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.
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.
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 operation | Day 1 after your operation | Day 2 after your operation | Day 3 after your operation | Day 4 after your operation | Day 5 after your operation |
|---|---|---|---|---|---|
| Drink freely as tolerated | Eat and drink freely as tolerated | Eat and drink as tolerated | Eat and drink normally | Eat and drink normally | You will only be in hospital if your drains have not yet been removed |
| Drink Fortijuce/Fortisip | Drink 3 Fortisip/ Fortijuce | Drink 3 Fortisip/ Fortijuce | Drink 3 Fortisip/ Fortijuce | Drink 3 Fortisip/ Fortijuce | Eat and drink normally |
| Eat a light diet as tolerated as otherwise advised | You can sit up, between 45 and 60 degrees – a nurse will help you with this after you have seen your doctor | Try to get dressed into your day clothes | Get dressed into your day clothes | Get dressed into your day clothes | Drink 3 Fortisip/Fortijuce |
| Remain on bed rest | Start 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 you | Mobilise normally – aim for 4 walks a day Maintain a slightly stooped position | Mobilise normally – aim for 4 walks a day Maintain a slightly stooped position | Continue to mobilise |
| Continue breathing exercises | Ask for laxatives if your bowels have not opened | Ask for laxatives if your bowels have not opened | Practice stairs with physio | ||
| have you opened your bowels? if not inform your nurse | Fitting of a sports bra | Ensure you are wearing your sports bra | |||
| Start planning for discharge home | Plan for going home tomorrow | Discharge 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.
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