Breast Reconstruction

PROCEDURE:

  • Breast reconstruction can either be performed at the time of mastectomy or as a delayed procedure. Most are performed immediately, although surgical findings may dictate postponement of reconstruction until after radiation treatment has been completed.
  • Reconstruction is usually performed in 2 -3 stages. With the 1st stage consisting of the creation of a breast mound and ending with the nipple-areola reconstruction.
  • Reconstruction may be autologous (own tissue), prosthetic (implant) or a combination depending on the requirements, adjuvant therapy and patient preference.
  • The options will be thoroughly discussed during your consultation to ensure the best procedure option and expected outcome.

PRE-OPERATIVE:

  • Please stop any over-the-counter herbs, vitamins, or drugs 2 weeks prior to your scheduled surgery.
  • Disprin, NSAIDS and blood thinners should be stopped 7 days prior to surgery unless specified or instructed differently by Dr F. Spruyt. This is done to prevent excessive bleeding.
  • NO SMOKING is allowed within 4 weeks of your surgery up to and including 4 weeks after surgery.
  • You should be fasted for 8 hours prior to your scheduled surgery.
  • If possible, please bath or shower with Hibiscrub soap 2 hours prior to admission. This assists in reducing the chance of infection post operatively.
  • Wear loose-fitting clothing, that will be easy to change into after your surgery.
  • Please be at the hospital 2 hours prior to your surgery to allow for admission and preparation.
  • You will be counselled on the risks, complications, and healing process prior to your surgery. If you have any questions, please write them down and bring them with you so that they may be discussed prior to surgery.
  • Your skin will be marked before you are taken into theatre.

POST-OPERATIVE:

  • You will be monitored in the ward after surgery. If you are eating/drinking, your vitals are normal and your pain is controlled you will be discharged, unless booked for an overnight stay.
  • The nursing staff will show you how to empty and measure the wound drainage. Do not leave without having them assist you with this procedure.
  • Do not open the dressings after surgery. Dressings will be opened when the drains are removed at your follow-up appointment.
  • If you did not receive a follow-up appointment, please phone the rooms.
  • No driving is allowed for 2 weeks after your surgery.
  • Walking as a form of exercise may be resumed after 2 weeks.
  • Normal activities (overhead activities/lifting of heavy objects etc.), general exercise and running may be resumed at 6 weeks.
  • Do not wear tight restrictive clothing.
  • Only wear the support bra/sports bra for 6 weeks post surgery. Bras with underwire may be worn after 6 weeks.
  • Wound healing takes time. The breast will continue to undergo changes in shape, sensation and firmness with results noted after 12 months and onwards.
  • Avoid using tissue oils on the scars, only a cream like Epimax or a silicone cream may be applied once healed.
  • Avoid exposing the scars to sunbeds or direct sunlight i.e. tanning for the 1st year after surgery as this will darken the scars. A sunscreen (SPF 50) may be used as soon as wounds are healed should you plan on exposing the area to direct sunlight.

RISKS AND COMPLICATIONS DEPENDING ON PROCEDURE:

  • Bleeding and hematoma (blood collection)
  • Seroma (fluid collection)
  • Infection
  • Necrosis of skin and or nipple-areola complex, wound breakdown
  • Change in sensation
  • Abnormal scarring (hypertrophic or keloid scarring)
  • Asymmetry (usually minor and normal as breasts are never 100% symmetrical to begin with)

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