What to Expect When Having Breast Reconstruction

Anesthesia: General. You will sleep through the entire procedure.

Location of Operation: Hospital.

Length of Surgery: Tram Flap 4-5 hours, Bilateral Tram Flap 6 hours, Latissimus Flap with or without expander 4 hours, Tissue Expanders 1 ½ to 2 hours.

Length of Stay: Tram Flap 3-4 days, Latissimus Flap 1-2 days, Tissue Expander 1-2 days

Discomfort: Moderate with Tram Flaps; will have 5 day Stryker pain pump for abdominal pain. Mild with latissimus flap and expanders. All are well controlled with pain medications and muscle relaxants.

Swelling and Bruising: Moderate, usually resolves within 4-6 weeks.

Bandages: The initial dressing is usually a surgical support bra which is worn day and night for the first two weeks. Showering can usually start 2-3 days after surgery. No tub baths for 2-3 weeks depending on wound healing and drain status.

Stitches: All sutures are dissolvable.

Drains: Usually there is a drain for each breast. For trams there are two abdominal drains that come out in 7-10 days. For latissimus flaps, usually a back drain that comes out 10-14 days after surgery. Drain care and teaching will be provided.

Second Stage Procedure: This usually consists of nipple reconstruction and for tissue expander patients also the exchange of their expanders for permanent breast implants. The second stage is usually done 3 months after the initial reconstruction and is usually an outpatient procedure. Nipple tattooing is usually done several months after the final reconstruction and is done in the office.

Bowel Prep: Tram flap patients also undergo a 2 day bowel prep just before their surgery. It is included in this surgery folder.

Work: With trams, usually 6 weeks, latissimus flaps and tissue expanders 2-3 weeks.

Exercise: Light activities can be resumed in 2 weeks. Unrestricted activities can begin in 6 weeks.

Special Care: ABSOLUTELY NO SMOKING!!!!! Smoking is prohibited 4 weeks prior to and a minimum of 4 weeks after surgery.

back to top