DIEP Abdominal Flap Breast Reconstruction

Serving Patients in Jacksonville, Florida

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HOSPITAL COURSE: FREE TRAM / DIEP ABDOMINAL FLAP BREAST RECONSTRUCTION

  • Most patients are in the hospital 4-6 days. You will be placed in a surgical bra immediately after surgery.
  • You will have 4-6 drains, leg pump/stockings, and oxygen immediately after surgery. You will be on a self-dosing pain pump after surgery. It will administer pain medication on demand. Do not be afraid to use it. You will have medication ordered for nausea that can be given at your request.
  • No CAFFEINE, NICOTINE, OR SECOND HAND SMOKE for 6 weeks. We cannot offer patches because they contain nicotine.
  • You will receive Lovenox shots (a blood thinner) and a daily Aspirin.
  • The night of surgery – Try to walk with nursing assistance at least once to prevent a blood clot.
  • Post-op Day 1 (the day after surgery)
  • Begin sitting in chair and ambulating.
  • Walk with you hips slightly bent. You will be able to stand straight in 2 weeks.
  • The flap will be monitored closely.
  • Post-op Day 2
  • Begin oral pain medications if you haven’t already.
  • Post-op Day 3-5
  • Diet can be advanced as tolerated.
  • If your pain is controlled, you will be discharged with pain medications and antibiotics. The drains will be left in place until your followup visit in most circumstances.

POST-OP INSTRUCTIONS: ABDOMINAL FLAP BREAST RECONSTRUCTION

Once your surgery is completed, you must follow all the instructions given to you in order to heal properly and have good outcomes.

Included are normal post-surgical experiences and key health considerations that may be a cause of concern.


TYPICAL POST-OPERATIVE SYMPTOMS

Typical symptoms of breast reconstruction and signs to watch for include the following:

  • Tightness in the chest region and stiffness; Tingling, burning or intermittent shooting pain: These are normal experiences as the skin, muscles and tissue stretch, and as sensory nerves heal. Pain medication and muscle relaxants will help you cope with any discomfort. If you have drains, you may experience additional localized discomfort. Consistent sharp pain should be reported to our office immediately.
  • Shiny skin or any itchy feeling: Swelling can cause the breasts’ skin to appear shiny. As the healing process advances, you may also find a mild to severe itchy feeling of the breasts. An antihistamine like Benadryl can help to alleviate severe, constant itchiness. If the skin becomes red and hot to the touch, contact our office immediately.
  • Asymmetry, the breasts look different, or heal differently. Breasts may look or feel quite different from one another in the days following surgery. This is normal; no two breasts are perfectly symmetrical in nature or following breast reconstruction surgery.

OUR OFFICE SHOULD BE CONTACTED IMMEDIATELY IF YOU EXPERIENCE ANY OF THE FOLLOWING:

  • A high fever, (over 101º) severe nausea and vomiting, continued dizziness or incoherent behavior
  • Any pain that cannot be controlled by your pain medication.
  • Bright red skin that is hot to the touch.
  • Excessive bleeding or fluid seeping through the incisions.
  • A severely misshapen breast or bruising that is localized to one breast or region of the chest.

Do not apply COLD compresses.


YOUR RELEASE FROM THE HOSPITAL

You will only be released to the care of a responsible adult. All of these instructions must be clear to the adult who will monitor your health and support you, around the clock in your first days home from the hospital.

  • Rest, but not bed rest: While rest is important in the early stages of healing, equally important is that you are ambulatory, meaning that you are walking under your own strength. Spend 10 minutes every 2 hours engaged in light walking indoors as you recover.
  • You will also experience difficulty standing fully upright if your donor site is from the abdominal region: Standing upright could greatly affect your results and could cause serious injury.
  • Recline with your head and chest slightly elevated above your lower body.
  • Good nutrition: Fluids are critical following surgery. Stick to non-carbonated, non-alcoholic, caffeine-free, and green tea-free beverages including fruit juices and water, milk, and yogurt drinks. You must consume at least 8 ounces of fluid every 2 hours. Stick with soft, bland, nutritious food for the first 24 hours.
  • Take all medication, exactly as prescribed:
  • Do not change your incision dressings unless there is a significant amount of fluid under the film. If you have a drain placed in your incisions, carefully follow the instructions for drain care and record drained fluid on the Drain Care Instructions and Log.
  • Wear a support bra or your surgical garment around the clock. Follow the instructions specifically and wear this garment at all times.
  • Do not smoke. Smoking can greatly impair your safety prior to surgery and your ability to heal following surgery. You must not smoke.
  • Relax. Do not engage in any stressful activities or anything to raise your blood pressure. Do not lift your hands over your head. Do not lift anything heavier than a paperback book. Take care of no one, and let others tend to you.

FIVE TO TEN DAYS AFTER YOUR JACKSONVILLE DIEP FLAP BREAST RECONSTRUCTION

During this time you will progress with each day that passes. Ease into your daily activities. You will receive clearance to begin driving or return to work after 2 weeks and after you are no longer taking pain medications:

  • Continue to cleanse wounds as directed; you may shower. Take a warm, not hot shower. Do not take a bath. Limit your shower to 10 minutes. Do not rub your incisions.
  • Take antibiotic medications and supplements as directed. Take pain medication and muscle relaxants only as needed. You may wish to switch from prescriptive pain medication to acetaminophen or ibuprofen.
  • Maintain daily walking. Walking is essential every day to prevent the formation of blood clots. In addition, you may begin stretching and range of motion exercises.
  • Maintain a healthy diet. Do not smoke. Do not consume alcohol.

TWO to FOUR WEEKS AFTER YOUR JACKSONVILLE DIEP FLAP BREAST RECONSTRUCTION

As you resume your normal daily activities, you must continue proper care and healing.

  • Ease into light weight-bearing exercise (nothing more than one to two pounds). However no twisting or lifting anything over your head. No tennis, golf, softball or other sports with similar swinging motions. Avoid aerobic exercise that may cause a lot of bounce.
  • Do not smoke. While incisions may have sealed, smoking deprives your body of necessary oxygen that can result in poorly healed, wide, raised scars.
  • Continue to wear a proper support bra. The bra you first wore following surgery may feel somewhat loose. You may replace it, however no under wires for 6 weeks. You may sleep without a bra; however a camisole with built-in shelf support can be comfortable and provides added support as you continue to heal.
  • You may sleep flat. However do not sleep on your stomach. If you are a side sleeper, a soft pillow under your mid-back and shoulders may offer more comfort and support than a single pillow under your head.
  • Practice good sun protection. Do not expose your breasts or back to direct sunlight. If you are outdoors, apply at least an SPF 30 to the chest area at least 30 minutes prior to sun exposure.

SIX WEEKS AFTER YOUR JACKSONVILLE DIEP FLAP BREAST RECONSTRUCTION

Healing will progress and your breasts will settle into a more final shape and position.

  • You may ease into your regular fitness routine. However realize that your upper body may require some time to return to prior strength.
  • You may resume wearing under wires, although these are not necessary.
  • Discomfort or tightness and tingling will resolve. Any lingering nipple sensitivity or lack of sensation should begin to greatly improve.
  • No need to resume smoking. You have now gone 10 weeks (4 weeks prior to surgery and 6 weeks following) without a cigarette. For your long-term health, there is no need to resume smoking.
  • Nipple and Areola reconstruction can be scheduled as advised by Dr. Desai.

YOUR FIRST YEAR AFTER YOUR JACKSONVILLE DIEP FLAP BREAST RECONSTRUCTION

  • Practice monthly breast self exam.
  • Continue healthy nutrition, fitness and sun protection.
  • Your scars will continue to refine. If they become raised, red or thickened, or appear to widen, contact our office. Early intervention is important to achieving well-healed scars. Scars are generally refined to fine incision lines one year after surgery.
  • A one-year post surgery follow-up is required and a yearly followup is recommended. However you may call our office at any time with your concerns or for needed follow-up.

Your body will change with age. The appearance of your breasts will change too. Contact our office with any of your questions or concerns, at any time.

Contact Us

Desai Center of Plastic & Reconstructive Surgery
14540 Old St. Augustine Road Suite 2391 | Jacksonville, Florida 32258
(904)262-DESAI (3372)
(877)907-3067

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