Post-Operative Expander Implant
If you have not yet had your surgery, you may want to start by reading the Preparing for Surgery content in this section. If you have taken the time to prepare for surgery, all that will be left to do upon arriving home from the hospital is rest and heal. In this section you will find tips to help you with your reconstruction recovery. It is important to remember that everyone is different, and we all heal at our own pace. What works for some, may not work for others. We hope this section will serve as a helpful guide for you.
Reconstruction Recovery in the Hospital
After mastectomy and tissue expander reconstruction, you may wake up feeling groggy as you awaken from the anesthesia. You will have compression sleeves on your legs that help with circulation. You will be on pain medication, and usually have two drains for each breast that are under your skin and exit from your underarms. If you had any lymph nodes removed, you may feel especially tender in your underarm area. You will be wrapped in a post surgical bra which may feel tight across your chest, and you may have limited arm mobility. This pain should become easier to manage within a few days.
Once you are moved from recovery into your hospital room, you can try to get out of bed with assistance, and use the bathroom on your own. You will be shown how to use an incentive spirometer, which is a breathing device that helps you expand your lungs. The sooner you are up and slowly moving around, the sooner you can go home and recover in the peace and quiet of familiar surroundings. The nurse will teach you how to care for the drains, and what you need to do at home. You will be given a prescription for pain medication, and possibly an antibiotic. Please refer to Preparing for Surgery for tips about the car, and what to wear home. When you get home you will need plenty of rest. Be sure to stay hydrated. The sooner you can stop taking the narcotic pain pills and switch to Tylenol, the easier your recovery will be.
Reconstruction Recovery at Home
Some women have an easier time with their in the beginning than others. You probably will be too tired to shower during the first week, but if your surgeon gives you permission, and you feel up to it, you can shower. You may need someone to help you. You will need to pin all of your drains either to a Velcro drain belt, or you may be given something in the hospital like a gauze necklace to support the drains around your neck. It may help if you have a shower stool (you can get them in most drug stores) so you can sit down in the shower, and someone can help you wash. Alternatively, you may buy (or obtain from the hospital) packs of disposable wash cloths. As the drains come out, it will be much easier to shower.
Early in your reconstruction recovery, you will most likely see your surgeon weekly until the last drain has been removed. You cannot rush removing the drains; as bothersome as they may be, they are essential to proper wound healing. Generally once an individual drain produces less than 20 to 30 cc's in a 24 hour period, your surgeon will remove it. In most patients, the drain removal does not hurt.
Every day it is important to try to stretch a little more. Getting back mobility in your arms and relieving the tightness in your chest will really speed up the healing process. Your surgeon may recommend certain stretches for you to do at home. The most common includes walking the wall with your finger tips. Similar to the “Itsy Bitsy Spider” that you probably sing with your children or grandchildren, standing parallel to the wall, you can slowly walk your arm up the wall leading with your fingertips. For the first few days, you may only be able to go as high as your breast. Within a few weeks you should be able to walk the wall with the full range of your arm, and reach high over your head. With every passing day the feeling of tightness in your chest will ease.
The Next Step
Once your tissue expanders are completely filled and ready for your exchange surgery, you may start to feel the anxiety of entering the hospital for surgery all over again. You can rest assured knowing that almost every patient finds expander exchange to be a much easier procedure than the mastectomy and expander placement. The firmness of the tissue expander will be immediately lifted, and replaced with the softer feel of the final implant. Although you may still awaken from surgery with feelings of tightness across your chest, this pain will ease at a much faster rate, and you will likely not have any drains.
Keep in mind that it takes time for swelling to go down and for your body to heal after surgery. If you are having a procedure done to your opposite breast such as reduction or lift, you will require more time to heal. Almost always, these surgeries are outpatient, and you will be resting comfortably in your home within a few hours. Getting a first peek at your new breasts is exciting, and can evoke many feelings. If your surgeon has asked for you to keep a surgical or sports bra on following surgery, trying to sneak a peek isn't worth it. No one can wrap or bandage you better than your surgeon or the nurse, and it may be better to do the unveiling in your surgeon’s office.
As part of your reconstruction recovery, it is essential that you adhere to all lifting restrictions your surgeon has set in place for you. You should not engage in any strenuous activity. Doing laundry, vacuuming the house, and lifting heavy objects may result in wound healing problems. After everything you've just been through, give yourself a break! Take time to rest and heal.
Many women have asked when it is safe to resume sexual activity. Physically, it is safe once your drains are removed, and you feel up to it. Emotionally, it will take as much time as you need. Some women feel uneasy about not having nipples. If this is the case, wearing a camisole may make you more comfortable. The general concern is wondering how your partner will feel. If you are comfortable and confident with the process of reconstruction, you can ease any concerns your partner may have. The most common concern partners may have is that they will hurt you if they touch you the wrong way. It is helpful to communicate and be receptive to what your partner is saying. If you find yourself having a hard time emotionally, it may be helpful to talk with other women who have already had reconstruction, or to seek help from a counselor.
Reconstruction recovery is part of the overall reconstruction process. It may take several procedures to achieve the final aesthetic result you desire. Stay committed to your goals and communicate them to your surgeon. Always remember that every day gets better than the one before, and in time, the scars will fade, and surgery will become a distant memory.