INSTRUCTIONS FOLLOWING BREAST SURGERY
GENERAL
You must have a responsible adult with you for the first 24 hours after surgery. Due to the presence of anesthetic drugs, you should not make any major decisions for the first 48 hours after surgery. You are not allowed to drink alcoholic beverages, drive, or operate dangerous equipment while on any narcotic pain medications.
WOUND CARE
If your wounds are covered with a bandage you can remove it and shower on post op day two. You may have small white tapes covering the incision. You can shower with these in place and they will fall off on their own or be removed during your post-operative appointment.
If your bandage is skin glue, you may shower with this in place starting the morning after surgery. No additional bandages are needed. The glue will flake off in 7-10 days on its own.
Regardless of your dressing type, do not swim or bathe for 2 weeks after surgery, or until your wound has healed.
Things to watch for at the incision: fevers, increased pain, redness, swelling or any discharge are signs of a possible infection. Please call the office immediately if you experience any of these symptoms.
SCAR MANAGEMENT
Scars will turn ugly before they turn pretty. Expect them to darken in the first 3-6 weeks. After that, they should lighten with time. It can take up to a year for a scar to fully mature. After your postoperative visit, you can use any non-fragranced, non-colored lotion such as Lubriderm, Neutrogena, Eucerin or Aquaphor, but is not necessary. If your scar will be exposed to the sun, it is important to apply sunscreen.
DRAIN CARE
If you had a mastectomy or axillary lymph node dissection, you will have a small, round drain in place. The “grenade” suction bulb should always be depressed, ensuring a suction action on the system. The goal of the drain(s) is to keep fluid out of the wound bed and to ensure good healing of the skin down to the chest wall. If the fluid builds up in the space, new blood vessels cannot form and you can get poor healing and breakdown of the skin. You should empty the bulb as needed (no not let it completely fill before emptying it) and keep track of how much fluid comes out of the drain. The nurses at the hospital will teach you how to do this before you are discharged. Usually, the drain(s) will be removed when the drainage is less than 30 mL per 24 hours for 2-3 days in a row. This decision will be made at your office visit.
ACTIVITY
Moderate exercise is encouraged. Limit your exercise to walking in the immediate week following surgery. If you have had a mastectomy or axillary lymph node dissection, you should begin with range of motion exercises after your first post-operative visit. Stand sideways next to a wall and place your hand on the wall. Slowly, walk your fingers up the wall until your arm is all the way over your head and your side is touching the wall. Do this twice per day, slowly working up to getting your arm over your head. This exercise will prevent “frozen shoulder”.
MEDICATIONS
- Narcotic pain medication is available by prescription only. There may be a tendency to dizziness or nausea. The medication is best tolerated on a full stomach. Do not drive or drink alcohol while on narcotic pain medications.
- Ibuprofen (Advil or Motrin) are all the same type of anti-inflammatory medication broken down in your kidneys. They are in the same class of medication as Aspirin. We recommend using 1-2 tablets (200mg each) every six hours for the first three days. After three days, use the medication only as needed. If you have a history of stomach ulcers, gastrointestinal bleeding, a history of kidney problems do not take these medications, instead, take only Tylenol.
- Tylenol (acetaminophen) is a pain reliever that is broken down in your liver. The recommended dose for Tylenol is 500 mg three times per day.
- Ibuprofen and Tylenol can be taken together safely. We recommend alternating the medications every 3-4 hours for best relief.
- Stool Softeners hydrate the stool by holding water. They have little laxative activity. Obtain the least expensive, once per day formulation (Colace is a common brand). If your bowel movements are very loose, stop the stool softener. If the bowel movement is too hard, you may add an additional dose in the evening.
- If your pain is not controlled with the combination of these drugs, please call the office.
DIET
Narcotic pain medications can make you constipated, so it is important to take in plenty of fluids while on these pills. A balanced diet of lean meat, fish, vegetables and fruits is important to give you strength for the healing process.
PATHOLOGY
Your pathology results should be back 3-4 business days after surgery. We will try to call you with results. Feel free to call the office on the 5th business day following your surgery if you want to discuss the results and have not heard from someone in the office yet.