Houston Methodist. Leading Medicine.
Houston Methodist. Leading Medicine

Post-op instructions

Patient Surgery Guide - Post Operative Instructions

 

Medications

There are four medications that you will be required to take:

  • Antibiotic – Augmentin 500mg twice daily (if not allergic) until the drains are removed
  • Pain Medication – remember this medication might make you feel groggy and constipated and cannot be mixed with alcohol
  • Aspirin – 325 mg every day for two weeks after surgery
  • Iron – same dose as taken before the surgery.

 

Flap Monitoring

The flap(s) should always be pink and warm. When you press gently with your finger, the flap should blanch for 2 to 3 seconds. If there is any change in the color, temperature, or pain notify the office immediately. The implantable Doppler wires will be kept in place and removed on your first clinic visit.

 

Drains

You will probably be discharged with your drains in place. There are usually two drains in the abdominal area, and one in each operated breast. It is necessary to record total daily output for each drain. When the drain is near full, empty the contents into a measuring cup and record the amount in ml (equal to cc). You can also use the drain bulb itself that has markings to measure the output. Strip the drain tubing every time the drain is emptied. If the drain requires emptying more than once per day, enter the DAILY TOTAL in the appropriate space on the Drain Record Sheet. Once your drain output is less than 20cc total per drain, that drain will be removed in clinic. We use silastic drains, which reduce any discomfort during removal of the drain. The small opening that will remain in the skin will seal in 24-48 hrs.

 

Incision Care

Most of the incisions have absorbable sutures that are hidden underneath the skin. Sometimes, you might feel a small knot come up in the incision area. Do not worry, this cansometimes happen and will be removed during your clinic visit. For the first week after surgery, apply Bacitracin (antibiotic ointment) to the incisions in your breast and abdomen. After the first week, start using a regular skin moisturizer creme to keep the areas from drying out.

 

Umbilicus

Your new umbilicus will have some absorbable sutures around it. There might be some drainage and moisture in that area. Apply Bacitracin ointment for the first week and after that apply dry gauze to keep this area clean and dry.

 

Surgical Garments

You will be fitted with a surgical bra and girdle preoperatively. You can wear the bra for two weeks and thereafter as you wish for comfort. The girdle helps to control swelling and provides support and should be worn for at least three weeks.

 

Swelling

After surgery, your breast and abdominal area will feel swollen around the incision, especially at the end of the day. This is normal and usually takes at least a month to resolve.

 

Showering

You will be able to shower on the third postoperative day in the hospital. Baths can be resumed one month after surgery, and swimming 6 weeks after surgery.

 

Activities

Regular daily activities can be resumed within one week after surgery. You may perform light chores and start taking walks. Of course, no lifting anything heavier than 10 pounds for the first month. After that, you may gradually resume your exercise regimen and you can return to full active status in 6 weeks.

 

Sleep Position

When you come home after the surgery, you might find it more comfortable to sleep with your head elevated for the first week to decrease the tension in your abdominal area. You should only sleep on your back, and avoid at anytime sleeping on the reconstructed breast flap.

 

Driving

You may start driving after you have stopped all your pain medication. It is best to wait at least two weeks after surgery, in order to feel confident when driving.

 

Scars and Massage

After the incisions have completely healed, you can start applying pressure massage to the incisions to improve the appearance of the scars. Remember, that for the first 6 months, your scars will remain red and with time they will turn lighter as they mature.

 

Smoking

ABSOLUTELY NO SMOKING for six weeks after surgery (this includes staying out of the room with smokers).

 

Support

This is a very difficult period when mood swings and emotions can be overwhelming. Contact our office, there are many support groups available.

 

Mammograms

A routine mammogram does not need to be performed on the reconstructed breast. However, it can be performed if requested by your oncologist or other physician.

If you would like to have additional information please contact us at 713-441-6102.