The days after surgery
Breast surgery is surprisingly less painful than many other forms of surgery. But, the amount of pain will correspond to the size of the performed operation.
Excision of a lump (Benign or Malignant):
– Often is carried out as a day case.
– Needs simple analgesia like: Paracetamol or Ibuprofen.
– We don’t usually leave drains.
– We recommend wearing a support Bra 24/7 to help prevent bruising and
prevent pain and help shaping the breast.
– Patients can resume near normal activity at home next day.
– As the patient could feel tired for a little while, we recommend a week off
work.
Excision of the lump or Mastectomy + Removal of the Lymph Nodes:
– Surgery on the Armpit is the source of pain in this type of surgery.
– Patients stay 1 -2 days in hospital after surgery.
– Usually the surgeons leave a drain or 2, one in the breast and the other in the armpit.
– The breast drain is removed day 2-3 (unless she had mastectomy when it is removed when the drainage is less than 50/day) and the patient can go home with the armpit drain attached and trained on caring for it by the
nurses.
– The patient returns to the hospital one week after surgery to have the last drain removed.
– The patients need regular pain killers in the first 3 days like Paracetamol + Ibuprofen. When needed afterwards.
– Patient will start arm exercises day one after surgery.
– Patients will be given instructions as to arm exercises at home.
– Patients will be given instructions how to care for their arms to prevent arm swelling later in life.
– Patients are to avoid excessive lifting or arm movements.
Breast Reconstruction using FLAPS:
– The operation takes longer to perform and bigger size of an operation
means more pain.
– The patient will need Patient controlled analgesia for better pain
management in the first 48 hours.
– Oral, simple pain killers from day 3 plus injections as needed.
– There will be a urinary catheter for collecting and measuring the urine
output which guides the doctors on estimating the daily need of fluids.
– The catheter could be removed after 2 days if the patient moves well
enough to use the bathroom.
– There will be 2 -4 drains depending on type of surgery, at least one in the
donor site.
– Most drains could be removed when the drainage is less than 50mls a day except the back drain which is left a minimum of one week or even longer.
– Occasionally the patient goes home with the back drain.
– Patient will have daily blood tests to check the Haemoglobin and Kidney
function for three days.
– Patients need Antibiotics for 5 days.
– If Haemoglobin is less than 12 before the operation, need cross match 2
units of blood.
– Patients will need blood transfusion if after surgery the Haemoglobin drops bellow 8.5
– We start supervised physiotherapy day 3 onward.
– On leaving the hospital, the patient will be given instructions on performing exercises .
– No daily dressing unless the dressing is soiled.
– Patients are to avoid heavy lifting or excessive arm movements.
Implant only reconstruction:
– Patients usually stay 2 days in hospital.
– Drains are removed when drain less than 30 mls a day
– Antibiotics are given for minimum of 5 days or until drains removed.
– Patients need simple analgesia.
– Patients are instructed to avoid any excessive arm movements or lifting
