Common Questions and Answers After TRAM Breast Flap Surgery
This handout answers many questions often asked by patients who are having TRAM reconstructive breast surgery.
Planning for Surgery
How long will I stay in the hospital?
You will have a 3-4 day stay. It will depend on how well your incisions are healing and how you are moving around.
What should I expect after surgery?
The nurses will be checking on your incisions, monitoring your drains and pain levels. Someone will be there to help you get out of bed and walk. At first, you will want to walk slowly and bent over at the waist in order to avoid pulling on your abdominal incision.
Drains
What are drains?
Drains are small tubes with a collection bulb at the end. During surgery, these are inserted under your skin near your incisions. They are used to help drain away excess fluid that will collect from your reconstructed breast and abdomen area after surgery.
Will I be going home with drains?
Yes. The drain tubes will most often be taken out at about one week after surgery at your first clinic visit. Your nurse will give you instructions and have you watch a videotape in the hospital showing you how to care for your drains at home.
Can I shower with the drains in place?
Yes. When you go home, you may shower with the drains in place. Have someone nearby the first time you shower in case you faint.
Don’t take tub baths until your drains are out and the drain sites are well healed.
Stitches
How long will I have stitches?
Dissolvable stitches are used most of the time. They will feel prickly at first. They will dissolve under the skin. You may see some white stitch material loosen and fall out in 5-14 days. This is normal.
Can I use soap and water on my stitches when I go home?
Yes, if you shower, allow the soap and water to run down over your stitches. Rinse with clear water and pat dry. Do not rub the stitches.
Will there be any scarring from the incisions?
There will be scars at the incision lines. The scar will be pink at first, and will fade over time. But, the scar will remain. Avoid sun exposure to your incisions. If you cannot avoid sun exposure, use a sunscreen.
Breast
Will my new breast look the same as it looks right after surgery?
No, at first there will be swelling and most likely, bruising. You may not see the final results of your surgery for several months.
Will my new breast "match" the size of my other breast?
It may not exactly “match” the size of your other breast. The size of the new breast depends upon how much abdominal tissue you have. Other factors, such as previous radiation therapy to the area, will also affect the size of your new breast.
Can anything be done if my breasts do not “match?”
If your new breast is smaller or larger than your other breast, another surgery to change the size of either breast, at a later time, may be a choice for you. There are also partial breast forms that fit into the pocket of special bras to help “match” the sizes of your breasts.
Will I have a lot of feeling in my new breast?
No, your new breast will have less feeling in it. It may feel slightly numb. This is normal.
When can I start wearing a bra?
You can wear a bra as soon as the drains are out. A front closing "athletic bra" is most comfortable. You may want to wear a slightly larger size at first because of swelling.
Abdomen
How long will my abdomen feel sore?
You will have some soreness in your abdomen for about 3-6 weeks after you go home. You will have pain pills to help you feel more comfortable. Your abdomen may feel slightly numb for quite a while. This may be long term.
Activity
When can I start doing arm exercises?
For the first 2 weeks, raise your arms only to the level of your shoulder. Do not reach your arms above your head. You can start doing shoulder shrugs, shoulder circles and arm curls the second to third day after surgery. After the second week, you can start doing larger arm exercises. Your clinic nurse will review these with you at your first visit.
How much should I lift after I go home?
You should only lift 10 pounds for the first 3 weeks. After that you can slowly begin to increase the amount of weight you pick up.
How long before I can go back to work?
Often, it is about 4 weeks before you can go back to work. This depends on the type of work you do.
Clinic Visits
How often will I need to return for clinic visits?
At first, you will be seen every week for 2-3 weeks. After that, the clinic visits will be less often, likely at 1 month, 6 weeks, and then 6-month intervals.
Mammogram and Breast Self Exams
Do I need to check my new breast by doing a self exam?
Yes. You should do monthly breast exams to both breasts, including feeling your armpits and up to your collarbone. You also need to check along the incision line(s) of your new breast.
Will I need to have a mammogram of my new breast?
No. Since there is no longer breast tissue present, a mammogram is not needed. You will continue follow-up appointments with your oncologist or doctor. You will need to have mammograms of the other breast.
Sleep
Can I sleep on the side that the new breast is on?
Yes. After you go home, you may sleep in your favorite position. For a few weeks, you may find it is not easy to sleep on the side with the new breast
The information provided should not be used during any medical emergency or for the diagnosis or treatment of any medical condition. A licensed physician should be consulted for diagnosis and treatment of any and all medical conditions. Call 911 for all medical emergencies. Any duplication or distribution of the information contained herein is strictly prohibited.
Last Updated: 08/11/2011
Copyright © 08/11/2011 University of Wisconsin Hospitals and Clinics Authority. All rights reserved. Produced by the Department of Nursing. HF#4341
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