Breast Reconstruction - depending on the type
of surgery that was needed initially will probably need the patient to stay in
the hospital overnight. Pain following the surgery is typically mild to
moderate intensity, and if you are staying in the hospital for a night you will
have a morphine pump to help relieve the pain. After you are discharged
from the hospital, oral pain medication usually is enough to keep the patient
comfortable.
The
recovery from having
breast reconstruction with implants; will leave a patient sore for a few weeks. The patient will be tired, which is normally from the anesthesia that was
given.
Drains will be put in place for a short amount of time after the
surgery to help remove the accumulation of excess fluids that will collect at
the surgical site.
The patient will be asked to measure and record the amount
of fluid each day, so that the surgeon will know when it is safe to remove the
drains. The drains stay in place until the amount of fluid draining decreases.
This is to prevent a seroma or a
hematoma from forming.
Sutures, both permanent
and dissolvable, will be in place after your surgery. The absorbable sutures
will eventually be absorbed by the body within 60 – 90 days. Scarring is of
course, permanent; however the scars will fade over time. Your surgeon will let
you know when it is safe to start scar therapy to help minimize the incisions.
Steri-Strips
are common to have on top of your incision line and sutures – or if you have
internal sutures with tissue glue to help bind the external incision edges.
Your surgeon will remove these when you have your sutures removed, and more than
likely re-apply the strips to the incision after the stitches are removed. Most
surgeons will ask their patients to leave these strips on the incision to help
keep tension off of the incision line during recovery. By doing this you will
allow your scar to heal into a thin line.
Sutures (mostly the
dissolvable ones) will work themselves to the surface of the incision. This
happens quite commonly, and actually when a stitch does pop out, it can come to
the surface with an inflamed red spot. Usually you can feel something like
‘fishing line’ around this area. It is best to call the Plastic Surgeon when
any suture makes it way to the surface for removal. You really do not want to
attempt to do this yourself, as this is way that infections can start, and you
have to make sure you are removing a suture that is not something that is
permanent. Dissolvable sutures are usually clear color (like fishing line), and
permanent sutures are dark blue in color.
There are various types of
suture material that is used in closing an incision. Some
patients do have problems with sutures, and some sutures are more likely to
cause this than others. Braided sutures (such as Vicryl) can cause this and,
for that reason, many surgeons have switched to monofilament (unbraided)
sutures, such as Monocryl or PDS. Vicryl is an excellent and strong suture
material, but it has been associated with "spitting”.
It is very important that if
you see any discharge around this area, if the area feels inflamed or is hot to
the touch. Please call your Plastic Surgeon immediately, as this could mean
that you have an infection started, and you will need to start on antibiotics
immediately.
Most surgeons like the
patients to take things easy for a number of weeks after the procedure.
Anywhere from six to eight weeks you will be asked to refrain from lifting
anything over 10 lbs. You should also limit any activity that has excessive arm
movements, like vacuuming, ironing, etc.
No strenuous exercises are
advised during recovery, in fact check with your own surgeon to find out what
you can and cannot do. Any unnecessary bending or exercising can put undue
pressure on the chest and slow the healing down. It is important to make sure
you are not doing too much during the recovery process. By doing activities too
soon could lead to swelling or edema in the breast area. Also making sure your
blood pressure is not elevated during the recovery process, as this can lead to
bleeding or a possible hematoma.
Numbness in the
surrounding breast tissue after breast reconstruction surgery is normal. In some cases this numbness can be
permanent. Unfortunately this is the byproduct of having a
mastectomy. The nerves that were in the breast tissue are removed. How much sensation is regained and to what degree will vary from patient to
patient.
In
general, reconstruction will not restore the normal sensation to your breast,
however; some feeling may return. It
is not unusual for the breast to remain numb in the front of the breast and
retain sensation in the outer perimeters of the breast. Shooting pain from the
nerves and tingling during breast lift recovery is also normal. This means the
nerves are trying to regenerate, so these sensations are a good sign that the
nerves are returning to normal function.
Plastic surgeons will tell their patients to give this at least a
year before diagnosing this as permanent sensation loss, as nerve fibers grow at
a very slow rate and can take months before the feeling comes back into the
breast area.
The newly reconstructed nipple/areola complex
will also remain numb after mastectomy with reconstruction because it lacks the
nerve endings and muscle fibers needed to receive sensation. Most patients
who are faced with breast reconstruction feel that this is a small price to pay
to not only have their life back, but to also have a new breast.
It is preferred that if
you do smoke, to quit if possible. Smokingreduces circulation
which can lead to poorly oxygenated blood – which is needed to heal from the
surgery.
It is not
uncommon for your menstrual cycle to be altered for a month or two
after you undergo surgery. The stress of the surgery and
anesthesia plays havoc on your system. Your period will return
to normal within a couple of months.
Depression after any
plastic surgery procedure is very normal, and recovery from breast
reconstruction can have a huge range of emotions. Most patients experience
some sort of “let down” after the procedure simply because there was so much
anxiety and anticipation preparing for the surgery. Both physical and emotional recovery takes time. After
mastectomy and reconstruction, you may find yourself concerned with different
things, ranging from your physical appearance to your sexual identity.
It is perfectly normal to
go through this depression post operative period. A life changing episode
occurred. You are still beautiful inside and out and reminding yourself of
this will help boost your body image. A mastectomy is a loss and should be
mourned, but don't forget to remind yourself that there is a light at the end of
this tunnel and you will emerge a beautiful sexual woman with your newly
reconstructed breast. The recovery period can seem long but with the
support of family and friends you will find yourself once again getting back to
your old self.
Focus
on the positives. Life is filled with negative things, but it
can also be wonderful. Remind yourself about the things you love
to do and about all the good things in your life.
Talk
with others. Join a support group, forum, or discussion board,
talk to family or friends, or meet with other women who have
experienced mastectomy with reconstruction.
Don't
rush yourself.
Recovery takes time. Take things one day at a time.