Checklist: Mastectomy Without Reconstruction or With Reconstruction Using a Tissue Expander

This information outlines what to do and expect before and after your mastectomy without breast reconstruction or mastectomy with breast reconstruction using a tissue expander.

Follow your care team’s instructions while you’re getting ready for and recovering from surgery. Read the resource About Your Mastectomy or About Your Mastectomy: Information for Men.

Getting Ready for Your Surgery

What to do

• Set up a MyMSK account if you haven’t already. Visit www.mskcc.org/pe/enroll_mymsk for instructions.
• Complete a Health Care Proxy form. You can find it online at www.health.ny.gov/publications/1430.pdf or ask a member of your care team for a copy.
• Identify your caregiver.
• Arrange for someone to take you home after surgery.
• Follow your healthcare provider’s instructions for taking medications.

What to buy

• Buy a 4% chlorhexidine gluconate (CHG) solution antiseptic skin cleanser, such as Hibiclens®.
• Buy 325-milligram acetaminophen tablets (such as Tylenol® Regular Strength).

Presurgical Testing (PST) appointment

• Bring a list of all the prescription and over-the-counter medications you take.
• Bring any important medical notes or results from tests done outside of MSK. (If your MSK care team already has them, you don’t need to bring them.)

1 Day Before Your Surgery

A staff member will call you between 2:00 p.m. and 7:00 p.m. They’ll tell you what time to arrive for your surgery. If your surgery is on Monday, they’ll call you on the Friday before. If you don’t get a call by 7:00 p.m., call 212-639-5014.

Eating and drinking

• Do not eat anything after midnight the night before your surgery. This includes hard candy and gum.
• You can drink a total of 12 ounces of water between midnight and 2 hours before your scheduled arrival time. Do not drink anything else.

Taking your medications

• Follow your healthcare provider’s instructions.

Showering

• Shower in the evening.
  • Wash your hair, face, and genital area as usual.
  • Wash from your neck to your feet with 4% CHG solution. Avoid your head and genital area.
  • Dry yourself with a clean towel. Don’t use lotion, cream, deodorant, makeup, powder, perfume, or cologne afterward.

The Day of Your Surgery

Eating and drinking

• Do not eat anything.
• Do not drink anything starting 2 hours before your scheduled arrival time. This includes water.

Taking your medications

• Take only the medications your healthcare provider told you to take. Take them with a small sip of water.

Showering

• Shower before your surgery. Follow the same steps you did the night before.

Things to remember

• If you use contact lenses, wear glasses instead.
• Remove any metal objects and jewelry, including body piercings.
• Leave valuable items at home.
• Wear a button-down or loose-fitting top and flat, safe shoes for walking.
• Bring your Health Care Proxy form and other advance directives, if you’ve filled them out.

In the Hospital After Your Surgery

Learning to care for yourself at home

• Meet with your nurse to review:
  • How to manage your pain
  • How to take care of your drain(s) and incision(s)
  • How to shower
  • When you’ll be able to drive
• Review arm and shoulder exercises to do at home.

Getting ready for discharge

• Make sure you have a responsible care partner to take you home.

At Home

Follow your care team’s instructions. They’ll give you written instructions for your arm and shoulder exercises. You can also find them online at www.mskcc.org/pe/exercises_mastectomy.

Taking your medications

• Take your medication as directed and as needed.
• Don’t drive or drink alcohol while you’re taking prescription pain medication.

Caring for your drain(s)

• Empty your drain(s) in the morning and evening. Milk the tubing each time. Follow the instructions in the resource Caring for Your Jackson-Pratt Drain.
• If you didn’t have reconstruction, follow your breast surgeon’s instructions for when to call their office to schedule your drain removal.
• If you had reconstruction, follow your plastic surgeon’s instructions for when to call their office to schedule your drain removal.

Showering

• If you didn’t have reconstruction, shower 24 hours after your surgery.
• If you had reconstruction, follow your plastic surgeon’s instructions.

Exercise and physical activity

• Do your arm exercises 5 times every day until you can move your arm as you did before surgery. After that, do them once every day.
• If you had reconstruction, don’t lift objects heavier than 5 pounds (2.3 kilograms) until your healthcare provider tells you it’s safe.

Sexual activity

• You can start sexual activity when you feel ready.

When to Call Your Healthcare Provider

Call your healthcare provider if:

• You have a fever above 100.4 °F (38 °C)
• The skin around your incision(s) is redder or warmer than usual
• You have increased discomfort in the area of your surgery
• There’s drainage from your incision(s)
• Your arm or the area around your incision(s) is starting to swell or getting more swollen
• You have trouble breathing
• You have any questions or concerns