Breast Reconstruction with Autologous Tissue
Medically reviewed by Drugs.com. Last updated on Jul 7, 2024.
AMBULATORY CARE:
What you need to know about breast reconstruction:
Breast reconstruction is surgery to rebuild one or both breasts with your own tissue. This tissue is called a flap. The flap may be taken from your lower abdomen, upper back, buttock, or thigh. The flap may contain skin, fat, muscle, or a combination of these.
How to prepare for breast reconstruction:
Your healthcare provider will talk to you about how to prepare for surgery. You may need to stop taking blood thinners or aspirin several days before surgery. You may need a CT angiogram before surgery. CT angiogram pictures will check the blood vessels in the tissue flap that will be used. You may be given contrast liquid to help the blood vessels show up better in the pictures. Tell the healthcare provider if you have ever had an allergic reaction to contrast liquid. Your provider may tell you to shower the night before your surgery. He or she may tell you to use a certain soap to help prevent a surgical site infection. Your provider may tell you not to eat or drink anything after midnight on the day of your surgery. He or she will tell you what medicines to take or not take on the day of your surgery.
What will happen during breast reconstruction:
- You may be given general anesthesia to keep you asleep and free from pain during surgery. You may be given an antibiotic through your IV to help prevent a bacterial infection. Your healthcare provider will make an incision over one or both breasts. He or she will also make an incision at the donor site. Your healthcare provider may remove skin, muscle, fat, blood vessels, or a combination, from this area. This tissue is the flap. He or she may keep the flap attached to blood vessels and move it through a tunnel under your skin to your chest. Your provider may instead cut the flap free and reattach it to the tissue and blood vessels in your chest.
- Your healthcare provider may place several drains at the donor site and at the new breast or breasts. The drains will help remove extra fluid and help your incisions heal. Your donor site and breast incision or incisions will be closed with stitches. A bandage will be placed over each incision. Your healthcare provider may place a binder across your abdominal incision. This will help prevent bleeding and decrease pain.
What will happen after breast reconstruction:
- Healthcare providers will monitor you until you are awake. You may spend the first night in an intensive care unit (ICU). Healthcare providers will closely monitor the blood flow to your flaps in the ICU. After that you may spend several more days in the hospital before you can go home. Bruising and swelling are normal and expected. You will not be able to lie flat in bed if tissue has been taken from your abdomen. This may put too much stress on your incision. Your healthcare provider will give you instructions on how to avoid putting stress on your incisions.
- Nipple and areola reconstruction can be done after you have healed from surgery. Tissue may be taken from other parts of your body to rebuild your nipple and areola. Ask your healthcare provider for more information about nipple and areola reconstruction.
Risks of breast reconstruction:
You may bleed more than expected or get an infection. Nerves, muscles, or blood vessels may be damaged during your surgery. Fluid or blood may collect under your skin at the flap or donor site. You may need surgery to drain or remove it. The blood flow to your flap may stop. This could cause the tissue to die. You may need surgery to remove the dead tissue or repair the blood vessels. You may develop a hernia (a bulging of tissue organs through your abdominal wall) if tissue was taken from your abdomen. You may get a blood clot in your arm, leg, or lung. This may become life-threatening.
Call 911 for any of the following:
- You feel lightheaded, short of breath, and have chest pain.
- You cough up blood.
- You have trouble breathing.
Seek care immediately if:
- Blood soaks through your bandage.
- Your leg or arm is painful and looks larger than normal.
- Your stitches come apart.
- Your drain falls out or stops draining fluid.
- Your drain has pus or foul-smelling fluid coming out of it.
- Your breasts look pale, purple, or feel cold.
- You feel a hard lump in your breast.
Contact your healthcare provider if:
- You have a fever or chills.
- Your wound is red, swollen, or draining pus.
- Your pain does not get better after you take pain medicine.
- You have nausea or are vomiting.
- Your skin is itchy, swollen, or you have a rash.
- You have questions or concerns about your condition or care.
Medicines:
You may need any of the following:
- Antibiotics help prevent a bacterial infection.
- Prescription pain medicine may be given. Ask your healthcare provider how to take this medicine safely. Some prescription pain medicines contain acetaminophen. Do not take other medicines that contain acetaminophen without talking to your healthcare provider. Too much acetaminophen may cause liver damage. Prescription pain medicine may cause constipation. Ask your healthcare provider how to prevent or treat constipation.
- NSAIDs , such as ibuprofen, help decrease swelling, pain, and fever. NSAIDs can cause stomach bleeding or kidney problems in certain people. If you take blood thinner medicine, always ask your healthcare provider if NSAIDs are safe for you. Always read the medicine label and follow directions.
- Antiplatelets , such as aspirin, help prevent blood clots. Take your antiplatelet medicine exactly as directed. These medicines make it more likely for you to bleed or bruise. If you are told to take aspirin, do not take acetaminophen or ibuprofen instead.
- Take your medicine as directed. Contact your healthcare provider if you think your medicine is not helping or if you have side effects. Tell your provider if you are allergic to any medicine. Keep a list of the medicines, vitamins, and herbs you take. Include the amounts, and when and why you take them. Bring the list or the pill bottles to follow-up visits. Carry your medicine list with you in case of an emergency.
Care for your wounds as directed:
Ask your healthcare provider when your incisions can get wet. You may need to take a sponge bath until your drains are removed. When you can shower, carefully wash around the incisions with soap and water. It is okay to allow the soap and water to gently run over your incision. Dry the area and put on new, clean bandages as directed. Change your bandages when they get wet or dirty. It may feel more comfortable to place gauze over your incisions before you put on a bra. Check your incision every day for redness, pus, or swelling. Do not put powders or lotions on your incisions.
Self-care:
- Limit your activity as directed. Do not lift anything heavier than 2 pounds. Do not push, pull, or reach with your arms. Do not play sports or do vigorous activities. Do not have sex until your healthcare provider says it is okay. Start with short walks around the house. This may prevent blood clots and help with healing. Gradually walk further each day. Ask your healthcare provider when you can return to your normal activities. You may need to follow other instructions depending on where donor tissue was taken from.
- Keep stress off your abdominal incision by doing the following:
- Do not lie flat in bed. Keep 1 pillow under your thighs and 1 under your head. This will keep your hips flexed and take stress off of your abdominal incision.
- Bend forward from your hips when you get out of bed and walk. Ask your healthcare provider how long you need to do this.
- Wear your abdominal binder as directed.
- Do not drink caffeine for 4 weeks or as directed. Caffeine can shrink blood vessels and decrease the blood flow to the flaps.
- Empty your drains as directed. You may need to write down how much fluid you empty from your drains each day. Ask your healthcare provider for more information about how to empty your drain.
- Wear a supportive bra as directed. You may be given a surgical bra or told to wear a sports bra. A supportive bra may help hold your bandages in place. It may also help with swelling and pain. Do not wear bras with lace or underwires. They may rub against your incision and cause discomfort.
Physical therapy:
You may need physical therapy. It may be difficult or painful to use muscles at the donor site. A physical therapist teaches you exercises to help improve movement and strength, and to decrease pain.
Follow up with your healthcare provider as directed:
Write down your questions so you remember to ask them during your visits.
Follow up with your doctor as directed:
Write down your questions so you remember to ask them during your visits.
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The above information is an educational aid only. It is not intended as medical advice for individual conditions or treatments. Talk to your doctor, nurse or pharmacist before following any medical regimen to see if it is safe and effective for you.
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