Breast Reconstruction

Postoperative Instructions for Patients Undergoing DIEP Breast Reconstruction Surgery

1. Getting home and postoperative supervision.
   You will be discharged from hospital four or five days following surgery. Please arrange for a responsible adult to drive you home and stay with you for (at least) the first 24 hours.
2. Sleeping position.
   For two weeks after surgery try to sleep on your back.
3. Diet.
   Try to eat your normal diet.
4. Medications, herbal supplements, vitamins and alcohol.
   Fill your prescriptions and take your post-operative medications as directed. If you should become nauseated or develop a rash, call the office. You may resume your regular medications
   unless Dr. Boyd directs otherwise. Take one baby aspirin (81mg) per day for two weeks. Remember, many herbal supplements adversely affect the clotting process and actively cause bruising
   and bleeding. These should be stopped two weeks before surgery and may be resumed two weeks afterwards. Avoid alcohol until post-operative medications are finished. Dr. Boyd does not
   recommend taking mega doses of vitamins in excess of the normal daily requirement (which is more than adequately met by a regular balanced diet). Please discontinue this form of medication
   for two weeks before and after surgery unless you are being treated for a specific deficiency. One multivitamin tablet per day is permissible, however.
5. Dressings.
   Wear a non-underwire bra at all times. The bra supports the incisions, helps keep the dressing in place and prevents traction on the microvascular anastomoses (junctions between the tiny
   vessels supplying the new breast). Remove your bra and outer dressings to shower but leave any Steri-Strips in place. Once the drain is removed from the abdomen, you should wear a supportive
   panty-girdle not only for comfort, but also to minimize fluid accumulation and swelling.
6. Wound care, shampooing, showering.
   Showering may be difficult if you have multiple drains: however, the drain evacuators may be clipped to a plastic belt around your waist to prevent them being pulled out. You may find it
   convenient sit on a plastic lawn chair. Put some Vaseline around the skin where the drainage tubes leave the body in order to create a seal. Shower daily and wash over the incisions with
   a soft sponge and soapy water. Rinse and dry. Reapply an absorbent pad over the incisions and hold it in place with some paper tape.
7. Activity (including driving).
   After returning home, get out of bed and walk around the house. Do this several times a day increasing the activity as tolerated. After two weeks, you may walk longer distances, but avoid
   strenuous exercise for six weeks. Avoid abdominal crunches for two months. You may drive one week after your surgery IF you feel up to it and as long as you are NOT taking pain medication.
   You can return to the gym or the pool in six weeks if your drains have been removed, unless Dr. Boyd instructs you otherwise. It is extremely important to limit the use of your arms for two
   weeks after surgery. Do not raise them above your shoulders until you are told to do so. Do not lift anything heavy, including children. Avoid household chores such as vacuuming until cleared
   for this type of activity.
8. Things to avoid. (See 2 and 5 also)
   It is vital that you do not smoke after surgery to avoid respiratory and wound healing complications. Smoking can cause healed wounds to break down and may result in serious tissue loss and
   failure of the operation.
9. Bruising, swelling and color changes.
   Your breasts and abdomen will have some initial swelling, which will subside over a few weeks. Unusual, severe pain accompanied by noticeable swelling, bleeding, fever or rash should be
   called to the attention of Dr. Boyd. It is common to experience some numbness in the abdomen and breasts for several weeks or months. Sharpness, burning sensations and pains just below
   the armpit are common during healing. You may also experience mild bruising. This should disappear in ten days to two weeks. However a sudden color change (white purple or blue) in the
   exposed portion of the DIEP flap – particularly if swollen or cool to the touch – is a sign of impending flap loss. If this occurs, get in touch with Dr. Boyd immediately.
   It will take several weeks for the tissues to settle before you can see the final result. If you have unusual or severe pain or swelling, excessive bleeding from the dressing or any other
   concerns, contact Dr. Boyd.
   Someone in the office will call you the day after surgery to check on your condition and answer any questions you might have. You can reach Dr. Boyd or a staff member around the clock by
   calling (310) 530-4200.

These instructions are not intended to cover every possible problem that could arise. Good judgment on your part is essential for a good result.