Hospital ~ Week 1
Your time in Hospital & what to expect
Most people spend 5–7 days in hospital after DIEP flap reconstruction, although this can vary depending on your surgery, recovery, and your surgeon’s preferences.
Surgery Duration
The operation itself can take anywhere from 4–10 hours. The length of surgery depends on several factors, including whether one or both breasts are being reconstructed, and how straightforward it is for the surgical team to locate, harvest and connect the blood vessels.
Drains and Tubes
You may have 2–6 drains placed in the abdominal and breast wound areas to help remove excess fluid. These drains usually remain in place for 3–14 days, depending on your fluid output and your treating team’s recommendations.
Flap Monitoring
In the first few days, nurses will closely monitor the reconstructed breast tissue to make sure it has a stable blood supply. This often involves hourly flap checks, including checking the skin temperature and colour, and using an ultrasound probe to listen to blood flow.
Muscle Involvement
Although a DIEP flap aims to preserve the abdominal muscles, some muscle involvement may still occur. The surgeon needs to carefully separate the muscle fibres to access the blood vessels, and in some cases, a small amount of muscle fibre may need to be cut. The extent of this is usually determined during the operation.
Wound Vacuum Pumps
Some people will have a Closed Incision Negative Pressure Therapy system, also known as a wound VAC or Prevena pump, placed over the abdominal wound. These systems are often used to support wound healing and may help reduce the risk of wound complications.
Common things you may experience
Pain or discomfort, especially around the abdomen, chest and drain sites.
Extreme fatigue, which is very normal after a long and complex operation.
A tight or pulling sensation across the abdomen.
Poor sleep, often due to hourly flap checks, discomfort, hospital noise and positioning restrictions.
Difficulty lying flat.
Difficulty lying on your side for the first few weeks. Please check your specific timeline with your surgeon.
Potential Complications to Be Aware Of
Your treating team will monitor you closely for any signs of complications. These may include:
Infection.
Haematoma, which is a collection of blood under the skin.
Lymphoedema.
Cording.
Reduced or compromised blood flow to the reconstructed breast tissue, which may require further surgery.
Wound healing issues
Before Leaving Hospital: Questions to Clarify with your treating team
Wound Management and Dressings
How should I care for my wounds?
Do my dressings need to be changed?
What should I do if I still have drains in place?
What signs of infection or wound problems should I look out for?
Compression Garments and Supportive Clothing
Do I need to wear a compression garment or supportive bra?
How many hours per day should I wear it?
How many weeks should I continue wearing it?
Are there any garments or clothing styles I should avoid?
Follow-Up Care
When is my first follow-up appointment?
Who should I contact if I am worried about pain, swelling, wound changes or drain output?
When should I contact my surgeon, breast care nurse, GP or emergency department?
Hospital Exercises
In hospital, exercise is gentle and simple.
The aim is to:
improve circulation
reduce the risk of blood clots
support your breathing
help you start moving safely
build confidence before going home
Your early exercises may include:
ankle pumps while resting in bed
gentle breathing exercises
sitting out of bed when safe
short walks with help from your nurse or hospital team
learning how to get in and out of bed safely
At this stage:
move gently
do little amounts often
avoid straining or pushing through pain
do not pull on drains and be careful of your stiches
follow your surgical team’s instructions
Please watch the following videos for the exercises we recommend while you are in hospital. A hospital physiotherapist may also visit you during your stay and provide exercises, which may be similar to these.
This stage is not about fitness. It is about safe, early movement to support healing and recovery.
