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Tissue Expansion for Breast Reconstruction Surgery Post-Operative Instructions

Instructions

  • Shower with Bactoshield the night before and morning of each tissue expansion.
  • You need someone to drive you to your appointment for the first 3 weeks post-operatively or as long as you requiring narcotic pain medicine.

Activities

  • You can not perform house hold chores or heavy lifting greater than 5 to 10 pounds for 6 weeks post-operatively.
  • No hot tubs, swimming in lakes while the tissue expander is in place.
Be Aware:
  • You can not have an MRI if you have tissue expanders in place.
  • The tissue expanders may be detected via the security scanners at the airport. You will need a note from your Doctor if you plan to travel indicating you have tissue expanders in place with metal.

Incision Care

  • You can shower 48 hours after the last drain tube has removed.
  • Avoid sun exposure to scars for at least 12 months after your last surgery.
  • If sun exposure is unavoidable then always use a sun block with 35 SPF or higher.
  • Shower regularly to keep the incisions clean and inspect for signs of infection.
  • You can use moisturizer on the incisions and surrounding skin starting 3 weeks.

What to Expect After Tissue Expansion

  • You may experience minor discomfort for the following 12 to 24 hours after each tissue expansion. This discomfort usually subsides 2 to 3 days after each tissue expansion.
  • The tissue expander may shift after the 1st or 2 nd expansion.
  • You may experience more discomfort on one side than the other if you have bilateral tissue expanders placed.
  • Your posture may change causing you to have some upper and/or mid back pain as you're expanded.
  • Your shoulder range of motion may become stiff requiring continuing to perform the shoulder exercises during the tissue expansion process to prevent shoulder stiffness and a frozen shoulder.
  • You may find it difficult to sleep because you feel tight across the chest and shoulders.
  • You may find it difficult to fit into certain types of tight fitting clothing. You may need to wear over sized shirts until the final exchange of the tissue expander (s).
  • You may feel chest persist tightness or heaviness secondary to being expanded. This usually subsides with time.
  • The tissue expanders will remain in place for a minimum of 8 weeks after completing the last tissue expansion. This will allow for the soft tissues (i.e. skin and muscle) to heal and recover from being stretched before the second surgery takes place for the exchange of the tissue expander for a permanent breast implant.
  • You'll see your surgeon when we think you have achieve your desired breast size to determine if you need additional expansions and for surgical planning.

Treatment for Discomfort

Ibuprofen (or other NSAIDs) 600 mg by mouth every 6 to 8 hours with food starting the morning of each tissue expansion and continue to take around the clock for 3 to 5 days as needed for discomfort. You can start this 2 weeks after surgery.

If you need additional pain control at night, you may take the prescribed Vicodin or Norco you were prescribed for pain immediately after surgery.

You can take the ibuprofen with the Vicodin or Norco if additional pain relief is required. If the discomfort does not subside or becomes painful please call the clinic for further guidance. 734-998-6022.

Desired Breast Size

This is determined on an individual basis.

There is no scientific way to determine the exact breast size. It will be determined by a number of different factors i.e.

  • How well you tolerate each tissue expansion.
  • How well your skin reacts to the expansions.
  • The size of the other breast (if a unilateral tissue expander).
  • Previous surgeries or amount of scarring

We recommend trying on a desired bra size as you approach your desired breast size to see how well the bra size fits.

Appearance

  • While the tissue is being expanded, a bulge will be created. Depending upon the location of the tissue expander, the bulge may be considered desirable or unsightly.
  • Following the exchange of the tissue expander, a more normal and desirable look should be restored.
  • After the exchange for permanent implant, the breasts will feel softer with less fullness in your axilla.

When To Call

  • If you have increasing 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 mediations; such as, rash, nauseas, headache, vomiting, etc.
  • If you have an oral temperature of 100.5 degrees or higher.
  • If you have any yellow or greenish drainage from the incisions or notice a foul smell.
  • 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.
For adult appointments, please call 734.998.6022