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

This information describes 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 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.msk.org/pe/enroll_mymsk for instructions.
• Fill out a Health Care Proxy form. You can ask a member of your care team for a copy or find it at www.health.ny.gov/publications/1430.pdf
• Identify your caregiver.
• Arrange for someone to take you home after surgery.
• Follow your healthcare provider’s instructions for taking medicines.

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 medicines 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

Note the time of your surgery

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

Taking medicine

• Follow your healthcare provider’s instructions for taking medicines.

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. Do not use lotion, cream, deodorant, makeup, powder, perfume, or cologne afterward.

Instructions for eating and drinking: 8 hours before your arrival time

Stop eating 8 hours before your arrival time, if you have not already.  Your healthcare provider may tell you to stop eating earlier. If they do, follow their instructions. 8 hours before your arrival time, do not eat or drink anything except these clear liquids: Water. Soda. Clear juices, such as lemonade, apple, and cranberry juices. Do not drink orange juice or juices with pulp. Black coffee or tea (without any type of milk or creamer). Sports drinks, such as Gatorade®. Gelatin, such as Jell-O®. You can keep having these until 2 hours before your arrival time.

The day of your surgery

Remember, starting 8 hours before your arrival time, do not eat or drink anything except the things listed earlier.

Instructions for drinking: 2 hours before your arrival time

Stop drinking 2 hours before your arrival time. This includes water.

Taking medicine

• Only take the medicines 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.
• Take off 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 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 exercises to do at home.

Getting ready for discharge

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

At home

Remember to follow your care team’s instructions while you’re recovering from your surgery.

Taking medicine

• Take your medicines as directed and as needed.
• Do not drive or drink alcohol while you’re taking prescription pain medicine.

Caring for your drain(s)

• Empty your drain(s) in the morning and evening. Milk the tubing each time. Follow the instructions in Caring for Your Jackson-Pratt Drain.
• If you did not 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 did not have reconstruction, shower 24 hours after your surgery.
• If you had reconstruction, follow your plastic surgeon’s instructions.

Exercise and physical activity

• Follow the instructions in Exercises After Your Mastectomy or Breast Reconstruction.
• Do your arm exercises 3 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, do not 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.