After chest reconstruction
After you come round from the anaesthetic you will stay in hospital overnight.
You will return to your room with intravenous fluids, a tight binder across your chest (this is to minimise any swelling or formation of haematoma).
The nurses will monitor you closely. They will check your pressure dressings which are over your nipples and suture lines.
You will be able to eat and drink on return to the ward.
You will be seen post surgery by Mr Yelland.
The following morning after your surgery Mr Yelland will examine you to ensure you are fit for discharge. You will be seen by a physiotherapist and you will be given exercises to follow in your recovery period.
You will be advised to wear a binder post-operatively which is of Neoprene construction. These are quite sweaty and do contain some latex. It is wise to wear a T-shirt between this and your skin.
The nurses will give you dressings to take home. Will discuss your post operative care, give you contact numbers for night and day.
A sick certificate will be issued should you require one for two weeks. If you require longer Mr Yelland will assess you in your post operative consultation.
You will be given an appointment on the day of discharge for your post operative appointment, this is usually 7-10 days.
At you post operative appointment your dressings will be removed by Mr Yelland or Specially Trained Nurse.
If you have clips around your areolar these will be removed, sutures will be removed and a further dressing will be applied for 24 hours. This can then be removed.
Possible Post Operative Complications
DVT (Deep Vein Thrombosis), pulmonary embolism. It is important for you to mobilise post surgery. Drink plenty of water. DO NOT SMOKE, this can reduce the blood supply to your nipples and contribute to nipple necrosis.
Binders and Dressings
Your incisions will usually be covered with gauze dressings and a pressure dressing over your chest to provide both support and protection.
A binder (compression vest) is usually worn to aid healing for up to four weeks after chest reconstruction surgery and this can encourage the skin of the chest to tauten and prevent fluid build-up.
If you have had breast reduction with liposuction rather than chest reconstruction you will be required to still wear a binder for four weeks during the healing process.
If you had nipple grafts then these will be covered with special cushioning and gauze dressings that stay in place for around 7-10 days after FTM surgery until removed by the surgeon to check healing.
Checking for Infection
Following removal of your dressings. It is important to observe any changes in your incisions (you may need to use a mirror or get a friend to check for you).
If you can see any redness that extends more than an inch from the incision site this may be a sign of infection and should be investigated.
Some redness and tenderness at the incision is perfectly normal but any fluid seepage or changes in inflammation, particularly if you have a headache or fever, should be reported immediately.
Swelling, Tenderness, and Numbness
Swelling and tenderness is common for at least a month after surgery and initial bruising is usually no cause for concern.
If, however, you observe any increased bruising and develop a pooling of blood under the skin causing a visible lump then seek immediate medical attention as this can indicate a haematoma.
Burning pain, sharp shooting pains and general discomfort can be common, and this will usually dissipate over the first few days after surgery.
Numbness may occur across the chest and in the nipple, this will usually subside (sometimes taking up to a year) as the nerves in the chest heal but may be a permanent feature if severe nerve damage occurs.
Returning to Work
Your surgeon will give you specific instructions regarding post-surgical care and recovery from chest reconstruction.
If you have a fairly sedentary occupation then you may be able to return to work after a couple of weeks once normal movements are no longer painful.
Any profession which requires heavy lifting, frequent raising of the arms above the head, or strenuous activity is likely to necessitate a longer hiatus from work such as a month or two.
You may be able to alter your responsibilities at work for a few weeks such as switching to a desk job temporarily and you should discuss this with your employer where possible.
Your surgeon will offer guidance on post-operative care to minimise potential scarring.
Your GP or nurse should be able to address any rupture of a small number of stitches but you will most likely require attention from your surgeon if your wound begins to open up or if fluid builds up in your chest.
If adequate healing time is not allowed then increased visibility of scarring is more likely.
You should not attempt any weight-lifting exercises until cleared by your surgeon as any increase in pectoral muscle size during the healing period may tear the stitches, cause substantial pain, and/or lead to a necessity for further surgery.
Some degree of scarring is the natural response of the body to help heal itself following trauma.
This occurs due to the deposition of fibrous collagen and can create temporarily raised and darkened scars.
These usually fade over the next few months but can occasionally remain thickened and red if you develop hypertrophic scarring.
This type of scarring may be connected to genetic factors but is also a feature of overstretched scars which have not been given adequate healing time prior to the resumption of activities.
Treatments to reduce the visibility of hypertrophic scarring are available although their success is variable. Most scars will look their worst at six weeks or so after FTM surgery and will start to fade after that time.