Breast reconstruction instructions
- Drain Care
- Breast Reduction
- Tissue Expander / Implant-based breast reconstruction
- DIEP / Free TRAM Flap (abdominal tissue flap-based breast reconstruction)
- Latissimus Flap (back tissue flap-based breast reconstruction)
- LTP/TUG/PAP (thigh flap-based breast reconstruction)
- SGAP / IGAP (buttock flap-based breast reconstruction)
- Oncoplastic Breast Reconstruction
- Implant Exchange/Replacement
- Fat Grafting
- Nipple Reconstruction
What is a JP drain?
A Jackson-Pratt (JP) drain is a type of drain that is placed in an incision during surgery. The drain is made up of a hollow tube that is connected to an egg-shaped bulb. The hollow tube begins inside the incision and exits the body. Attached to the end of the tube outside of the body is the collection bulb. This bulb collects fluid from the incision (see diagram below). What does a JP drain do? The JP drain helps drain excess blood and fluid from under the skin and the incision site. When you squeeze the egg-shaped bulb, fluid is sucked out. If the bulb is not squeezed tightly, the fluid will not drain. Why is the JP drain needed? The JP drain helps to keep fluid from collecting in the wound. It does this by removing the excess blood and fluid from under the skin and in the incision. The JP drain is temporary. It stays in place until the drainage has slowed down or stopped. As healing occurs, the fluid collected in the drain bulb should change color. It becomes less bloody, and the amount gradually decreases. Your doctor will decide when the drain should be removed. It will be removed in your doctor’s office. How do I care for the JP drain at home? Pin your JP drain to your clothing by using a safety pin through the plastic loop on the top of the bulb. If the drain is not attached to your clothing, it may pull out from under your skin. Also, a drain usually feels more comfortable when it is attached. To care for the JP drain at home, you will have to empty the drain and change the dressing. Emptying the drain You will need: --the measuring cup provided by the hospital, or a similar small measuring cup used exclusively for this purpose. --paper to make a daily JP drainage chart for each drain. Record AM drainage and PM drainage each day and record. 1. Wash your hands with soap and water. 2. Hold the drain securely. 3. Remove the drainage plug from the emptying port. 4. Carefully turn the bulb upside down over the measuring cup, and gently squeeze all of the drainage into the measuring cup. 5. Squeeze the middle of the bulb. 6. While still squeezing the bulb, replace the drainage plug. This step is important to keep the drain sucking. 7. Measure how much fluid you removed from the bulb. 8. Write down the amount of the fluid you removed from the bulb. If you have more than one drain, keep a separate record for each one. 9. Empty the fluid into the toilet and flush. 9. Rinse the measuring cup, and wash your hands with soap and water. 10. You should empty the drain at least two times each day, in the morning and at bedtime. Stripping the Drain To prevent clots from blocking the drain, you will need to “strip” it. Stripping means that you use your fingers to squeeze along the length of the drain to help maintain the flow of drainage. 1. Using one hand, firmly hold the tubing near the insertion site (close to your skin). This will prevent the drain from being pulled out while you are stripping it. 2. Using your index finger and thumb of the other hand, squeeze the tubing below the first hand. You should squeeze it firmly enough so the tubing becomes flat. 3. As you are squeezing, slide your index finger and thumb down the tube about 6 inches toward the bulb. Then, release the tubing held by the hand closest to your body. Repeat. 4. Do not release the pressure you are creating in the tubing until you reach the bulb. 5. Strip the drain each time you empty it. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS! |
breast reduction
ACTIVITY:
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. Remember that protein intake is extremely important for wound healing. We recommend 70-90 grams of protein daily after surgery. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising.
POSITIONING:
Do not lay on your sides or stomach for 4 weeks after breast reduction surgery.
WOUND/DRAIN CARE:
There may be drains present to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. NO ICE PACKS!
BATHING:
(Ignore this part if you've had nipple grafting, and follow the specific directions given to you in the hospital.)
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place. Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office. Occasionally we do use prescription ointments to help with wound healing if necessary.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. If you've had nipple grafting (Dr. Gimbel would have discussed this with you), you will have yellow gauze stitched to the skin over each nipple. If you've had nipple grafting, leave the bra and dressings in place until your first post-op clinic visit (4-6 days after surgery). If you've not had nipple grafting, you may remove the bra and gauze 48 hours after surgery. Go ahead and shower at this point, gently running your soapy hands over the operative sites. Rinse and gently pat dry, and redress with sports bra.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
Please note that it is normal for there to be some pain at the surgical site(s). Pain is unavoidable with most surgeries and should be addressed with the pain medications that were prescribed to you. Mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 1 week off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work). Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. Remember that protein intake is extremely important for wound healing. We recommend 70-90 grams of protein daily after surgery. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising.
POSITIONING:
Do not lay on your sides or stomach for 4 weeks after breast reduction surgery.
WOUND/DRAIN CARE:
There may be drains present to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. NO ICE PACKS!
BATHING:
(Ignore this part if you've had nipple grafting, and follow the specific directions given to you in the hospital.)
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place. Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office. Occasionally we do use prescription ointments to help with wound healing if necessary.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. If you've had nipple grafting (Dr. Gimbel would have discussed this with you), you will have yellow gauze stitched to the skin over each nipple. If you've had nipple grafting, leave the bra and dressings in place until your first post-op clinic visit (4-6 days after surgery). If you've not had nipple grafting, you may remove the bra and gauze 48 hours after surgery. Go ahead and shower at this point, gently running your soapy hands over the operative sites. Rinse and gently pat dry, and redress with sports bra.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
Please note that it is normal for there to be some pain at the surgical site(s). Pain is unavoidable with most surgeries and should be addressed with the pain medications that were prescribed to you. Mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 1 week off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work). Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Tissue Expander/Implant-based Breast Reconstruction
ACTIVITY:
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
It is important to limit the use of your affected arm(s). Do not extend them above shoulder level until your drains are out. Soreness will persist for weeks to months. Most patients can return to desk-type work when they feel comfortable to do so (2-3 weeks). You can resume most normal activity after 3 weeks, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back to help prevent additional swelling of the breasts. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by your surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. You can remove the bra and dressing at 48 hours after surgery, shower, and replace with clean sports bra. Another trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Remember to wear your support bra 24 hours a day except to shower for 4 weeks. This helps lessen any fluid collection accumulation under the skin. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Malaise
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 2-3 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The expansion process is the time to develop and mature the pockets. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on.
Also, it is normal to have pain and discomfort after mastectomy. This discomfort will improve slowly with time, but 50% of women still have residual discomfort here and there at two years after mastectomy, even without reconstruction! Healing is a slow process.
It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
It is important to limit the use of your affected arm(s). Do not extend them above shoulder level until your drains are out. Soreness will persist for weeks to months. Most patients can return to desk-type work when they feel comfortable to do so (2-3 weeks). You can resume most normal activity after 3 weeks, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back to help prevent additional swelling of the breasts. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by your surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. You can remove the bra and dressing at 48 hours after surgery, shower, and replace with clean sports bra. Another trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Remember to wear your support bra 24 hours a day except to shower for 4 weeks. This helps lessen any fluid collection accumulation under the skin. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Malaise
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 2-3 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The expansion process is the time to develop and mature the pockets. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on.
Also, it is normal to have pain and discomfort after mastectomy. This discomfort will improve slowly with time, but 50% of women still have residual discomfort here and there at two years after mastectomy, even without reconstruction! Healing is a slow process.
It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Abdominal Tissue flap-based breast reconstruction (DIEP/FTRAM)
ACTIVITY:
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. NO STRENUOUS ACTIVITY is allowed. Do not lift, push, pull anything heavier than a gallon of milk (about 5-10 lb) for 8 weeks after surgery. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay in a "lounge chair position" for 2 weeks. This can be done in a recliner or in bed with your head elevated on two pillows and your knees elevated with two pillows. You will also need to walk in a ''bent-over" position for the first week after surgery. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. In some people, this puts strain on the back. If necessary, you can request a walker while in the hospital to help walk bent over (but most people do not need this). Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be one to two drains present in the abdomen and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel.
Keep the abdominal binder on most of the time for one month. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you may have gauze dressings on your abdomen with an abdominal support binder holding them in place: It is helpful to safety pin your drains to the binder to keep them secure. It is very important to keep this binder in place at all times except for when cleansing your wounds, showering, or when washing the binder. Please change the gauze pads daily after wound cleansing or as needed when soiled, making sure your drains are well padded beneath the binder. No need to use tape, the binder holds everything in place. An optional trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Another trick is to wear an oversized clean cotton T-shirt beneath the beneath the binder, as it will help protect your skin from the scratchy binder. Please note -- you may wash your abdominal binder in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on.
Also, it is normal to have pain and discomfort after mastectomy. This discomfort will improve slowly with time, but 50% of women still have residual discomfort here and there at two years after mastectomy, even without reconstruction! Healing is a slow process.
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. NO STRENUOUS ACTIVITY is allowed. Do not lift, push, pull anything heavier than a gallon of milk (about 5-10 lb) for 8 weeks after surgery. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay in a "lounge chair position" for 2 weeks. This can be done in a recliner or in bed with your head elevated on two pillows and your knees elevated with two pillows. You will also need to walk in a ''bent-over" position for the first week after surgery. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. In some people, this puts strain on the back. If necessary, you can request a walker while in the hospital to help walk bent over (but most people do not need this). Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be one to two drains present in the abdomen and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel.
Keep the abdominal binder on most of the time for one month. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you may have gauze dressings on your abdomen with an abdominal support binder holding them in place: It is helpful to safety pin your drains to the binder to keep them secure. It is very important to keep this binder in place at all times except for when cleansing your wounds, showering, or when washing the binder. Please change the gauze pads daily after wound cleansing or as needed when soiled, making sure your drains are well padded beneath the binder. No need to use tape, the binder holds everything in place. An optional trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Another trick is to wear an oversized clean cotton T-shirt beneath the beneath the binder, as it will help protect your skin from the scratchy binder. Please note -- you may wash your abdominal binder in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
- Any change in breast flap color (purplish, blueish, or white changes can all signify problems – call immediately!)
- Severe pain uncontrolled with prescribed pain medication
- Excessive swelling or tightness
- Fever above 101.5 degrees or shaking chills
- Excessive, thick, or foul smelling drainage
- Sudden onset of shortness of breath, chest pain, or calf pain
- Hives or rashes
- Nausea/Vomiting with inability to tolerate fluids
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on.
Also, it is normal to have pain and discomfort after mastectomy. This discomfort will improve slowly with time, but 50% of women still have residual discomfort here and there at two years after mastectomy, even without reconstruction! Healing is a slow process.
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
back tissue flap-based breast reconstruction
ACTIVITY:
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
It is extremely important that you limit the use of your arms, keeping your elbows to your sides, and do NOT extend them above shoulder level for about 2 weeks, or until your drains are out. Soreness will persist for weeks to months. Most patients can return to desk-type work when they feel comfortable to do so (3-4 weeks). You can resume most normal activity after 4 weeks, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back to help prevent additional swelling of the breasts. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks. See Drain Care section for information about properly draining and recording drain output.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by you surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
If you happen to still have any dressings in place when you get home, go ahead and remove them. Please start wearing a mildly snug sports bra day and night for 4 weeks. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 3-4 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The expansion process is the time to develop and mature the pockets. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
It is extremely important that you limit the use of your arms, keeping your elbows to your sides, and do NOT extend them above shoulder level for about 2 weeks, or until your drains are out. Soreness will persist for weeks to months. Most patients can return to desk-type work when they feel comfortable to do so (3-4 weeks). You can resume most normal activity after 4 weeks, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back to help prevent additional swelling of the breasts. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks. See Drain Care section for information about properly draining and recording drain output.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by you surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
If you happen to still have any dressings in place when you get home, go ahead and remove them. Please start wearing a mildly snug sports bra day and night for 4 weeks. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 3-4 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The expansion process is the time to develop and mature the pockets. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
thigh flap-based breast reconstruction (LTP, TUG, PAP flaps)
ACTIVITY:
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. Please avoid flexing the hips more than 45 degrees for 2 weeks. This means NO SITTING on chairs in the usual sitting position, as it puts tension and shearing forces on the thigh incision and can cause the incision to open up. NO STRENUOUS ACTIVITY is allowed. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay keep your hips flexed less than 45 degrees for 4 weeks. Standing and walking are fine, and are encouraged. Laying down on your back is also fine. However, sitting should only be done on a reclining-back chair. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar.
Toilets are a little tougher. Obviously you have to obey Nature's call. We recommend purchasing a "women's camping funnel" before surgery to allow you to urinate without sitting down on the toilet seat. These funnels can be purchased on-line from REI or GoGirl for around $12-$23 and are a huge help after surgery. That solves "number one", but what about "number two"? It cannot be helped that you must sit on the toilet when having a bowel movement. But when doing so, try to avoid putting all your weight on your incision and avoid shifting your bottom around while sitting.
Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be a drain present in the thigh and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel's office.
Keep the compression garment on most of the time for 2 weeks. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck or waist during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have a compression garment on your thighs and waist: It is helpful to safety pin your drains to the garment to keep them secure. The garment helps protect the incisions from sheering forces on the skin and helps prevent fluid collections under the skin. It is very important to keep this garment in place at all times except for when cleansing your wounds, showering, or when washing the garment. Please note -- you may wash your compression garment in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. Please avoid flexing the hips more than 45 degrees for 2 weeks. This means NO SITTING on chairs in the usual sitting position, as it puts tension and shearing forces on the thigh incision and can cause the incision to open up. NO STRENUOUS ACTIVITY is allowed. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay keep your hips flexed less than 45 degrees for 4 weeks. Standing and walking are fine, and are encouraged. Laying down on your back is also fine. However, sitting should only be done on a reclining-back chair. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar.
Toilets are a little tougher. Obviously you have to obey Nature's call. We recommend purchasing a "women's camping funnel" before surgery to allow you to urinate without sitting down on the toilet seat. These funnels can be purchased on-line from REI or GoGirl for around $12-$23 and are a huge help after surgery. That solves "number one", but what about "number two"? It cannot be helped that you must sit on the toilet when having a bowel movement. But when doing so, try to avoid putting all your weight on your incision and avoid shifting your bottom around while sitting.
Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be a drain present in the thigh and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel's office.
Keep the compression garment on most of the time for 2 weeks. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck or waist during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have a compression garment on your thighs and waist: It is helpful to safety pin your drains to the garment to keep them secure. The garment helps protect the incisions from sheering forces on the skin and helps prevent fluid collections under the skin. It is very important to keep this garment in place at all times except for when cleansing your wounds, showering, or when washing the garment. Please note -- you may wash your compression garment in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
- Any change in breast flap color (purplish, blueish, or white changes can all signify problems – call immediately!)
- Severe pain uncontrolled with prescribed pain medication
- Excessive swelling or tightness
- Fever above 101.5 degrees or shaking chills
- Excessive, thick, or foul smelling drainage
- Sudden onset of shortness of breath, chest pain, or calf pain
- Hives or rashes
- Nausea/Vomiting with inability to tolerate fluids
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
buttock flap-based breast reconstruction (SGAP/IGAP Flaps)
oACTIVITY:
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. Please avoid flexing the hips more than 45 degrees for 4 weeks. This means NO SITTING on chairs in the usual sitting position, as it puts tension and shearing forces on the thigh incision and can cause the incision to open up. NO STRENUOUS ACTIVITY is allowed. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay keep your hips flexed less than 45 degrees for 2 weeks. Standing and walking are fine, and are encouraged. Laying down on your back is also fine. However, sitting should only be done on a reclining-back chair. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar.
Toilets are a little tougher. Obviously you have to obey Nature's call. We recommend purchasing a "women's camping funnel" before surgery to allow you to urinate without sitting down on the toilet seat. These funnels can be purchased on-line from REI or GoGirl for around $12-$23 and are a huge help after surgery. That solves "number one", but what about "number two"? It cannot be helped that you must sit on the toilet when having a bowel movement. But when doing so, try to avoid putting all your weight on your incision and avoid shifting your bottom around while sitting.
Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be a drain present in the butt and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel's office.
Keep the compression garment on most of the time for 2 weeks. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck or waist during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have a compression garment on your thighs, buttocks and waist: It is helpful to safety pin your drains to the garment to keep them secure. The garment helps protect the incisions from sheering forces on the skin and helps prevent fluid collections under the skin. It is very important to keep this garment in place at all times except for when cleansing your wounds, showering, or when washing the garment. Please note -- you may wash your compression garment in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!NO ICE PACKS!
Rest is important for the first 24-48 hours after you get home. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. Please avoid flexing the hips more than 45 degrees for 4 weeks. This means NO SITTING on chairs in the usual sitting position, as it puts tension and shearing forces on the thigh incision and can cause the incision to open up. NO STRENUOUS ACTIVITY is allowed. No major straining, lifting, bending, pushing, pulling, or exercising. Wait on running the vacuum (sweeper) for a month, and then only if someone else carries it up and down the stairs. Drive only when you are not taking pain pills and when you feel your reaction time is normal.
POSITIONING:
You will need to stay keep your hips flexed less than 45 degrees for 2 weeks. Standing and walking are fine, and are encouraged. Laying down on your back is also fine. However, sitting should only be done on a reclining-back chair. Doing this will help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar.
Toilets are a little tougher. Obviously you have to obey Nature's call. We recommend purchasing a "women's camping funnel" before surgery to allow you to urinate without sitting down on the toilet seat. These funnels can be purchased on-line from REI or GoGirl for around $12-$23 and are a huge help after surgery. That solves "number one", but what about "number two"? It cannot be helped that you must sit on the toilet when having a bowel movement. But when doing so, try to avoid putting all your weight on your incision and avoid shifting your bottom around while sitting.
Do not sleep on your side or front until OK’d by Dr. Gimbel in the office (usually not for at least 1 month after surgery).
WOUND/DRAIN CARE:
There will be a drain present in the butt and one or two in each affected breast to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days. If you have redness of the skin around your drain site that is larger than a quarter, call Dr. Gimbel's office.
Keep the compression garment on most of the time for 2 weeks. It is OK to remove it for a little while to wash it if needed.
BATHING:
You may take a sponge bath or shower 48 hours after surgery and wash your hair (you’ve probably already done this in the hospital). You may NOT take a tub bath for several weeks after surgery. You may shower even with your drains still in place (unless you've been told otherwise by Dr. Gimbel or his team). Try pinning your drains to a string tied in a long loop around your neck or waist during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have a compression garment on your thighs, buttocks and waist: It is helpful to safety pin your drains to the garment to keep them secure. The garment helps protect the incisions from sheering forces on the skin and helps prevent fluid collections under the skin. It is very important to keep this garment in place at all times except for when cleansing your wounds, showering, or when washing the garment. Please note -- you may wash your compression garment in the washing machine in cold water and air dry if it is badly soiled. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office (day or night) for any of the following observations:
- Any change in breast flap color (purplish, blueish, or white changes can all signify problems – call immediately!)
- Severe pain uncontrolled with prescribed pain medication
- Excessive swelling or tightness
- Fever above 101.5 degrees or shaking chills
- Excessive, thick, or foul smelling drainage
- Sudden onset of shortness of breath, chest pain, or calf pain
- Hives or rashes
- Nausea/Vomiting with inability to tolerate fluids
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 1-2 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office.
DRIVING:
You should refrain from driving a car until you are no longer taking narcotic pain medications and until you feel that your reaction time is back to normal. Also, your range of motion should be near normal before getting behind the wheel.
RETURN TO WORK:
Most patients take from 4-6 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. If your work requires heavy physical labor, you may need to do “light duty” beginning at 4-6 weeks, as you will not be able to lift/push/pull greater than 10 lb for 10 weeks after surgery. Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. The second stage surgery is when much of the refinement is done to improve contour and symmetry. Don't be too worried about appearance early on. It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!NO ICE PACKS!
oncoplastic breast reconstruction
ACTIVITY:
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. Remember that protein intake is extremely important for wound healing. We recommend 70-90 grams of protein daily after surgery. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5lb). No major straining, lifting, bending, pushing, pulling, or exercising. NO ICE PACKS!
POSITIONING:
Do not lay on your sides or stomach for 4 weeks after breast lift surgery.
WOUND/DRAIN CARE:
There may be drains present to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days.
BATHING:
(Ignore this part if you've had nipple grafting, and follow the specific directions given to you in the hospital.)
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place. Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office. Occasionally we do use prescription ointments to help with wound healing if necessary.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. If you've had nipple grafting (Dr. Gimbel would have discussed this with you), you will have yellow gauze stitched to the skin over each nipple. If you've had nipple grafting, leave the bra and dressings in place until your first post-op clinic visit (4-6 days after surgery). NO ICE PACKS!
If you've not had nipple grafting, you may remove the bra and gauze 48 hours after surgery. Go ahead and shower at this point, gently running your soapy hands over the operative sites. Rinse and gently pat dry, and redress with sports bra.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 1-2 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work). Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. Don't be too worried about appearance early on. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Rest is important for the first 24-48 hours after surgery. Rest in bed or in a recliner. However, take at least three walks about the house or in your neighborhood daily to help prevent swelling in your legs and to avoid possible blood clots. It is best to have only clear liquids when you first arrive home and then slowly advance to regular foods as tolerated the next day. Remember that protein intake is extremely important for wound healing. We recommend 70-90 grams of protein daily after surgery. NO STRENUOUS activity is allowed. Do not lift anything heavier than a gallon of milk (about 5lb). No major straining, lifting, bending, pushing, pulling, or exercising. NO ICE PACKS!
POSITIONING:
Do not lay on your sides or stomach for 4 weeks after breast lift surgery.
WOUND/DRAIN CARE:
There may be drains present to assist in the removal of fluid that can cause discomfort and delay proper healing. These drains will be sutured in place to prevent accidental removal. If this should happen, please notify the office. You will also be given instructions on how to care for your drains, empty them, and record drainage amounts in order to determine when the drains are ready to be removed. It may be necessary for your drains to remain in place for 2 weeks or more, but every patient is different. It is possible for the drain to get clogged with dried blood and it may be helpful to "milk" or “strip” the tubing to dislodge the clot if necessary. It is also normal for some drainage to leak out around the tubing - simply use gauze pads or sanitary napkins to absorb this drainage. The drainage fluid will be quite red at first, but will then become a clearer pinkish yellow after a few days.
BATHING:
(Ignore this part if you've had nipple grafting, and follow the specific directions given to you in the hospital.)
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place. Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office. Occasionally we do use prescription ointments to help with wound healing if necessary.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. If you've had nipple grafting (Dr. Gimbel would have discussed this with you), you will have yellow gauze stitched to the skin over each nipple. If you've had nipple grafting, leave the bra and dressings in place until your first post-op clinic visit (4-6 days after surgery). NO ICE PACKS!
If you've not had nipple grafting, you may remove the bra and gauze 48 hours after surgery. Go ahead and shower at this point, gently running your soapy hands over the operative sites. Rinse and gently pat dry, and redress with sports bra.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take 1-2 weeks off of work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work). Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
You just had a big surgery! You will have unevenness in the skin and asymmetry between the breasts for a long time after surgery. The healing process over the first 3 months will allow swelling to subside and contours to improve. Don't be too worried about appearance early on. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
implant exchange/replacement
ACTIVITY:
This surgery is generally easier to recover from than your first surgery, when the tissue expanders were placed. That being said, it is wise to take it easy for a few days after surgery. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
Most patients can return to desk-type work when they feel comfortable to do so (4-7 days). You can resume most normal activity after 1 week, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back for 4 weeks to help prevent implant shifting. Doing this will also help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks. Remove the dressings and bra at 48 hours after surgery.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by your surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. You can remove the bra and dressing at 48 hours after surgery, shower, and replace with clean sports bra. Another trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Remember to wear your support bra 24 hours a day except to shower for 4 weeks. This helps lessen any fluid collection accumulation under the skin. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Malaise
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take just a few days off of office work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. More physical work may require a longer time off, or light duty. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
Don't be too worried about asymmetry or lumpiness early on. The implant typically needs to settle for a few weeks after surgery. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
This surgery is generally easier to recover from than your first surgery, when the tissue expanders were placed. That being said, it is wise to take it easy for a few days after surgery. Do not lift anything heavier than a gallon of milk (about 5 lb). No major straining, lifting, bending, pushing, pulling, or exercising for 8 weeks.
Most patients can return to desk-type work when they feel comfortable to do so (4-7 days). You can resume most normal activity after 1 week, but no running, swimming, tennis, golfing, or equivalent activities until 8 weeks after surgery.
POSITIONING:
You will need to sleep on your back for 4 weeks to help prevent implant shifting. Doing this will also help reduce tension on your incision line, help with wound healing, and help to avoid a widened scar. Do NOT sleep on your stomach for at least 4 weeks after surgery in order to prevent shifting of the implant.
WOUND/DRAIN CARE:
Your breasts will be wrapped in a surgical bra or ACE wrap for 2 days following surgery until your first follow-up visit. No underwire bras for 6 weeks. Remove the dressings and bra at 48 hours after surgery.
BATHING:
You may take a sponge bath 24 hours after surgery and wash your hair. You may NOT take a tub bath for several weeks after surgery. You may take a shower 48 hours after completion of surgery. If you have drains, you may shower even with your drains still in place (unless instructed otherwise by your surgical team). Try pinning your drains to a string tied in a long loop around your neck during a shower. Wash with antibacterial soap and water right over your incisions. If they are still somewhat crusted with dried blood or drainage, you may cleanse with a half and half mixture of hydrogen peroxide and water to remove this drainage - it works quite well. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
DRESSINGS:
When you leave the hospital, you will have gauze over each breast with a surgical bra holding the gauze in place. You can remove the bra and dressing at 48 hours after surgery, shower, and replace with clean sports bra. Another trick is to use feminine sanitary napkins or a mini-pad to absorb some of the drainage that may occur. Remember to wear your support bra 24 hours a day except to shower for 4 weeks. This helps lessen any fluid collection accumulation under the skin. No underwire bras for 6 weeks. NO ICE PACKS!
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. If you have a fever or redness, malaise or overall ill-feeling, call the office immediately. Do not wait from morning until night, or night until morning to call. Please call the office for any of the following observations:
• Severe pain uncontrolled with prescribed pain medication
• Excessive swelling or tightness
• Malaise
• Fever above 101.5 degrees or shaking chills
• Excessive, thick, or foul smelling drainage
• Sudden onset of shortness of breath, chest pain, or calf pain
• Hives or rashes
A mild temperature elevation during the first 48 hours after surgery is your body’s natural reaction to surgery and anesthesia, and is completely normal.
FOLLOW-UP APPOINTMENT:
Please call the office to schedule a follow up appointment in the time period indicated in your discharge papers. It is wise to bring some of your pain medication with you to your appointment as you may need another dose while at the office - we do not have pain medicine available in our office. REMEMBER TO BRING YOUR DRAIN OUTPUT CHART TO THE OFFICE APPOINTMENT! WE USE THE INFORMATION TO DETERMINE WHETHER IT IS TIME TO REMOVE THE DRAINS!
RETURN TO WORK:
Most patients take just a few days off of office work for the recovery period. Depending on your type of work, you may be able to return sooner if desired. More physical work may require a longer time off, or light duty. Our office staff will be happy to assist you with your medical leave information through your employer. Since we do not charge you for this service, kindly assist us by filling in all the info you know on the papers (your name, your surgeon's name and address, date of surgery, and date you are planning to return to work).
Vigorous sports or activity is not permitted for several weeks following surgery. Your surgeon will advise you when it is safe to return to strenuous activity.
REMEMBER:
Don't be too worried about asymmetry or lumpiness early on. The implant typically needs to settle for a few weeks after surgery. It is our goal to make your experience with us as pleasing as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
fat grafting
ACTIVITY:
Please stay active and moving. Try not to lift heavy things for 2 weeks.
POSITIONING:
Avoid sleeping on your grafted site for 2 weeks.
WOUND/DRESSINGS:
You will have bandages at the sites of fat removal and fat injection. Leave the bra and dressings in place for 48 hours after surgery. Then you may remove all and shower (not bathing). No need for more dressings unless the sites are still leaking fluid (common for 2-4 days after surgery). Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
BATHING:
You may take a sponge bath immediately (avoiding the surgical sites) and shower 48 hours after surgery. You may NOT take a tub bath for 2 weeks after surgery.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. That being said, there are also normal findings after nipple reconstruction that should not alarm you.
Normal findings include:
Please call the office (day or night) for any of the following observations:
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 2-3 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720.
RETURN TO WORK:
Most patients may return to work the day after surgery, bearing in mind the restrictions on pressing boxes and items against the chest.
REMEMBER:
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Please stay active and moving. Try not to lift heavy things for 2 weeks.
POSITIONING:
Avoid sleeping on your grafted site for 2 weeks.
WOUND/DRESSINGS:
You will have bandages at the sites of fat removal and fat injection. Leave the bra and dressings in place for 48 hours after surgery. Then you may remove all and shower (not bathing). No need for more dressings unless the sites are still leaking fluid (common for 2-4 days after surgery). Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
BATHING:
You may take a sponge bath immediately (avoiding the surgical sites) and shower 48 hours after surgery. You may NOT take a tub bath for 2 weeks after surgery.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. That being said, there are also normal findings after nipple reconstruction that should not alarm you.
Normal findings include:
- Pink, watery discharge from fat donor sites for 2-4 days. It's OK, just reinforce with dry dressings.
- Oozing or bleeding from incision line. These little incisions can ooze, but they will stop with gauze and gentle pressure (usually with just a single finger).
- Discoloration of a portion of the nipple skin. These tiny little skin flaps sometimes have bruising on the ends. No intervention is needed other than just letting it resolve.
- Visible stitches. The tabs of skin are too small to put the stitches on the inside. Don’t worry though, the stitches are dissolvable and do not need to be removed.
Please call the office (day or night) for any of the following observations:
- Severe pain uncontrolled with prescribed pain medication
- Excessive swelling or tightness
- Fever above 101.5 degrees or shaking chills
- Excessive, thick, or foul smelling drainage
- Sudden onset of shortness of breath, chest pain, or calf pain
- Hives or rashes
- Nausea/Vomiting with inability to tolerate fluids
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 2-3 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720.
RETURN TO WORK:
Most patients may return to work the day after surgery, bearing in mind the restrictions on pressing boxes and items against the chest.
REMEMBER:
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Nipple reconstruction
ACTIVITY:
Please stay active and moving. Try not to lift things that are pressed against your chest (boxes, laundry baskets, etc.) for 2 weeks.
POSITIONING:
Avoid sleeping on your grafted site for 2 weeks.
WOUND/DRESSINGS:
You will have yellow vaseline gauze and 4x4 inch gauze with a hole cut into the middle (“donut gauze”) covering the new nipple. This is then held in place by a surgical bra. Leave the bra and dressing in place for 48 hours after surgery. Then you may remove all and shower (not bathing). After showering, redress the nipple with a new “donut gauze” by fashioning one from 4x4 gauze, 3-ply thick. Wear the donut gauze under your bra for 2 weeks after surgery, after which the nipple needs no more dressings. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
BATHING:
You may take a sponge bath immediately (avoiding the surgical sites) and shower 48 hours after surgery. You may NOT take a tub bath for 2 weeks after surgery.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. That being said, there are also normal findings after nipple reconstruction that should not alarm you.
Normal findings include:
Please call the office (day or night) for any of the following observations:
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 2-3 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720.
RETURN TO WORK:
Most patients may return to work the day after surgery, bearing in mind the restrictions on pressing boxes and items against the chest.
REMEMBER:
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!
Please stay active and moving. Try not to lift things that are pressed against your chest (boxes, laundry baskets, etc.) for 2 weeks.
POSITIONING:
Avoid sleeping on your grafted site for 2 weeks.
WOUND/DRESSINGS:
You will have yellow vaseline gauze and 4x4 inch gauze with a hole cut into the middle (“donut gauze”) covering the new nipple. This is then held in place by a surgical bra. Leave the bra and dressing in place for 48 hours after surgery. Then you may remove all and shower (not bathing). After showering, redress the nipple with a new “donut gauze” by fashioning one from 4x4 gauze, 3-ply thick. Wear the donut gauze under your bra for 2 weeks after surgery, after which the nipple needs no more dressings. Do not apply any lotion, powder, or cream to your incisions unless directed to do so by our office.
BATHING:
You may take a sponge bath immediately (avoiding the surgical sites) and shower 48 hours after surgery. You may NOT take a tub bath for 2 weeks after surgery.
MEDICATION:
You will be prescribed a narcotic pain reliever upon hospital discharge. You may experience side effects including nausea constipation, sleepiness, or itching. Nausea can be helped by taking the medication with food. Constipation is avoided by lessening use of narcotic pain reliever and using an over-the-counter stool softener twice daily while you are taking the pain medicine. Itching can be helped by taking over the counter antihistamine such as Benadryl along with the pain medicine, but be aware you may become excessively sleepy. You are not permitted to drive a vehicle while using narcotic pain medication. If nausea or itching persists or a rash develops, call your doctor. He may choose to change your medication.
SIGNS AND SYMPTOMS TO WATCH FOR:
Complications can occur after any procedure. When they do occur, they are best treated as soon as they are recognized. That being said, there are also normal findings after nipple reconstruction that should not alarm you.
Normal findings include:
- Oozing or bleeding from incision line. These little incisions can ooze, but they will stop with gauze and gentle pressure (usually with just a single finger).
- Discoloration of a portion of the nipple skin. These tiny little skin flaps sometimes have bruising on the ends. No intervention is needed other than just letting it resolve.
- Visible stitches. The tabs of skin are too small to put the stitches on the inside. Don’t worry though, the stitches are dissolvable and do not need to be removed.
Please call the office (day or night) for any of the following observations:
- Severe pain uncontrolled with prescribed pain medication
- Excessive swelling or tightness
- Fever above 101.5 degrees or shaking chills
- Excessive, thick, or foul smelling drainage
- Sudden onset of shortness of breath, chest pain, or calf pain
- Hives or rashes
- Nausea/Vomiting with inability to tolerate fluids
FOLLOW-UP APPOINTMENT:
A follow-up appointment will be listed on your discharge instruction papers from the hospital (generally 2-3 weeks after date of surgery). If you do not have an appointment already scheduled, please call the office to schedule one at 412-641-3720.
RETURN TO WORK:
Most patients may return to work the day after surgery, bearing in mind the restrictions on pressing boxes and items against the chest.
REMEMBER:
It is our goal to make your experience with us as comfortable as possible. Please do not hesitate to call the office for any concerns or if you have questions about caring for yourself after surgery. We are here to help in any way that we can!