Enhanced Recovery After Surgery (ERAS)

Mastectomy with Tissue Expander Placement ERAS

Appointment New Patient Appointment or 214-645-8300

A mastectomy – the surgical removal of one or both breasts – may be followed by the placement of tissue expanders. These are temporary empty implants that help stretch your skin, preparing it for permanent implants through breast reconstruction.

Our mastectomy with tissue expander placement ERAS program is designed to help patients return to health more quickly after undergoing the procedure.

Goals

  1. Make this an ideal surgical experience for you, the patient.
  2. Incorporate innovative pain medications to improve your postoperative pain control while decreasing your narcotic needs.
  3. Prevent potential surgical and anesthesia complications.
  4. Reduce the amount of time you are in the hospital, with the many patients leaving after one night.
  5. Decrease the likelihood of having to return to the hospital after discharge.

Before Surgery

  • Your surgeon will meet with you to explain surgical plans and set your expectations for surgery.
    • Contact your surgeon via MyChart or call the surgical clinic with questions: 214-645-2353
    • You will receive instructions for surgery and medications via a phone call prior to surgery. You may also be scheduled for an appointment in our pre-surgical testing clinic to meet with our anesthesia team or have bloodwork drawn.
  • We may request testing from your other physicians.
  • Call our pre-surgical testing clinic with any questions: 214-633-4202.
  • Lifestyle modifications:
    • We encourage you to stop smoking and/or consuming alcohol for one month prior to surgery.
    • We encourage you increase your physical activity prior to surgery.
    • Eat a balanced, healthy diet high in protein and remain hydrated.
  • On the night before surgery, do not eat solid foods after 11 p.m.
  • Follow instructions from your surgeon regarding skin preparation.
  • You can drink clear liquids (such as water, Gatorade, or Sprite) until two hours before your surgery start time.
  • Drink either a bottle of water or 12 oz. of Gatorade, but stop at least two hours before your surgery start time.
  • In the pre-op area, you will receive non-narcotic pain medications (celecoxib and acetaminophen) to improve your postoperative pain.

During Surgery

  • You will receive general anesthesia and be completely asleep during the procedure.
  • Your anesthesia team will monitor you very closely while you are asleep and will insert additional intravenous (IV) line if necessary.
  • You will receive multiple medications during surgery to treat pain and nausea.
  • There will be a specific and tailored anesthetic protocol to decrease the stress on your body, improve pain, and accelerate your recovery.
  • A nerve block might be performed during the procedure. This is designed to decrease your postoperative pain and need for IV and oral pain medications.

After Surgery

  • After surgery, patients will go to the recovery area for further monitoring. Select patients may be able to return home the same day of their surgery. Other patients will go to a hospital unit bed.
  • You will be asked to chew gum and ice chips and drink clear liquids to help with recovery of bowel function.
  • You will be given an incentive spirometer to remind you to take deep breaths.
  • Starting on the day of your surgery, we encourage you to get out of bed and walk with help from your nurse.
  • Try to increase the distance and frequency of your walks each day; doing so will help your bowel function return to normal, prevent deconditioning, and speed up your recovery.
  • Start gently raising your arms at the shoulder 10 times an hour while awake.
  • Unless instructed otherwise by your nurse or surgeon, you will be able to eat a normal diet the day of your surgery. Continue to chew gum or hard candy, as well.
  • You will take scheduled non-opioid pain medications during your recovery and have narcotic medications available for breakthrough pain, if necessary.

Important Contact Information