Waverley House Plastic Surgery Centre BREAST RECONSTRUCTION TIMELINE – LATISSIMUS DORSI (LD) + IMPLANT RECONSTRUCTION These approximate timeframes are a guide to assist you through your breast reconstruction journey LATISSIMUS DORSI FLAP RECONSTRUCTION ( SKIN, FAT & MUSCLE FROM YOUR BACK) WITH TISSUE EXPANDER Length of surgery per breast 4 – 6 hours Muscle, skin & fat (flap) are taken from your back and tunnelled through your armpit, to be placed on your chest. A tissue expander is placed under the flap. Nights in hospital 56 You will have wound drains in your back & chest and stay in hospital until fluid in drains reduces. First post operative outpatient visit 57 days after discharge You will be reviewed by the surgeon or breast reconstruction nurse. All your wound dressings will be changed. You will commence tissue expansion 2 weeks after this appointment. Recovery period 6 12 weeks Get plenty of rest/eat a balanced diet/do not smoke/avoid alcohol/avoid heavy lifting/start walking Tissue expansion 2 – 3 months 2 – 3 weeks following your reconstruction, your surgeon or breast reconstruction nurse will start adding more fluid into the tissue expander to slowly stretch the skin & muscle to allow insertion of a permanent implant. 50 – 100 mls of fluid will be added at weekly or fortnightly appointments until the tissue expander is filled or you reach a size that you prefer. Time between completion of tissue expansion and second stage reconstruction 2 – 3 months This will allow the soft tissues (i.e. skin and muscle) to heal and recover from being stretched before the second surgery takes place for the exchange of the tissue expander for a permanent breast implant. EXCHANGE OF TISSUE EXPANDER FOR PERMANENT IMPLANT Length of surgery per breast 1 hour To remove the tissue expander and insert permanent implant Nights in hospital 1 – 2 nights May have a wound drain in place First post operative visit 5 – 7 days post discharge You will be reviewed by the surgeon or breast reconstruction nurse. All your wound dressings will be changed. Recovery period 2 – 3 weeks SURGERY TO BALANCE OTHER BREAST If you require surgical to balance the size of your other breast to match your breast reconstruction, this may be done 2 – 3 months after insertion of a permanent implant under your latissimus dorsi flap. NIPPLE RECONSTRUCTION This will be planned 2 – 3 months post insertion of implant or any surgery to balance other breast Length of surgery 45 mins– 1 hour per nipple Will be done in the day surgery theatre or in the outpatient clinic. Nights in hospital 01 You will require followup 10 days after procedure in the outpatient clinic NIPPLEAREOLAR TATTOO 2 – 3 months post nipple reconstruction This is done by your surgeon or breast reconstruction nurse in the outpatient clinic. 45 – 60 minutes per nipple. FINAL FOLLOW UP 6 – 8 WEEKS AFTER YOUR TATTOO