BREAST SURGERY

Post-Op Breast Surgery Instructions

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General

This page is intended to be a handy reference for the typical questions which arise during the post-operative period, specifically related to the surgery you had. Most questions you may have will likely be answered here. However, if you feel you need to speak to the physician on call, you may call our office number 404-508-4320 at any time of the day or night. After hours, this phone number is forwarded to our automated answering service, which will typically connect you to the surgeon on call in just a minute or so, while you are still on the line. If the surgeon cannot take your call immediately, he will return your call, usually within about 20 minutes. If your call is not returned in 30 minutes, quality the second message. Of course, if you feel you may be having a life-threatening emergency, you should call 911 for immediate assistance.

 

PAIN MEDICATION

BANDAGES

DRAINAGE TUBES

DIET

DRIVING

RETURN TO WORK

FOLLOWUP OFFICE APPOINTMENT

 

PAIN MEDICATION:

The medicine which was used may affect you for up to 24 hours after your procedure, so you might feel sleepy; this feeling will slowly wear off. BECAUSE THE MEDICINE MAY STILL BE IN YOUR SYSTEM FOR THE NEXT 24 HOURS, YOU SHOULD NOT:

Drive a car or operate machinery or power tools

Drink any alcoholic beverages

Make any important decisions, such as signing important papers

A prescription for pain medication may be given by your physician. This should be taken as directed, and if the pain is not relieved, contact your physician. If your physician does not prescribe medication, you may take a non-prescription, non-aspirin medication which can be purchased at your drugstore. Please follow the directions on the label. Please be aware that any pain medication can affect your judgment.

The narcotic medications typically prescribed (eg, hydrocodone or oxycodone) can cause nausea, itching, or other side effects. It is best NOT to take these on an empty stomach. If you are nauseated or just not eating much yet, at least take a cracker along with this medication, to help lessen the possibility of worsening nausea. If you experience itching after taking one of these narcotic medications, it is likely due to an allergy to the medication. While in most cases, this is not severe, it is most likely best not to use even smaller doses of that specific narcotic in the future. You can use over the counter medications, such as Tylenol (acetaminophen), Aleve (naproxen), or Motrin or Advil (ibuprofen) instead, and in many cases, these options will be sufficient. But if not, call to report your problem, and an alternative choice will be given. And if you have experienced an allergic reaction, be sure to note the medication name, and add it to your written list of drug allergies and adverse effects.

Be aware that the narcotic medications (eg, hydrocodone (Lortab), oxycodone (Percocet)) usually include some acetaminophen. This improves the effect of the narcotic. Be aware that large daily total doses of acetaminophen can cause liver damage, so be sure to follow the instructions on the package or prescription. Here is a link to more information about acetaminophen.

If you require additional narcotic pain medication, be aware that a written prescription is required by law.  That means that a refill can NOT be transmitted electronically or by phone. You or someone for you, will need to come to the office to pick it up.

 

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BANDAGES:

You may place ice packs covered with a towel over the incision to decrease swelling during the first 24-48 hours after surgery. The use of ice packs is optional, but many patients find that it helps to lessen their pain, and speed up their recovery. Some swelling or bruising at the incision site is normal.

Keep any clear plastic dressings on until your followup visit if possible.

Your may take a brief shower leaving the clear dressings in place; do not soak in a tub bath.

Your dressings may become soaked or may leak. If so, you may remove the dressings and replace with dry gauze and adhesive tape daily. You may still gently shower and re-cover with gauze and tape afterward.

If surgical glue is used, you may shower as long as there is no drainage from the incision.  The glue will remain in place typically for a few weeks until it eventually peels off.

 

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DRAINAGE TUBES

You may have a drain in place. You and your family should have been instructed in how to care for the drainage bulb, and how to empty and record the output. Keep the drainage bulb capped. The bulb should typically be “collapsed”, in order to maintain some negative pressure in the tubing. Empty the bulb anytime it gets up to halfway full, and at least twice a day if less. Measure the amount emptied (in cc’s or in mL’s), and record it on the paper you were given for this purpose, or use what is shown below. To keep the tubing open and free of clot, it helps to “strip” the tubing anytime you empty the bulb. This is done by squeezing the tubing between your thumbnail and index finger, starting close to the body, stripping toward the bulb. Hold the tubing with your other hand close to the body, to prevent pulling the tubing out of the body. Repeat the stripping process until the tubing is slightly collapsed. You may see some thin strips of blood clot in the tubing, and these should be “stripped” into the bulb.

There usually is very little drainage AROUND the tubing at the skin exit site. If you suddenly start seeing a lot of drainage AROUND the tubing, it may indicate that the tubing has become occluded. The instructions below explain how to change the dressing around your drain. But this is only necessary if there is enough drainage to saturate the dressings. If you note that there is little drainage into the bulb, but drainage saturating the dressings, call your doctor for instructions.

breast-surgery

DIET:

After general anesthesia, you may not have much appetite for the first 1-2 days after surgery.

Start with light foods (breads, bananas, soups) and advance as tolerated.

If you are nauseated, limit yourself to liquids until the nausea resolves. If the nausea is your worst symptom, you may call the office phone number (404-508-4320) and ask for some medication to help with it.

Be aware that the pain medications prescribed, such as hydrocodone and oxycodone frequently cause constipation. If you are using these medications regularly for pain control, consider taking milk of magnesia once or twice daily to help prevent constipation from being a problem.

 

DRIVING:

You can usually resume driving in just a day or two, but if you are still in a lot of pain, wait until it subsides.

 

RETURN TO WORK

In most cases, one can return to work in less than a week, but it does depend on what type of work you do, whether you have resumed driving as discussed above, and how much pain you are experiencing after surgery. You can get a written work release and permission to return to work from the DeKalb Surgical office if needed.

 

FOLLOWUP OFFICE APPOINTMENT

In most cases, your surgeon will want to see you back in the office in about one week, unless you have been instructed differently. You can call during regular office hours to make the appointment, using our main office phone number, 404-508-4320. Please be sure to make note in advance whether you have sufficient pain medication left, and if not, you can request a refill during your appointment. If there is any pathology report to go over, your surgeon should typically have it available by the time of the first visit. You may have a copy for your own records if requested. Prior to your appointment, it would be good to write down any questions you need answered, to be sure you don’t forget. If you have a drain in place, be sure to bring the paper on which you have been recording the output, as this will help determine when the drain(s) can be removed.

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