likely have several drains near your incision. These help with healing. The drains will be removed when the fluid buildup slows. Drains are usually removed in the first few weeks after surgery.

Stitches usually are removed in 5 to 10 days.

Your new breast may feel firmer and look rounder or flatter than your other breast. It may not have the same shape as your breast did before surgery. It will not exactly match your other breast. Breast reconstruction can't restore normal feeling to your breast. But in time, some feeling may return. It may take several months for your breast to heal.

If you aren't able to have a nipple-sparing mastectomy, you have options if you want your new breast to have a nipple and areola. You can have surgery to create a nipple out of tissue. A tattoo can add colour to the raised nipple and create an areola. Another option is a tattoo of a nipple and areola that creates a 3-dimensional look. Or you may use a prosthetic nipple and areola that attaches temporarily to your breast.

This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.

How can you care for yourself at home?

Activity

Rest when you feel tired. Getting enough sleep will help you recover.
For about 6 weeks after surgery, avoid lifting anything that would make you strain. This may include a child, heavy grocery bags, milk containers, a heavy briefcase or backpack, cat litter or dog food bags, a vacuum cleaner, or anything that weighs more than 4.5 to 7 kilograms (10 to 15 pounds). Do not lift anything over your head for 3 to 6 weeks.
When you bend or cough, use your hands or a firm pillow to support the area where the muscle flap was taken. This will help reduce pain.
Ask your doctor when you can drive again.
Ask your doctor when it is okay for you to have sex.
You can take your first shower the day after the drain near your incision is removed. This is usually in about 1 week. Do not take a bath or soak in a hot tub for about 4 weeks.
You will probably be able to go back to work or your normal routine in 3 to 6 weeks. This depends on the type of work you do and any further treatment.

Diet

You can eat your normal diet. If your stomach is upset, try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt.
Drink plenty of fluids (unless your doctor tells you not to).
You may notice that your bowel movements are not regular right after your surgery. This is common. Try to avoid constipation and straining with bowel movements. You may want to take a fibre supplement. If you have not had a bowel movement after a couple of days, ask your doctor about taking a mild laxative.

Medicines

Your doctor will tell you if and when you can restart your medicines. He or she will also give you instructions about taking any new medicines.
If you stopped taking aspirin or some other blood thinner, your doctor will tell you when to start taking it again.
Take pain medicines exactly as directed.
- If the doctor gave you a prescription medicine for pain, take it as prescribed.
- If you are not taking a prescription pain medicine, ask your doctor if you can take an over-the-counter medicine.
If you think your pain medicine is making you sick to your stomach:
- Take your medicine after meals (unless your doctor has told you not to).
- Ask your doctor for a different pain medicine.
If you were given medicine for nausea, take it as directed.
If your doctor prescribed antibiotics, take them as directed. Do not stop taking them just because you feel better. You need to take the full course of antibiotics.

Incision care

If your doctor gave you specific instructions on how to care for your incision, follow those instructions.
You may be wearing a special bra that holds your bandages in place after the surgery. Your doctor will tell you when you can stop wearing the bra. Your doctor may want you to wear the bra at night as well as during the day for several weeks. Do not wear an underwire bra for 1 month.
If you have strips of tape on the incision, leave the tape on for a week or until it falls off.
Wash the area daily with warm, soapy water, and pat it dry. Don't use hydrogen peroxide or alcohol, which can slow healing.
You may cover the area with a gauze bandage if it weeps or rubs against clothing. Change the bandage 1 or 2 times every day. Consider having someone help you with this.
Keep the area clean and dry.

Drain care

You may have one or more drains near your incision. Your doctor will tell you how to take care of them.

Exercise

Try to walk each day. Start by walking a little more than you did the day before. Bit by bit, increase the amount you walk. Walking boosts blood flow and helps prevent pneumonia, constipation, and blood clots in your legs.
Avoid strenuous activities, such as bicycle riding, jogging, weight lifting, or aerobic exercise, until your doctor says it is okay. This includes housework, especially if you have to use the arm on the side of your surgery.
Your doctor will tell you when to begin stretching exercises and normal activities.

Elevation

Prop up the arm on the side of your surgery on a pillow when you sit or lie down. Try to keep your arm above the level of your heart. This will help reduce swelling.

Follow-up care is a key part of your treatment and safety. Be sure to make and go to all appointments, and call your doctor or nurse advice line (811 in most provinces and territories) if you are having problems. It's also a good idea to know your test results and keep a list of the medicines you take.

When should you call for help?

Call 911 anytime you think you may need emergency care. For example, call if:

You passed out (lost consciousness).
You have chest pain, are short of breath, or cough up blood.

Call your doctor or nurse advice line now or seek immediate medical care if:

You have pain that does not get better after you take pain medicine.
You are sick to your stomach or cannot drink fluids.
You cannot pass stools or gas.
You have loose stitches, or your incision comes open.
Bright red blood has soaked through the bandage over your incision.
You have signs of infection, such as:
- Increased pain, swelling, warmth, or redness.
- Red streaks leading from the incision.
- Pus draining from the incision.
- A fever.
You have signs of a blood clot in your leg (called a deep vein thrombosis), such as:
- Pain in your calf, back of the knee, thigh, or groin.
- Redness or swelling in your leg or groin.

Watch closely for changes in your health, and be sure to contact your doctor or nurse advice line if you have any problems.

Where can you learn more?

Go to https://www.healthwise.net/patientEd

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Care instructions adapted under license by your healthcare professional. If you have questions about a medical condition or this instruction, always ask your healthcare professional. Healthwise, Incorporated disclaims any warranty or liability for your use of this information.