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Breast Reconstruction with Implants and Expanders
What you need to know about breast reconstruction:
Breast reconstruction is surgery to rebuild one or both breasts with implants. Breast reconstruction may be done at the same time as a mastectomy or in a separate surgery. You may need to have a tissue expander, or balloon like sac, placed in each breast before an implant is placed. Expanders are slowly filled with saline over 2 to 3 months. This helps stretch the tissue and make room for an implant. The tissue expander may be removed and replaced with an implant in a later surgery. Saline (salt water) implants, silicone gel implants, or a combination may be used to rebuild the breast.
How to prepare for breast reconstruction:
Your healthcare provider will talk to you about how to prepare for surgery. You may need to stop taking blood thinners or aspirin several days before surgery. Your provider may tell you not to eat or drink anything after midnight on the day of your surgery. He or she will tell you what medicines to take or not take on the day of your surgery. Your provider may tell you to shower the night before your surgery. He or she may tell you to use a certain soap to help prevent a surgical site infection. Ask your healthcare provider if you will need to stay in the hospital after surgery. Arrange for someone to drive you home and stay with you for 48 hours. They may need to help you cook, bathe and dress. They can call 911 or drive you to the hospital if there is a complication from surgery.
What will happen during breast reconstruction:
You will be given general anesthesia to keep you asleep and free from pain during surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection. If you are having an expander placed, your healthcare provider will make an incision and insert the expander under your muscle. If an implant will be placed, your healthcare provider will make an incision in your breast and make a space under the chest muscle. The implant will be placed into the space. Your healthcare provider may insert 1 or more drains near the incision to help remove extra fluid. This may prevent swelling and help your incision heal. He or she will close your incision with stitches and cover it with a bandage.
What will happen after breast reconstruction:
Healthcare providers will monitor you until you are awake. Bruising and swelling are normal and expected. You may be able to go home after surgery or you may need to spend a night in the hospital.
Risks of breast reconstruction:
You may bleed more than expected or get an infection. Nerves, muscles, or blood vessels may be damaged during your surgery. Fluid or blood may collect under your skin. You may need surgery to drain or remove it. Your implant may move out of place or leak fluid. You may need surgery to replace or remove your implant. You may get a blood clot in your arm, leg, or lung. This may become life-threatening.
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You have trouble breathing.
Seek care immediately if:
- Blood soaks through your bandage.
- Your stitches come apart.
- Your bruise suddenly gets bigger.
- Your leg or arm is larger than normal and painful.
Contact your healthcare provider if:
- You have a fever or chills.
- Your wound is red, swollen, or draining pus.
- You have nausea or are vomiting.
- Your skin is itchy, swollen, or you have a rash.
- Your implant moves out of place.
- Your pain does not get better after you take pain medicine.
- Your drain falls out or stops draining fluid.
- Your drain has pus or foul-smelling fluid coming out of it.
- You have questions or concerns about your condition or care.
You may need any of the following:
- Antibiotics help prevent a bacterial infection.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell him or her if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Care for your wound as directed:
Ask your healthcare provider when your incision can get wet. You may need to take a sponge bath until your drain is removed. Carefully wash around the incision with soap and water. It is okay to allow the soap and water to gently run over your incision. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. Check your incision every day for redness, pus, or swelling.
- Apply ice on your breast for 15 to 20 minutes every hour or as directed. Use an ice pack, or put crushed ice in a plastic bag. Cover it with a towel. Ice helps prevent tissue damage and decreases swelling and pain.
- Rest as directed. Do not lift anything heavy. Do not push or pull with your arms. Take short walks around the house. Gradually walk further as you feel better. Ask your healthcare provider when you can return to your normal activities.
- Empty your drain as directed. You may need to write down how much you empty from your drain each day. Ask your healthcare provider for more information about how to empty your drain.
- Wear a supportive bra as directed. You may be given a surgical bra or told to wear a sports bra. A supportive bra may help hold your bandages in place. It may also help with swelling and pain. Do not wear bras with lace or underwires. They may rub against your incision and cause discomfort.
Your healthcare provider may show you how to do arm stretches. Arm stretches may prevent stiff arms or shoulders. You may need to wait until after your drains are removed to begin stretching. Ask your healthcare provider for more information about arm stretches.
Follow up with your doctor as directed:
Write down your questions so you remember to ask them during your visits.
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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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