Delayed Post-mastectomy Prosthetic Breast Reconstruction

WHAT YOU SHOULD KNOW:

• Post-mastectomy breast reconstruction is surgery to remodel the shape of the breast after having a mastectomy. A mastectomy is surgery where part or all of the breast is removed to treat breast cancer (tumor). This may include removing one or both breasts, with or without the skin which covers them. Reconstruction surgery is done to make a breast that comes close in form and appearance to a natural breast.
  
  
• Delayed post-mastectomy prosthetic breast reconstruction is surgery done weeks after mastectomy. An implant may be placed after recovery from the mastectomy is complete. This surgery may also be done weeks after a tissue expander (balloon-like sac) was placed after the mastectomy. This allows the tissue expander to first stretch tight chest skin and tissues before placing the implant. It may also give time for you to think thoroughly about which type of implant you will get and type of surgery to have. You and your caregiver will decide which type of breast reconstruction is right for you.
  
  
• For this surgery, caregivers use a permanent implant filled with saline (salt water). You may also be offered an implant filled with silicone gel instead of saline. The tissue expander, if present, will be removed and replaced with the permanent implant. The permanent implant will give a fuller look to the shape of the breast. Sometimes, surgery to reshape the other breast may also be needed after reconstruction to match the new breast. Surgery to create a nipple and areola may also be performed at a later date.

INSTRUCTIONS:

Medicines:

• Keep a list of your medicines: Keep a written list of the medicines you take, the amounts, and when and why you take them. Bring the list of your medicines or the pill bottles when you see your caregivers. Do not take any medicines, over-the-counter drugs, vitamins, herbs, or food supplements without first talking to caregivers.
  
  
• Take your medicine as directed: Always take your medicine as directed by caregivers. Call your caregiver if you think your medicines are not helping or if you feel you are having side effects. Do not quit taking your medicines until you discuss it with your caregiver.
  
  
• Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your caregiver. Keep taking this medicine until it is completely gone, even if you feel better. Stopping antibiotics without your caregiver's OK may make the medicine unable to kill all of the germs. Never "save" antibiotics or take leftover antibiotics that were given to you for another illness.
  
  
• Pain medicine: You may be given medicine to take at home to take away or decrease pain. Your caregiver will tell you how much to take and how often to take it. Take the medicine exactly as directed by your caregiver. Do not wait until the pain is too bad before taking your medicine. The medicine may not work as well at controlling your pain if you wait too long to take it. Tell caregivers if the pain medicine does not help, or if your pain comes back too soon.

Ask your caregiver when to return for a follow-up visit. Keep all appointments. Write down any questions you may have. This way you will remember to ask these questions during your next visit.

Nipple and areola reconstruction: After the incisions in the new breast have healed, reconstruction of the nipple and areola may be done. The areola is the dark circle around the nipple. If the breast not operated on has a large enough nipple, a nipple graft may be done. The areola may be reconstructed using skin grafts, the areola on the other breast, or by tattooing. Tattooing helps match the color of the other side.

Rest: You may feel like resting more after surgery. Slowly start to do more each day. Rest when you feel it is needed.

Wound and drain care: When you are allowed to bathe or shower, carefully wash the incision (cut) with soap and water. Afterwards, put on clean, new bandages. Change your bandages every time they get wet or dirty. Always check your drain when changing your bandages. Do not pull it out. Ask your caregivers for more information about wound and drain care.

CONTACT A CAREGIVER IF:

• You have a fever (increased body temperature).
  
  
• You have discharge or pain in the area where the drain was inserted.
  
  
• You have nausea (upset stomach) or vomiting (throwing up).
  
  
• Your bandage becomes soaked with blood.
  
  
• Your skin is itchy, swollen, or has a rash.
  
  
• You have questions or concerns about your surgery, illness, or medicine.

SEEK CARE IMMEDIATELY IF:

• You feel something is bulging out into your chest and not going back in.
  
  
• You have pain in the chest or armpit that does not go away even after taking pain medicines.
  
  
• You have trouble breathing all of a sudden.
  
  
• Your incision has blood, pus, or a foul-smelling odor.
  
  
• Your shoulder, arm, or fingers feel numb, tingly, cool to touch, or look blue or pale.

Copyright © 2008 Thomson Healthcare Inc. All rights reserved. Information is for End User's use only and may not be sold, redistributed or otherwise used for commercial purposes.

The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.

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