TRAM FLAP BREAST RECONSTRUCTION

INSTRUCTIONS

• Have someone drive you home after surgery and help you at home for 1-2 days.
• Get plenty of rest.
• Follow balanced diet.
• Decreased activity may promote constipation, so you may want to add more raw fruit to your diet, and be sure to increase fluid intake.
• Take pain medication as prescribed. Do not take aspirin or any products containing aspirin.
• Do not drink alcohol when taking pain medications.
• Even when not taking pain medications, no alcohol for 3 weeks as it causes fluid retention.
• If you are taking vitamins with iron, resume these as tolerated.
• Do not smoke, as smoking delays healing and increases the risk of complications.

ACTIVITIES

• Start walking as soon as possible, this helps to reduce swelling and lowers the chance of blood clots.
• Do not drive until you are no longer taking any pain medications (narcotics).
• Do not drive for 3-4 weeks. When abdominal area will allow for sudden braking, you may resume driving.
• Unless stated on this form, discuss your time off of work with your surgeon.
• No heavy lifting for 6 weeks.

INCISION CARE

• You may shower 48 hours after removal of the drainage tubes.
• You may shower 48 hours post-operatively if you are without IVs or drainage tubes.
• Avoid exposing scars to sun for at least 12 months.
• Always use a strong sunblock, if sun exposure is unavoidable (SPF 30 or greater).
• Keep steri-strips on; replace if they come off.
• Keep incisions clean and inspect daily for signs of infection.
• No tub soaking while sutures or drains are in place.
• You may apply cool compress to the abdominal area but not to breast area. Do not use a heating pad: heat may burn the area.
• Do not wear a bra.
• Sleep with pillows under knee (some women choose to sleep in a recliner or lounge chair).

WHAT TO EXPECT

• Maximum discomfort will occur the first few days following surgery: you may experience incision discomfort and generalized discomfort in your breasts and abdomen.
• Oozing can be expected.

APPEARANCE

• A new breast(s) mound(s) will be constructed with sutures around the outer edges.
• The abdomen will be tight and much flatter in appearance.
• The majority of swelling will subside in 3-4 weeks, but some swelling may persist for up to 3 months.
• You will walk bent over and will slowly rise over the first 1-2 weeks.

FOLLOW-UP CARE

• Sutures will remain in place for 7-10 days.
• Remaining sutures will be removed 10-14 days following surgery, during your second post-operative Clinic visit.
• Your third post-operative visit will be scheduled somewhere between 4-6 weeks following suture removal.

WHEN TO CALL

• If you have increased swelling or bruising.
• If swelling and redness persist after a few days.
• If you have increased redness along the incision.
• If you have severe or increased pain not relieved by medication.
• If you have any side effects to medications; such as, rash, nausea, headache, vomiting.
• If you have an oral temperature over 100.4 degrees.
• If you have any yellowish or greenish drainage from the incisions or notice a foul odor.
• If you have bleeding from the incisions that is difficult to control with light pressure.
• If you have loss of feeling or motion.

FOR MEDICAL QUESTIONS, PLEASE CALL:

• (734) 998-6022, Monday - Friday, 8 a.m. - 5 p.m.
• After hours and on weekends, call Hospital Paging at (734) 936-6267 and ask for the Plastic Surgeon on call.