Planning for Surgery
Before surgery, your health status will be assessed. Tell your doctor or nurse about all medicines that you take, including prescription drugs, over-the counter medicines, and vitamins and herbal supplements. You will be asked to stop taking blood thinners, aspirin products, anti-inflammatory medications such as ibuprofen, vitamin E and all herbal drugs.
Exercise, get plenty of rest, and eat well so that you will be as healthy as possible before surgery. If you smoke, you should stop. Some surgeons will not perform breast reconstruction procedures on smokers because surgical wounds may not heal as well; this can also delay other forms of treatment you may need.
Your recovery period can be more comfortable if you think about and prepare for your needs before you return home. Planning meals in advance or lining up assistance from family or friends, for example, is helpful. You will not be able to lift heavy items (a rule of thumb is nothing heavier than an old phonebook) so gallon jugs of milk or large bags of pet food should be put in smaller containers. In most cases, you will not be able to raise your arms above your head right away – soft, oversize or front button-down shirts will be most comfortable. This discomfort will go away over time with exercise.
What to Expect for Surgery
Reconstruction surgery is performed in a hospital, at an ambulatory surgery center, or at an office-based surgical center. Your surgeon will use a skin marker to confirm the incisions and make other marks to guide the surgery. To make sure you are comfortable, you will receive general anesthesia (you are asleep and pain-free) or intravenous sedation (you are easy to awaken and pain-free) during your procedure. If general anesthesia is planned, you should not eat or drink for 8 to 12 hours before your surgery is scheduled.
When you awake from surgery, you will have gauze or bandages over your incision and a support bra or elastic bandage to reduce swelling and secure the reconstructed breast. A small, thin tube or tubes (surgical drains) will be under your skin to help remove excess fluid or blood from the surgery site. Ask your doctor about bathing, showering, how to measure the fluid, and keep the drain clean. Be sure you understand how to take care of the drains and incisions.
Your doctor will prescribe pain medicine and antibiotics. Make sure your pain is controlled. You may have a pain pump that allows you to press a button to receive narcotic pain medication through a vein for one to three days after surgery. Sometimes, your surgeon will use a “pain ball” (non-narcotic) which slowly deflates, dripping pain medicine and a local anesthetic to the reconstructed area. Visits to your plastic surgeon will be scheduled to remove the drains and make sure that you’re recovering well. You cannot drive when you are taking narcotic pain medication, so you should plan for someone to drive you.
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The first phase of the healing process for reconstructive surgery takes at least 4–6 weeks and you might feel tired and sore. When a woman opts for immediate reconstruction, she may recover 4-6 weeks faster than a woman who opts for delayed reconstruction. More than one operation may be required to complete the process or achieve the result you want.
The shape and position of the new breast will improve as swelling decreases. Over time, some sensation may return to the reconstructed breast. But, it is hard to re-create the look and feel of a natural breast; most women are pleased with their new breast silhouette after reconstruction.