This information will help you prepare for your nipple and areola reconstruction using a skin graft.
A skin graft is made by taking tissue from one part of your body (called the donor site) and moving it to the surgical site that needs to be covered (called the reconstruction site). Typical donor sites include the groin and lower abdomen; however, your surgeon may choose other sites. Your nipple will be made from the skin on your chest. Your areola will be made with a skin graft surrounding the nipple.
Before Your Procedure
During your presurgical testing (PST) appointment, you will meet with a nurse practitioner who works closely with anesthesiology staff (doctors and specialized nurses who give you medicine to sleep during surgery). You can eat and take your usual medications the day of your PST appointment. During your appointment, your nurse practitioner will review your medical and surgical history with you, including your medications. You will have tests, including an electrocardiogram (EKG) to check your heart rhythm, a chest x-ray, blood tests, and any other tests necessary to plan your care. Your nurse practitioner may also recommend you see other healthcare providers. It is very helpful if you bring the following with you to your PST appointment:
- Medication list
- Reports of any tests done outside of MSKCC, such as a cardiac stress test, echocardiogram, or carotid doppler study
- The name and telephone number of your doctor(s)
You will be given a card called Getting Ready for Surgery. This resource provides important information on how to prepare for your procedure. In addition to the information in Getting Ready for Surgery, please remember:
- On the day of your procedure, wear a thin, non-padded bra or a form fitting light colored shirt. This will help you and your surgeon finalize where your nipple-areola will be placed.
- If you were given stickers to help your surgeon place your nipple and areola, please remember to wear them the day of your procedure.
What to expect
Once you arrive at the hospital, doctors, nurses, and other staff members will ask you to state and spell your name and date of birth many times. This is for your safety. Patients with the same or similar names may be having procedures on the same day.
After changing into a hospital gown, you will meet your nurse. He or she will place an intravenous (IV) catheter into a vein, usually in your hand or arm. At first you will receive fluids through the IV, but it will be used later to give you anesthesia (medication to make you sleepy). Your doctor will explain the procedure, and answer any questions you have.
When it's time for your procedure, you will be brought into the procedure room and helped onto an exam table. You will be attached to equipment to monitor your heart, breathing, and blood pressure. You will also receive oxygen through your nose. Once you are asleep, your doctor will start the procedure.
After Your Procedure
In the recovery room
When you wake up after your procedure, you will be in the Post-Anesthesia Care Unit (PACU). Your nurse will continue to monitor your heart rate, breathing, and blood pressure. Once you are fully awake, your nurse will give you a drink and a light snack. He or she will remove your IV line. Once your healthcare providers feel you are ready, family and/or friends can visit you.
Your first post-operative visit will be_____________ days after procedure.
While you recover, do not wear clothing that rubs against your donor site incisions (surgical cuts). Do not wear a bra after your procedure. When you leave the hospital you should wear clothing that is loose and comfortable. If you will be traveling by car, place a small pillow or towel between the seat belt and your incision.
Caring for your chest
Do not touch, wet, or change the bulky bandage on your chest. Touching the bandage may interfere with the healing of your skin graft. Your bandage will be changed the first time at your follow up appointment. During that appointment your nurse will teach you how change your Xeroform® and gauze bandage. You will need to change them every day.
Do not apply any pressure or friction to your nipples for 2 to 4 weeks after your procedure.
Shower only from the waist down for the first 48 hours after your procedure. Your incision at the recipient site must be kept dry. Your doctor will tell you after your first post-operative visit when you can take a full shower.
Your incision site in the donor area may feel tender or tight after your procedure. You will be given a prescription for a mild pain medicine before you go home.
Restrictions on physical activity
If the donor site is your groin, do not perform any activity that may extend your leg beyond normal limits (hyperextend) for 6 weeks. Examples include squatting or straddling.
Your doctors and nurses will give you instructions on what exercises and movements you can do while your incisions are healing. Check with your doctor or nurse before starting heavy exercises, such as:
- Lifting weights
Call Your Doctor or Nurse If You Have:
- A temperature of 101° F (38.3° C) or higher
- Redness, warmth or increased pain in the nipple/areola area.
- Shaking chills
- Flu-like symptoms
- Shortness of breath
- Drainage or oozing from an incision
- Any type of skin infection on any part of your body