Double Incision Mastectomy
Showering
If you had nipple grafts, you cannot get your grafts wet. No showering is allowed until after your 1-week follow-up.
If you did NOT have nipple grafts, you can shower 24-48 hours after your surgery.
Avoid baths or soaking for 2 weeks as this will affect both your dressing and increases your chance for infection.
Shower with the paper tape on. It will stay on in the shower. You can pat it dry or blow-dry it dry after.
Sleeping
Most people find it most comfortable to sleep on their back at a slight incline initially. Any position (except on your front) is allowed as long as it is not painful.
Eating
You can eat whatever you want after surgery, but start with clear liquids, and gradually progress to the foods you like.
Dressings and binder
It is normal to have some drainage from the incisions after your surgery. As long as the drainage is mostly clear (it can be yellow or pink-ish), it is normal.
For the first week after your surgery, you should keep the thick large gauze pad over your chest under the binder. You can change the pad if it is overly soiled.
Leave the dressings on your nipples alone (if you had grafts)
You should wear the binder for support at all times, including during sleep for the first 4 weeks after surgery. Take it off to shower once you’re allowed to shower.
Avoid sliding the binder up and down to adjust it. Undo it completely and reposition it if you need to adjust it.
After you have no more drainage, you can wear a t-shirt under your binder for comfort.
Pain control- Medications
You are not allowed to drive for a minimum of 48 hours.
Take medication for your pain. Your pain medication plan is layered: The first baseline layer is acetominaphen. If you need more pain control, add ibuprofen, and if you need even more pain control, add tramadol. Just because your first layer isn’t giving you enough pain control does not mean it’s not acting on your pain.
For the first 24-48 hours, take the acetominaphen regularly whether you need it or not, but don’t wake up to take it (if you’re sleeping already).
Take 2 regular strength Acetominophen (325mg x 2) every 4 hours. You should not take more than 4000mg in 24 hours from any pills that have Acetominophen in them.
Take 2 regular strength Ibuprofen (200mg x 2) every 4-6 hours. You can take up to 600mg if you need the pain control and your stomach will usually tolerate it.
If more pain control is needed, take 1 Tramadol (50mg x 1) every 4-6 hours.
If you experience constipation, drink lots of water to start. You can also try prune juice or a product like Metamucil. Senokot S or something similar can also be an option.
Things to look out for:
Signs of infection include increased redness, increased pain, increase swelling despite not doing anything, fever, and sometimes, milky white fluid drainage. Most of the time the pain is around your incision and is one-sided, but not always.
Signs of a hematoma include increased swelling on one side of the chest that grows every hour. The swelling feels tense/hard and is sometimes very painful.
Sometimes there is increased bruising (Bruising should not get a lot worse after day 1 or 2.)
If you have any problems after surgery, please call the office at 905-273-4888. Someone is in the office to speak to you betwen 8:30am and 4:30pm weekdays.
For EMERGENCIES ONLY (e.g. a hematoma) there is a nurse on call. The Emergency number is your post-operative package.
Please notify the clinic if you are admitted to a hospital within 10 days of your procedure.
Activity Restrictions:
Avoid strenuous activities and heavy lifting for the first month after surgery.
Avoid raising your elbows higher than your shoulders for the first month after surgery. Your hands can go higher to wash your hair, but your elbows should go no higher than your shoulders.
