After Flap Reconstruction Instruction

In an effort to make you more comfortable with discharge home and to answer any questions you may have, the following instructions have been prepared for you. However, you may call the office at any time with additional questions or concerns.

For the Breast

You have just undergone a breast reconstruction with the DIEP flap. Your breast will likely have bruising and possibly some blistering on the skin, which is expected after a mastectomy. You have a small patch of skin on your breasts, which is a different color than the surrounding breast skin. This paddle of skin comes from the abdomen and is an indicator of how the flap is doing. It is important to check this skin paddle daily. The skin should remain the same color. If the color of the small patch changes (i.e blue, purple, pale), please call the office immediately.

For the abdomen

Your incision and belly button are covered in a special medical grade sealant, which will come off in the office, two-three weeks after surgery.

Drains

Both the breast and abdomen will have drains. It is important to empty the drains twice daily and record the outputs. Please bring this sheet to your appointment after surgery. Based on the output, the drains will be removed one to 3 weeks after surgery. For the drains to be working appropriately, the bulbs need to be collapsed to create a light suction. The nurse in the hospital will review the drain care with you and your family prior to discharge home. It is best to safely secure the drains to your clothes with a safety pin.

Incisions

No separate wound care is required for the incisions. Application of ointments, dressings, or lotions is not necessary. Do not massage the incisions until we instruct you in the office (six weeks after surgery).

Sleep

Sleep on your back for the first two weeks after surgery.

Showering

You may take sponge baths following discharge. Pat dry. We will instruct you to shower once you have drains removed from your breasts in the office.
Do not take a bath or submerge yourself in water.
You will have special adhesive glue or tape over the incisions. Do not take these off.

Activity

Rest at home during the first few days after surgery.
Walking is encouraged, but strenuous exercise is not allowed until six weeks after surgery. Sitting in a comfortable chair is better than sitting in bed.
You will stand slightly hunched over at the waist for the first few days after surgery. This will help decrease the stress and tension on your abdominal incision. You will stand more erect when you feel it loosen.
Avoid strenuous activity. Do not lift your arms above your head. Do not lift more than five-ten pounds.

Pain Controland Prescriptions

A prescription for pain medication will be sent to your pharmacy. Take this pain medication as prescribed as needed for moderate to severe pain. For less severe pain, you may take over the counter Tylenol (acetaminophen), instead of the prescribed pain medication.
Your prescription pain medication may contain acetaminophen. For example, Percocet (oxycodone/acetaminophen) contains 325mg of Tylenol. Do not exceed 4000 mg of Tylenol (acetaminophen) from all sources in a 24 hour period.
You may be prescribed another pain medication—Toradol/ketorolac. Take this medication as prescribed for pain.
Narcotic pain medication can be constipating, so drink plenty of water and non-caffeinated beverages to help with regular bowel movements. It is important not to strain to have a bowel movement. Any straining can jeopardize your safety and recovery.
Take an over the counter baby aspirin (81mg) daily for three weeks.
Please do not drive while taking narcotic pain medication.

Call the Office

Do not hesitate to call the office with any concerns or questions. A doctor is available to answer your questions 24 hours a day. Please notify us immediately if:

You have increased swelling, pain, or color change in the breast.
One breast becomes suddenly significantly larger than the other breast.
You have a sudden increase in swelling of the abdomen.
You have redness develop around the incisions.
You have a fever greater than 101 F.
You develop sudden increase in pain.
You develop drainage, spreading redness or foul odor.
You have any questions.

Post-Op Instructions

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Flap Reconstruction After Surgery