You will need to arrive at least two hours prior to the surgery. You will meet your anesthesiologist and will have the opportunity to see your surgeons before you are taken to the operating room. Your family members will be directed to a waiting room, but should remember that this is a long day and they may wish to be contacted on a cell phone instead as we will be sending periodic updates. After the surgery, you will be taken to the Surgical Intensive Care Unit for flap monitoring. This is usually performed with a special implantable Doppler, which is a device that connects a tiny wire to a machine that measures blood flow in the flap. You will also have plastic drainage tubes, two for the abdomen and one for each operated breast.
First Post-operative Day
This is a day in the Surgical Intensive Care Unit. You must remember, that the reason for being there is for flap monitoring, and not because of your medical status. You will be in a private room that will be kept quite warm for purposes of blood flow to the flap. You will have a button for pain control that you can push which will automatically administer a safe dose of pain medication in your IV. There will be a urinary catheter in place to drain your bladder. Depending on your appetite, you will be given clear liquids and advanced to a regular diet as tolerated. Also, you will be asked to exercise your lungs and expand them by breathing into a special plastic straw. You will have stockings on your legs and covered by a compressive booties that intermittently gently squeeze your calves to prevent blood clots from forming in your veins while you are in bed. As soon, as you feel up to it, the nurses will get you up into a recliner chair.
Second Post-operative Day
Usually, this is the day for the transfer from the Intensive Care unit to the surgical floor. Your dressings will be changed, and the nurses will continue to monitor the flap(s) every hour. You should be in the recliner at least twice and may start walking to the bathroom.
Third Post-operative Day
Your pain level usually will be much lower, and your pain medication will then be switched to pills by mouth. Your IV fluids will be discontinued, but the small IV catheter will stay in place for antibiotics. Your urinary catheter will be taken out. You will be a able shower with the nurses help and after you will put on the surgical bra and girdle. Ambulation is very important and you will be encouraged to walk in the hallway at least three times.
Fourth/Fifth Post-operative Day
Depending on your hospital course you will be ready for discharge on the fourth or fifth post-operative day. The nurses will teach you how to take care of the drains and incisions.