Planning for Reconstruction

How should you prepare for a breast reconstruction operation?


Before the day of your reconstruction operation, your surgeon will give you specific instructions for your individual procedure. Here are some general tips for you to consider before your operation.

Pre-op instructions

  • It is important to follow the instructions given to you at the time of your pre-operative appointment. These may include but are not limited to having blood tests, a chest x-ray and an EKG.
  • You will be asked to stop taking aspirin and any blood thinners, medications containing vitamin E and any non-steroidal anti-inflammatory medications, such as those containing ibuprofen.
  • You may be instructed to take a stool softener. Narcotic pain medication tends to cause constipation and taking a stool softener twice a day for a few days prior to your operation may be beneficial.

Don’t smoke.

  • If you are a smoker, your plastic surgeon should have already talked to you about the risks associated with smoking and reconstruction. Some plastic surgeons may not operate on a smoker because it can negatively affect the healing process after the operation.
  • Smoking produces nicotine and carbon monoxide, which can cause the blood vessels in your skin to constrict, resulting in poor wound healing.
  • In the setting of a tissue expander, skin on the breast may be compromised and this could result in loss of the tissue expander.
  • TRAM flaps in particular may be more likely to have complications in smokers, such as fat necrosis.
  • Also, smoking increases the risks related to anaesthesia. It is essential to quit smoking as soon as possible after your diagnosis, to allow as much time as possible for your body to recover from the effects of smoking prior to your operation.

Plan how you are getting home and ready for your recovery.

  • The most important thing you can do to ensure a smooth transition from hospital to the comfort of your home is to prepare as much as you can in advance.
  • Lifting restrictions apply to every type of reconstruction:
    • It is essential that you adhere to all lifting restrictions given to you by your surgeon. A good rule of thumb is that if an object is heavier than a large Sunday newspaper, you should not be lifting it during your first week home from the hospital.
    • If you have pets, you will be unable to lift large bags of pet food or cat litter. You should pre-package these items into smaller containers no heavier than 1-2 kilograms.
    • If your family consumes a lot of juice or drinks water by the litre, you may want to consider getting juice boxes or smaller bottles of water for easier lifting.
  • Planning meals in advance or having friends assist with meals can be very helpful.
  • You should not vacuum or do laundry, and you should avoid repetitive motion,like scrubbing pots and pans.
  • Feel relaxed about letting go of your household duties during this time, even if things get a little messy. And let others do the chores whenever possible. By following these restrictions you will be more likely not to compromise your reconstruction procedure.

Dress as comfortably as possible.

  • Another way to prepare for your operation is by garment shopping ahead of time. Most patients, especially those undergoing bilateral operation, will not be able to pull a shirt over their heads. Purchase soft, oversized, button-down shirts, or shirts with front zips. Also, shirts and sweatshirts with pockets on the inside can be used for pinning or tucking surgical drains.
  • Patients having TRAM flap reconstruction or any abdominal micro operations may want to purchase loose-fitting trousers as well. Trousers with an elastic waistband can pull on the already tender scar line from the operation. Many women find that oversized, cotton, snap-down trousers work very well. You can pin or tuck hip drains into trouser pockets and because they are one or two sizes too big, they will not cause abdominal discomfort.
  • You may want to purchase shoes and slippers as well. After the operation, most patients find it uncomfortable to bend over to put on shoes or trainers. Having a slip-on mule or sandal will be helpful. Slippers with a grip on the sole ensure that you won’t slip when you get out of bed or go to the bathroom.
  • You should pack these garments or have your carer bring them to you on the day of discharge. If your carer drives a vehicle that is higher off the ground such as a truck or SUV, you may have trouble climbing in and out of it. Travelling in a saloon car may be more comfortable. Bring pillows to support your back and neck, especially if you have a long drive home from the hospital. You can use a pillow to press against your abdomen when you laugh, cough or sneeze, or when you put the lap belt over yourself in the car.
  • Prepare your home bed and bedside table in advance, so that when you arrive from the hospital, it’s ready for you to climb in and relax.
  • You will need extra pillows on your bed for behind your back and under your legs. These will keep you in a position with your hips and knees flexed while you are in bed. You may want soft pillows for under your arms as well.
  • On your bedside table (all within arms reach) you should have a hand-held mirror, a tube of anti-bacterial ointment, your phone (if portable then take the charger), antibiotics and pain medication. The remote control and a few good magazines or books are also helpful.
  • In the bathroom, you should keep measuring cups your doctor may give you to empty your drains into and a pad and pen to write down the volume that the drains release every time you empty them.
  • You also may want to arrange ahead of time for someone to drive you to your follow-up appointments with your plastic surgeon. You will generally see your doctor on a weekly basis until all drains are removed and you may not be able to drive for 2 to 4 weeks, until you are no longer taking narcotic pain medication.

Go easy on yourself. It is absolutely normal to feel anxious before your operation.

  • Getting your house in order and enlisting friends and family to help you care for children and help with household chores can help you relax.
  • It’s very important after your operation to get plenty of rest in order for your body to heal. Taking care of this in advance will give you the peace of mind that you need.

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