Breast Reconstruction (mastectomy) Pre & Post-Operative Instructions

Pre-Operative Instructions

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  • Please advise the doctor if you are taking any blood thinning medication (e.g. Warfarin, Disprin, Aspirin, etc.)
  • This will need to be discontinued prior to surgery as per doctor’s instructions.
  • Uncontrolled high blood pressure raises the risk of bleeding complications in all forms of surgery – please ensure your blood pressure is well controlled prior to your surgical date.
  • DO NOT take any of the following medications prior to surgery:

– Anti-inflammatories (e.g. Brufen, Ibuprofen, Myprodol, Voltaren, etc.).

– Homeopathic medications (e.g. Arnica, Rescue Remedy, St John’s Wort).

– Vitamin E (oral or topical).

  • Prepare your skin for 3 weeks before surgery with Dermalac Lotion and Vitamin A, C & E Body Oil from Environ.
  • Take a bath or shower with antibacterial soap (or Bioscrub) on the morning of your admission.
  • Do not apply any body lotion.
  • Regardless of whether you are having a general anaesthetic or conscious sedation – you should not eat or drink anything for 6 hours prior to surgery.
  • If you are a smoker – NO SMOKING for 3 months prior to surgery.
  • Bring comfortable cotton underwear.

Post-Operative Instructions

  • You will need someone to drive you home after your surgery and help you for 1 to 2 days.
  • You will need plenty of rest.
  • Decreased activity and pain medication may promote constipation, so you may want to add more fruit and fibre to your diet.
  • Be sure to increase your fluid intake.
  • Take pain medication as prescribed. Do not take aspirin or any products containing aspirin.
  • Do not drink alcohol when taking pain medications.
  • If you are taking vitamins with iron, resume these as tolerated.
  • Do not smoke, as smoking delays healing and increases the risk of complications.

Activites

  • Start walking as soon as possible – this helps to reduce swelling and lowers the chance of blood clots.
  • Do not drive until you are no longer taking any pain medications.
  • Limit use of arms for 4 weeks, i.e. no heavy lifting or raising arms above your head.
  • Resume sexual activity as comfort permits, usually 2 to 3 weeks post-operatively.
  • Avoid strenuous exercise and activities for 4 to 6 weeks.
  • Social and employment activities can be resumed within 7 to 14 days.

Incision Care

  • You may shower only after your post-operative appointment (usually 4 days postoperatively).
  • Avoid exposing your scars to the sun for at least 12 months.
  • Always use sunblock – regardless of the weather – if you plan to go outdoors or not.
  • Apply Micropore to the incision lines for 3 months – change every 7 to 10 days. Do not remove the tape every day as it will cause irritation of the surrounding skin.
  • Keep incisions clean and inspect through Micropore daily for signs of infection or oozing.
  • DO NOT USE ANY CREAMS CONTAINING VITAMIN E TO TREAT THE INCISION AREAS FOR THE FIRST 3 MONTHS.
  • Incision areas may be massaged through the Micropore for the first 3 months.
  • ScarScience, available from the therapists, should be applied from 6 weeks postoperatively – over the Micropore for another 6 weeks – and then on the incision directly for another 3 months post-operatively.
  • No soaking in the bath while sutures or drains are in place.
  • Support garments should be worn 24/7 and only removed for short periods while taking a shower. You should wear the post-operative bra day and night for 6 weeks, and thereafter for 6 weeks during the day.

What To Expect

  • Discomfort will be maximal in the first 7 to 10 days, improving each day thereafter.
  • You may experience temporary pain, soreness, numbness, dry breast skin, swelling and discoloration or incision discomfort.
  • Scars will fade in several months to a year.

Appearance

  • Scars will be red for 6 to 9 months. After that, they will fade and soften.

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Follow Up Care

  • Drains will be removed when drainage is less than 30 ml for 24 hours.
  • Most of the sutures are buried and will dissolve in 6 to 8 weeks.
  • Any stitches will be removed in 7 to 10 days.
  • ScarScience must be applied on the incision from 6 weeks post-operatively to help with the prevention of hypertrophic and keloid scarring. It should be used for at least 3 to 6 months post-operatively.

When To Call

  • If you have increased swelling or bruising.
  • If swelling and redness persist after a few days.
  • If you have increased redness along the incision.
  • If you have severe or increased pain not relieved by medication.
  • If you have any side effects to medications, such as rash, nausea, headache, and vomiting.
  • If you have an oral temperature over 37°C.
  • If you have any drainage from the incisions or notice a foul odor.
  • If you have bleeding from the incisions that does not stop with light pressure.

Emergency Contact: 078 867 61372

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