Frequently Asked Questions

Usually a week, however this may vary slightly depending on the type of reconstruction you have.

Below is Check List of items to bring in to hospital with you.

• Slippers
• Dressing gown
• Loose fitting, button up night clothes (short sleeve)
• Supportive bra
• Basic toiletries; soap, toothbrush and toothpaste, moisturiser, lip balm
• Clothing to go home in (loose button up top, loose fitting skirt/trousers)
• Drinks bottle if desired
• Antibacterial wash
• Drinking straws
• Hand mirror

After your operation you will be transferred back to the ward. You will be looked after in one of the specialist high dependency bays or in an individual side room for the first 2-3 days. The High Dependency ward is for dependent patients, generally after long surgery. The operation usually takes many hours and you will probably feel drowsy until the next morning. Therefore on the day of surgery, it is advisable for your next of kin to telephone the ward before visiting.

After your operation you will be lying almost flat on your back. It is important for you to keep your upper body still. The surgery requires you not to move your shoulder on the side of your operation for the first few days. Usually there are no dressings on the reconstruction however you will have padding to keep the area warm. It is necessary to keep you warm to maintain a good blood supply to the flap. Your abdominal wound may feel tight following surgery. To improve comfort and aid healing your knees should be kept flexed whilst in bed, using pillows and bed controls to elevate the legs.

The staff will make regular observations for example, blood pressure, temperature, flap observations, drip monitoring and oxygen monitoring. The flap area is closely observed during your stay in hospital especially over the first few days. Occasionally after surgery there may be some bleeding or the blood supply to the flap may become compromised. In this instance it would be necessary to return you to theatre and investigate the cause.

You must not be alarmed at the number of drips and drains you have when you first return from your operation, they are quite normal for this type of surgery.

Your surgeon will usually want you to be on bed rest for the first night following your operation to allow your abdominal wound to settle and the blood supply to establish in your reconstructed breast. You will also be asked not to move your shoulder on the side of your operation during this time.

Your physiotherapist and/or nurse will show you some exercises you can do for your lower body to prevent stiffness and aching in your joints. Moving your feet and ankles assists the circulation and relieves any pressure on your heels. If you have previously had any back problems it is advisable that you tell them, as you can be given special exercises to minimise stiffness in your back.

When the surgeon is happy, usually the 1st day after your operation, the physiotherapist and/or the nursing staff will assist you into the chair, they will help you carry your drips and drains. As you move there will inevitably be a little pulling and soreness around your wounds but do not worry they will not split. You are able to stand as straight as feels comfortable.

Once you have sat out of bed, and you feel up to it, you will be encouraged to take a short walk. This is usually on the second day after your operation. Each day you will be able to walk a little further. Once most of your drips and drains have been removed you should be able to walk up and down the ward independently. Before you go home you will be given the opportunity to practice walking up and down a flight of stairs.

When you are ready to leave the ward you will be given several appointments:

Outpatient Clinic: This appointment will be approximately one week after you go home. This may be either to the Specialist Nurse Led Breast Clinic or occasionally to the Plastic Surgery Dressing Clinic. At this appointment the nurse will inspect your wounds and clean and dress them as required. You may need to attend the dressing clinic on a regular basis until all your wounds are healed.

Consultant Clinic Appointments: This appointment will be made after your operation. It may be at St Andrews, or in some cases, your local hospital. Your surgeon or one of his team will check your breast reconstruction to ensure that all is going well.

Physiotherapy Appointment: These will coincide with the above appointments. Your ward Physiotherapist will give you an appointment for your outpatient physiotherapy follow up. The physiotherapist will check your shoulder movement and give you further exercises and advice as appropriate. You will also be advised on how to massage your scars. The physiotherapist will then arrange further appointments with you until you have regained good movement.

If it is more convenient, it may be possible for you to have further physiotherapy at another hospital. It is important however for you to receive continuity of care throughout the process of breast reconstruction.

The Breast Reconstruction Nurse will be able to offer advice on wound care management and offer general support and advice either face to face in the Nurse Led Breast Clinic or by telephone. When you are discharged from hospital it can seem a long time until your next appointment with the doctor or nurse, and a post-discharge phone call with a nurse can often make all the difference if concerns arise.

A comment often heard is ‘I was so scared to go home with no one to look to for advice’ You will be given the contact details of the Breast Construction Nurses. You may contact them if you have any concerns.

You will probably be ready to go home a week after the operation. At this time you will still be unable to use your arm on the affected side for any lifting or carrying and you may still feel a little weak. You may therefore need someone at home to help initially.

It is normal to feel tired after major surgery so try not to over exert yourself for the first few weeks at home. You may find even simple tasks such as getting washed and dressed consume most of your energy. Try to get plenty of rest and always balance periods of activity with rest periods. Build up your general fitness by going for a walk each day, gradually building up the distance you walk.

When you get home you should continue with the shoulder exercises that your Physiotherapist taught you in hospital. You are advised to see the physiotherapist again two weeks after your operation. You can continue the exercises until twelve weeks after your operation to ensure you have regained full movement.

Usually 6 to 8 weeks after surgery.

You should avoid driving for six weeks after your operation.

You should not return to driving until you feel 100% alert and able to react correctly in an emergency. You should also have regained full shoulder movement before attempting to drive.

You must always wear your seatbelt whilst travelling in the car.

This will depend on the type of work that you do and it is therefore recommended that you discuss this with your surgeon. You may find it helpful to wait until at least 6 weeks after surgery to allow yourself time to regain your strength and energy before returning to work. If your work involves heavy lifting then it is certainly recommended that you take at least 3 months off.

There are no hard and fast rules for when you can return to work, sports, driving etc.

Your Physiotherapist will be able to give more specific advice on your individual activities.

After the initial two weeks and until six weeks after your operation it is advisable to do light household activities only e.g. dusting, preparing light meals, ironing. Do not lift anything heavier than a kettle. After six weeks you can gradually return to heavier housework e.g. hoovering, lifting loads of washing, carrying shopping bags etc.

It is important that you continue to avoid any lifting, straining or carrying heavy objects. Be particularly aware not to force your arm out to the side or push through the arm. After six weeks your body will have healed sufficiently for you to return gradually to most daily activities. You can expect to be back to normal by 8 weeks after your operation.

It is recommended that you avoid sports for 2-3 months after your operation. When you do go back to sports, bear in mind you will be a little unfit and will need to build up slowly.

The following is intended as a guideline only and you should discuss with your surgeon before going back to sports:

• Swimming: 6-8 weeks (all wounds must be fully healed)
• Aerobics/yoga: Can begin gently at 8 weeks
• Racquet sports/contact sports: 3 months