Double Mastectomy Care Instructions

If you have nipple grafts:

• You cannot get your grafts wet. 
• You’re not allowed to shower until after your 1-week follow-up.

If you did NOT have nipple grafts:

• You can shower 24-48 hours after your surgery.

Avoid baths or soaking for two weeks as this will affect your dressing and increase your chance of infection. Shower with the paper tape on. It will stay on in the shower. You can pat dry or blow-dry (on low heat) after.

After their surgery, most people find it most comfortable to sleep on their back at a slight incline. Any position (except on your front) is allowed as long as it is not painful.

There are no food restrictions after your surgery. Start with clear liquids, and gradually progress to the foods you like.

It is usual to have some drainage from the incisions after your surgery. The drainage should be mostly clear (it can be yellow or pinkish).

During the first week after your surgery, keep the large gauze pad over your chest under the binder. You can change the pad if it is overly soiled.

Leave the dressings on your nipples alone (if you had grafts).

You should wear the binder for support at all times, including during sleep for the first four weeks after surgery. Take it off to shower once you’re allowed to shower.

Avoid sliding the binder up and down to adjust it. Take off your binder and reposition it if you need to adjust it.

After all your drains are removed, you can wear a t-shirt under your binder for comfort.

You are not allowed to drive for a minimum of 48 hours.

Take medication for your pain. Your pain medication plan is layered: 

• The first baseline layer is acetaminophen. 
• If you need more pain control, add ibuprofen.
• If you need even more pain control, add tramadol.

Just because your first layer isn’t giving you enough pain control does not mean it’s not acting on your pain.

For the first 24-48 hours, take the acetaminophen regularly whether you need it or not, but don’t wake up to take it (if you’re sleeping already).

Take two regular-strength acetaminophen (325mg x 2) every 4 hours. You should not take more than 4000mg in 24 hours from any pills that have acetaminophen in them.

Take two regular-strength Ibuprofen (200mg x 2) every 4-6 hours. You can take up to 600mg if you need the pain control. Your stomach will usually tolerate it.

If more pain control is needed, take one tramadol (50mg x 1) every 4-6 hours.

If you experience constipation, drink lots of water to start. You can also try prune juice or a product like Metamucil. Senokot S or something similar can also be an option.

Signs of infection include: 

• Increased redness
• Increased pain 
• Increased swelling despite no movement
• Fever
• Milky white fluid drainage
• Pain is around your incision and usually one-sided

Signs of a hematoma include: 

• Increased swelling on one side of the chest that grows every hour
• The swelling feels tense/hard and is sometimes very painful
• Increased bruising (Bruising should not get a lot worse after day one or two.)

If you have any problems after surgery, please call the office during the day. Contact information is included in your post-op instruction documents.

All of your sutures are absorbable. There are no sutures to remove.
 
Your follow-up schedule should already have been provided to you. If you do not have it, please let us know.
 
You will follow up with us on postoperative day one and after one week. Please make sure you bring your caregiver/helper with you to these appointments so we can also answer their questions.