Breast Reconstruction Enhanced Recovery Surgery

The aim of Breast Reconstruction Enhanced Recovery Surgery is to get you back to full health as quickly as possible after your operation. There may be circumstances where the programme will not be appropriate for some patients and if this is the case, you will be fully informed.

Research indicates that after surgery your recovery will be quicker with fewer complications the earlier we get you out of bed, exercising, eating and drinking. In order to achieve this we need to work together to enhance your recovery.

Before surgery

The specialist breast care nurse will have already discussed appropriate lifestyle behaviour. It is important that you understand what you need to do in order to ensure you are fit and safely prepared for surgery. It is important to keep as active as you can before your operation. The nurse will discuss diet and exercise with you and returning to normal activities.

 

Fortisip

You will be given a choice of special nourishing supplement drinks called ‘fortijuce’ and ‘fortisip’, in a variety of flavours. These are nutritional supplements containing protein (to aid healing) and vitamins (to support your immune system). Regardless of your weight or appetite, you will be given some of these drinks to take home with you. Take them at the time discussed.

As you are likely to be in hospital for 4-5 days, it is important that you remember to bring a few things in with you, or get a family member to bring them in for you. Things you will need:-

  • Night wear with buttons down the front
  • Slippers/dressing gown
  • Sports bra/support bra
  • Support pants [Large enough to cover abdominal scar]
  • Toiletries [Including dry shampoo]
  • Comfortable clothes to wear in the ward and home
  • IPod, MP3 magazines and books

Support/Sports bra will be fitted once your breast drains have been removed, you need to wear it for 4-6 weeks following surgery. After Diep surgery, whilst in hospital you will need to try and wear support [spanks] pants to help support your abdomen and reduce some of the abdominal swelling, for at least 4 weeks.

 

Pre-op

If you were told to take Preop drinks, take them at the time discussed. These drinks are a clear liquid ‘breakfast’ to ensure your body has fuel to work with whilst you are not eating. If you are diabetic we will not give you these as they can cause your blood sugars to rise.

Once you arrive for surgery

Upon arrival, a member of the surgical team looking after you will check that you are fully aware of your surgery.

In order to help prevent blood clots you will be required to wear special support stockings (TEDS). The nurse will need to measure your legs to obtain the correct size.

After your surgery

You will return to the ward after your operation. You will need to stay in bed for the first 24 hours positioned with your knees bent/flexed to help your abdomen relax. For the first 24-72 hours you will be closely monitored to ensure that your new breast[s] is healing and that you are recovering from the anaesthetic.

Following this progression chart will help improve your recovery. The nurses on the ward will assist you or if you have any questions.

Day of Surgery, after your operationDay 1 after your operationDay 2 after your operationDay 3 after your operationDay 4 after your operationDay 5 after your operation
Drink freely as toleratedEat and drink freely as toleratedEat and drink as toleratedEat and drink normallyEat and drink normallyYou will only be in hospital if your drains have not yet been removed
Drink Fortijuce/FortisipDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceDrink 3 Fortisip/ FortijuceEat and drink normally
Eat a light diet as tolerated as otherwise advisedYou can sit up, between 45 and 60 degrees – a nurse will help you with this after you have seen your doctorTry to get dressed into your day clothesGet dressed into your day clothesGet dressed into your day clothesDrink 3 Fortisip/Fortijuce
Remain on bed restStart breathing exercises (the nurse & Physio will advise you)Aim to sit out and mobilise as soon as you have seen your doctor – the nursing staff can help youMobilise normally – aim for 4 walks a day Maintain a slightly stooped positionMobilise normally – aim for 4 walks a day Maintain a slightly stooped positionContinue to mobilise
  Continue breathing exercisesAsk for laxatives if your bowels have not openedAsk for laxatives if your bowels have not openedPractice stairs with physio
  have you opened your bowels? if not inform your nurseFitting of a sports braEnsure you are wearing your sports bra 
  Start planning for discharge homePlan for going home tomorrowDischarge home today of your drains are out 

You should try and be as mobile as you can once you are home. You will find that you will also need to take regular rests at intervals which may mean you have to go back to bed for a couple of hours each day. This surgery can be very tiring for the first couple of weeks and then improve slowly. The Physiotherapist will give you exercises to do once your are home, it is important to continue with the advice given to ensure you recover quickly and with full movement. We advise
no heavy lifting, washing clothes etc. for at least three to four weeks after surgery. This allows all wounds and scars to heal without any added stress to the area.

For further information:

Breast Reconstruction Enhanced Recovery Surgery