General Lumpectomy +/- Sentinel Lymph Node  Post-Operative Care Instructions:

• You may shower over your dressing the morning after surgery
• Remove the dressing in 48 hours — leave the tapes in place that are under the gauze and over the incisions. They will fall off by themselves in a few weeks, or I will remove them in the office upon follow-up. You may shower directly over the tapes once the dressings are removed. 
• If you have an adhesive allergy, and a clear glue-like dressing was applied instead, you may shower directly over this, and the glue-like skin covering will flake off in a few weeks
• You should expect some bruising, swelling and soreness in the breast and more soreness in the armpit
• Ice the breast intermittently for the first 24 hours after surgery
• You will be placed in a surgical bra after surgery. You may transition to your own bra when comfortable. Please wear a supportive bra when upright for 1-2 weeks after surgery 
• You may wear your bra at night if it gives added support
• Your skin may be stained green for a few days— this is normal

Medications:

• In most cases, your discomfort will be managed quite well with Extra Strength Tylenol. In certain instances, a stronger narcotic might be prescribed
• Avoid aspirin and Ibuprofen-like products for 7 days after surgery
• You may resume your daily preoperative medications (If you are are blood thinners, please resume them in 48 hours)

Activity:

• You should take it easy the day of your surgery
• You may resume your daily activity, including driving, after 1-2 days
• You may begin walking at any time, and low-impact exercising (no bouncing) in 7-10 days, high-impact (eg. Aerobics, jogging) after 2 weeks, but wear a comfortable sports bra during activity
• No lifting > 10 pounds or submerging incisions under water x 14 days

Diet:

• You have no restrictions

Follow-up:

• You should already have a postoperative appointment scheduled to go over your pathology results and check your wounds. If you do not, please call the office to schedule for approximately 5 working days

Call the Office (954)-54267001 if You Develop:

• Persistent fever over 101 degrees
• Increasing area of redness or excessive drainage from wound
• Severe pain or a tight swelling of your breast

Mastectomy with Sentinel Node Biopsy or Axillary Dissection Surgery

Care of the Wound:

• You may shower over your dressing(s) the morning after surgery
• You may leave all of your dressings on until your first post-op visit, at which time your drain and dressings will be removed
• You should expect some bruising, swelling and soreness in the breast and more soreness in the armpit
• You will be placed in a surgical bra after surgery, which you should continue to wear for 24-hours a day while the drain is in place, to secure the drain and prevent any inadvertent dislodgement
•      Keep your breasts warm after surgery low-level warming/heating pads if you had a nipple-sparing mastectomy
• Empty your drain once or twice a day as needed, and record daily outputs. Make sure to compress the bulb again before closing top
• Milk the drain twice a day by pinching on the tube a few inches from the exit site and running your fingers over the tube toward the bulb while securing the tube in place close to the exit site with other hand 

Medications:

• You will be given a prescription for a pain medication. If you find that you do not need the stronger medication, you may take Tylenol instead
• Avoid aspirin and Ibuprofen-like products for 7 days after surgery
• You may resume your daily preoperative medications

Activity:

• You should take it easy the day of your surgery
• You may resume your daily activity after 1-2 days, and driving in 3 days
• You may use your arm on the side with the drain but avoid excessive use and raising it higher than shoulder level until the drain is removed

Diet:

• You have no restrictions, but it's generally better to start off with clear liquids until the anesthetic has worn off completely, then advance your diet as tolerated

Follow-up:

• You should already have a postoperative appointment scheduled to review your pathology results. If you do not, please call the office to schedule. 
• For your drain, call for drain removal when the output is less than an ounce a day (30 cc) for two days in a row

Call the Office (954)542-6700 1 if You Develop:

• Persistent fever over 101 degrees
• Increasing area of redness or excessive drainage from wound
• Severe pain or a tight swelling of your breast

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Printable Drain Log

Jackson-Pratt Drain Care: Patient Discharge Instructions:

The Jackson-Pratt tube drains fluid from your surgical area, helping prevent swelling and reducing the risk for infection. The tube is held in place by a few stitches and may be covered with a dry dressing. The squeeze bulb at the end of the drain tube creates a gentle suction. The drain will be removed by Dr.Coste when you no longer need it, usually when the collected fluid is <30mL/bulb/day for at least 2 days based on your log.

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• Don’t sleep on the same side as the tube.
• Secure the tube and bulb inside your clothing with a safety pin,  specialty drain strap or equivalent. This helps the tube from  being pulled out accidentally.
• Empty your drain at least twice a day, or when it is half way full. Empty it more often if the drain is full.
• Wash hands and put on gloves (if applicable)
• Unpin drain from clothing
• Lift the drainage plug on the bulb
• Hold bulb upside down over a measuring container. Make sure the bulb is lower than the wound when draining to prevent drainage from flowing back into the wound. Drain the fluid into a measuring cup
• Gently squeeze the bulb until it is empty. Make sure the spout of the bulb does not touch the measuring container to prevent the spread of germs onto or into the drain
• Press the center of the bulb to get air out
• Collapse the bulb. Hold the compressed bulb with one hand, and plug with the other hand. The bulb should stay compressed until it starts to fill with fluid
• Re-pin drain to clothing
• Flush the drainage fluid down the toilet
• Wash and dry your hands
• Record the date, time, and amount of fluid collected each time you empty the drain. Share this information with your surgeon on your next visit

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How to strip your drains: