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Immediate Post-mastectomy Tissue And Implant 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.
- Immediate post-mastectomy combined autogenous tissue and implant breast reconstruction is surgery done right after mastectomy. This may help you better cope with the loss of a breast. However, a second operation at a later date will be needed. A combined autogenous tissue and implant breast reconstruction is done if the chest skin and tissues are tight and flat. You and your caregiver will decide if this type of reconstruction after mastectomy is right for you. For this surgery, caregivers use a tissue flap taken from another part of your body to rebuild the shape of the breast. The tissue flap is usually taken from your lower abdomen (stomach), buttocks, thigh, or upper back and is made up of skin, fat, and muscle.
- A tissue expander (balloon-like device) implant will be used to stretch the skin and tissues of the chest. It will be filled with saline (salt water) by your caregiver regularly. A tissue expander is only temporary and you will need another surgery to replace it with a permanent implant.
- A permanent implant may be filled with saline or silicone gel. Sometimes, surgery to reshape the other breast may be needed after reconstruction to match the new breast. Surgery to create a nipple and areola may also be performed at a later date.
- Keep a current list of your medicines: Include the amounts, and when, how, and why you take them. Take the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency. Throw away old medicine lists. Use vitamins, herbs, or food supplements only as directed.
- Take your medicine as directed: Call your primary healthcare provider if you think your medicine is not working as expected. Tell him about any medicine allergies, and if you want to quit taking or change your medicine.
- Antibiotics: This medicine is given to fight or prevent an infection caused by bacteria. Always take your antibiotics exactly as ordered by your primary healthcare provider. Do not stop taking your medicine unless directed by your primary healthcare provider. Never save antibiotics or take leftover antibiotics that were given to you for another illness.
- Pain medicine: You may need medicine to take away or decrease pain.
- Learn how to take your medicine. Ask what medicine and how much you should take. Be sure you know how, when, and how often to take it.
- Do not wait until the pain is severe before you take your medicine. Tell caregivers if your pain does not decrease.
- Pain medicine can make you dizzy or sleepy. Prevent falls by calling someone when you get out of bed or if you need help.
Ask for information about where and when to go for follow-up visits:
For continuing care, treatments, or home services, ask for more information.
- Ask your caregiver when you should return to have your wound checked, drain or stitches removed, and expander filled.
This implant has a small valve under the skin where caregivers can inject saltwater. Caregivers fill the tissue expander with saltwater from time to time until the skin has stretched enough. An expander may be filled more than the expected breast size. This may give a sag and a more natural looking breast when the expander implant is replaced with a permanent one. Ask your caregiver for more information about tissue expanders.
Nipple and areola reconstruction:
This may be done after the second operation and incisions in the new breast have healed. 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 when you need to while you heal after surgery.
Slowly start to do more each day. Return to your daily activities as directed.
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.
- 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 chest pain or trouble breathing that is getting worse over time.
- 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.
- 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.
- You suddenly feel lightheaded and have trouble breathing.
- You have new and sudden chest pain. You may have more pain when you take deep breaths or cough. You may cough up blood.
- Your arm or leg feels warm, tender, and painful. It may look swollen and red.
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