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Introduction

The following is a list of general instructions for your care following your surgery. Please read them carefully several times as most of your questions should be answered here. Instructions for your care will also be reviewed the morning after surgery. Carefully following these instructions should help you get the best results from your surgery.

 

Diet

Most people can resume a normal diet the evening of surgery. If you feel queasy or nauseated, start with clear liquids or soup. Advance your diet as tolerated to a regular diet. You may experience some constipation as a result of the pain medication. Over the counter laxatives such as Milk of Magnesia or stool softener is recommended. If this is not sufficient, then dulcolax or a glycerin suppository may be necessary. This can be purchased over the counter at your pharmacy.

 

Activity

Only very mild activity is encouraged during the first few post-operative days. Be sure to walk at least 300 yards daily. This can be broken up in multiple short trips.  It is OK and recommended that you walk more than the minimum of 300 yards.  This will help prevent Deep Vein Thrombosis (DVT’s/Blood Clots) and Pulmonary Embolisms (PE’s), however no lifting, pushing or pulling. Avoid use of your arms and do not raise your arms above your head. Wearing clothing that is loose and buttons/zips in the front is wise. Moderate physical exercise can be resumed when recommended by the doctor, usually 3-4 weeks post op. Please refrain from high impact or heavy exercise until released to do so.  Avoid contact sports for 6 weeks.  No heavy lifting (>10 lbs), vigorous activity, or straining, and avoid using a vacuum cleaner for 3 weeks. Refrain from sleeping on your stomach.  YOU MUST SLEEP ELEVATED ON YOUR BACK until otherwise directed by your doctor.

 

Wound Care

No ointment or Neosporin is needed for the incision line. Simply place dry/clean gauze along the incision line and then the surgical bra. The gauze helps prevent friction to the incisions.

 

You may shower starting 48 hours after surgery, but NO BATHS. DO NOT let the shower water directly hit your incisions.  Following a shower, apply clean gauze to the incisions and put the surgical bra on. The surgical bra should be worn at all times until the doctor advises otherwise(typically 4 weeks). You will be provided with 2 surgical bras at the hospital, one of which you will be wearing when you  wake up.  You may experience temporary electrical or tingling feelings in the breast and nipple in the weeks following your surgery. The feeling is similar to the feeling when your “foot wakes up after it has been asleep.” This represents nerve healing and is normal. Your chest will feel tight for 4 to 8 weeks, until the chest muscles relax. The exact time varies between patients depending on the muscle mass, breast elasticity and activity level after surgery. You may also experience more pain in one breast than the other.

 

Swelling, bruising, redness and of the skin is normal and will resolve over time. Many patients have drainage from the bottom of the breasts were the incisions often come together. This drainage is quite normal and may be bloody, yellow or clear in color.  Do Not apply a heating pad or ice to your incisions or breasts.  After surgery you will have decreased sensation and heat/ice can result in a burn/frost bite without you feeling it. Smoking causes multiple wound healing complications.  It is very important that you do not smoke and you are not around people that smoke for at least 6 weeks after surgery.  Second hand smoke is just as harmful as if you were to smoke.  After 4 weeks you can wear any bra of your choice as long as it fastens in the front, or back, and does not have an underwire.

 

Pain Control

Take the narcotic pain medicine as instructed and needed. Do not drive until you are no longer taking the narcotics and are free of significant pain. AVOID ASPIRIN, or anti-inflammatory medications (Motrin, Aleve, etc.) for 2-3 days after surgery, as these may increase the risk of bleeding immediately after surgery. Tylenol is safe immediately after surgery and may be alternated with (or used in place of) prescribed pain medication. Dr. Bernacki will not refill any prescriptions. When your prescription  medications are gone switch to the above recommended over the counter medications. In some cases, antibiotics may be prescribed.

 

Emergencies

Normal surgical pain and swelling should begin to gradually decrease 2-3 days after surgery. If you suspect infection at the surgical site, contact your provider as soon as possible to determine the appropriate treatment course.

Signs of bleeding: sudden increased swelling / mass-effect at the surgical site, drainage of blood from the wound, or severe bruising around the surgical site. Sudden onset (or increase) in pain can be a sign of bleeding as well. Drainage of a small or moderate amount of blood-tinged fluid, from the incisions or drain sites, is not uncommon and is usually not indicative of active bleeding. If there appears to be active bleeding, direct pressure on the site can be helpful. If you suspect significant bleeding following surgery, contact your provider to determine appropriate treatment.

Wound healing problems can manifest as separation of the skin edges or an open wound at the surgical site. This can be caused by a variety of factors and is usually a problem that can be managed by dressing changes and wound care. Keep the area clean and place a gauze dressing.

 

If there is a problem, please call our office. Most issues are easily addressed and do not require significant intervention.

 

The most common emergencies that might need attention are:

  • Nausea that lasts 4 hours or more and does not respond to medication
  • Bleeding that is persistent and uncontrolled
  • Sudden enlargement and/or pain of one side with bruising, or if you have a change in nipple color or appearance
  • High fever(101.5) lasting more than a few hours and not responding to medication
  • Shortness of breath
  • Chest pain that is considerably worse on one side
  • Leg swelling

 

If you feel the situation is urgent, call 911 and/or proceed directly to the closest emergency room. Please call us as well.

 

Follow-Up

Follow-up is typically in 7-10 days and should be scheduled by calling our office if it has not already been arranged.