Preoperative Guidelines

Board-Certified Plastic Surgeons Serving Denver, Lone Tree, Colorado & Nationwide

happy family outdoorsThe following tips and information are intended to provide a general idea of what to expect from the days before breast reconstruction surgery and in the hospital afterward. At The Breast Center Park Meadows Cosmetic Surgery, we want you to feel comfortable and prepared in advance of your reconstructive surgery appointment. You may also consider providing your family members with these guidelines so they know what to expect and how they can help you prepare.

If you have any questions about preoperative guidelines, please call us at 303-706-1100.

First Steps to Prepare for Surgery

Here are things to be aware of in the first few weeks before the surgery:

  • If you smoke or use nicotine gum/lozenges or other tobacco products, you must stop at least 3 weeks prior to surgery. This includes vape pens, electronic cigarettes and marijuana. These products significantly increase the risk of post-surgical complications, including delayed wound healing and autologous tissue flap failure.
  • Our experienced staff will let you know what time you can have the last meal prior to your surgery. A light meal is sometimes preferable because some patients experience mild constipation following surgery.
  • Pajamas, a robe and slippers are all things you may want to bring to your surgery. You will wear a hospital gown during and immediately after surgery, but you may want to change into your own comfy pajamas at some point. 

These first steps apply to any reconstructive surgery, whether implant-based or flap-based. Below, we will take a look at tips for each type of procedure.

Initial Preparation for DIEP Flap and Other Flap Reconstructions

One type of breast reconstruction uses a flap of your own tissue – harvested from a donor area such as the abdomen – to reconstruct a breast. For some women, the reconstruction can be performed at the same time as mastectomy. If you are having an immediate reconstruction, you should expect the operation itself to take 3-6 hours per side to complete. Afterward, you will spend 1-3 days recovering in the hospital. A family member or other guest will be allowed to come stay with you once you are recovering in a private room.

For guests and family members: For those loved ones waiting for you while you are in surgery, there is a hospital cafeteria, as well as grocery store nearby. There are also several hotels in the area, recommended by our staff. If you and your family are from out of town, our Patient Navigator is happy to assist you with hotel options and other matters related to your stay.

What to expect as you recover from surgery: After your time in the recovery area, you will be transferred to a private room on the floor. You will have a Foley catheter that is usually removed on the first day. You will wear special stockings and compression boots for improved blood flow in your legs. The hospital bed will be flexed as not to stress your incisions.

There will be multiple drains, 1 in the reconstructed breast and 1 or 2 in the donor site. The drains are the thickness of a pencil and have a bulb at the end to collect the excess fluid from the surgery sites. You may have some drainage from around the site where they enter the skin, which is normal. We will provide a drain record and instructions on drain usage.

Use gauze to keep the area dry. You will leave the hospital with drains, and they will instruct you on drain care prior to discharge. 

The Day After Your Flap-Based Reconstruction

You will be able to get out of bed the day after your procedure. You should be able to get up and walk around. It may be most comfortable to walk slightly bent forward. You will begin taking an oral pain medication before you leave the hospital, and you will have prescriptions for certain pain meds and antibiotics to take at home. Most patients fill these prescriptions prior to surgery so they don't have to worry about it when they get home.

Post-operative surgical bras: You will be provided with a prescription for a post-surgical bra to wear after surgery.  A post-surgical bra is not required and is optional for your comfort. You should attempt to be fitted and sized for one of these bras before your surgery day. If you wish to purchase more bras for after your procedure, we recommend the Nordstrom breast prosthesis program. This department store has multiple locations across the Front Range and the entire country, and their Breast Prosthesis Program features certified fitters trained to fit and size women who have undergone breast reconstruction, as well as women who have undergone mastectomy or lumpectomy without reconstruction.

Nordstrom carries a full line of garments that include postoperative garments and camisoles which also has the option to hold drains. Bring that binder/girdle to your surgery. They have many options and are well versed in helping our patients find garments that will be comfortable and meet each need postoperatively. They will work directly with your insurance company, too.

Returning Home After Surgery

Typically, most patients go home on the second day after surgery. When you go home, you may still be walking slightly bent over and will still have surgical drains attached to your body. You may want to prepare by having a recliner or first floor bedroom with lots of pillows for comfort. It is recommended to sleep in a flexed position.

You may shower 48 hours after surgery. You will still have the drains, and these can be supported using a long necklace/bathrobe tie or string. There is no real care for the incisions as they will all have surgical glue or steri-strips on them. You may notice a little oozing along the incision if the glue wears off. This is normal and you may place some triple antibiotic ointment and gauze over the area.

It is important that you follow the drain care instructions making sure to record the amounts in “cc’s” and keep the bulb flat which keeps it in suction. Make sure to bring the drain record to all of your postoperative appointments. Typical drain removal is 2-3 weeks following your surgery.

Many patients are prone to constipation or feel they cannot move their bowels. Patients may need to take both a stool softener, such as Colace, or a motility agent, like Senekot if this develops. The anesthesia and pain medication as well as lack of activity can all lead to constipation.

Nausea may also be a problem for some people following surgery. It is important to have food with pain medication if you start to feel nauseous. In addition, there are specific medications that can be prescribed if you continue to struggle with nausea. The nausea is usually from the pain medication, so sometimes adding a nausea medication is very helpful.

Preparing For Breast Reconstruction with Breast Implants

The preoperative guidelines for an implant-based surgery are the same as those listed above. Therefore, please see the guidelines listed above while keeping these implant-specific details in mind:

  • Tissue expanders are placed in the first operation. This takes about 50 minutes for each side of the chest. The tissue expanders increase the space beneath the skin so that breast implants can be placed at a later date.
  • Patients who have implant reconstruction feel stronger day by day. You mayfeel the expander in your chest. It is normal to feel sharp corners where the expander is folded in the midline and armpit area. You will be able to do most things by 6 weeks. You may be able to drive by 2-3 weeks if you are comfortable and are no longer taking pain medication. Heavy lifting, heavy exercise, and swimming are not recommended for 6-8 weeks. Most people take 4 weeks off work.
  • The procedure to place the implants varies depending on the details, such as type of implant used and whether both breasts are receiving breast implants. Our experienced plastic surgeons will make sure you know what to expect from that procedure.

Dr. Christopher Williams, Dr. Jeremy Williams, Dr. Michael Miller, and our entire staff want to make sure you feel fully prepared for your procedure. We encourage you to ask us about anything you have on your mind. We will be here with you every step of the way, from your very first consultation through your successful recovery.

To schedule a consultation in Lone Tree, near the greater Denver area, please call The Breast Center Park Meadows Cosmetic Surgery at 303-706-1100.