Anesthesia Recovery Fat Grafting Breast Reconstruction
Anesthesia recovery after fat grafting breast reconstruction as well as for phase one DIEP flap breast reconstruction have similarities. I will, however, focus on my most recent experience, phase two and the fat grafting portion of breast reconstruction.
Anesthesia Preparation
The routine for this surgery includes check-in at the hospital, dressing into surgical garments, and being wheeled into the surgical holding area to talk to your physicians before surgery. It has been my experience that the first physician you speak to is the anesthesiologist. The anesthesiologist will go over your health history. One of the key topics they ask you about is your tolerance to anesthesia and if you experience nausea when waking up from surgery. This is a dreaded side affect for many going into any type of surgery.
I have been very fortunate waking up nausea free from phase one and phase two of DIEP flap breast reconstruction. It was comforting to hear my anesthesiologist assure me that she would be by my side during the procedure to monitor my “just right cocktail” to prevent nausea. It was happy hour both times for me and I was pleased since I got sick twice after my mastectomy. Nausea is not something you want to deal with after this intricate surgery.
Scopolamine Patch
Additionally, you may have a scopolamine patch placed behind your ear. This also aids in anti-nausea. The effects of this patch last for three days. You can remove it when you wake up after surgery but I left it on for 48 hours. I was given two precautions about the patch. The first side effect of the patch is dry mouth. Secondly, you are cautioned NOT to touch it and then rub your eyes. I made sure I didn’t touch it and rub my eyes! I did experience dry mouth. Everything I put in my mouth after I woke up tasted like cardboard. I’m sure it was due to lack of saliva. My surgery was on Monday morning and I finally took it off Tuesday night because I had an appetite but nothing tasted good. It can also cause pupil dilation. This was the case for me. My eyes are blue and my pupils were so dilated after surgery all you could see was the black part of the eye, my pupils. I looked a bit scary! You may feel dizzy and lightheaded. Both are possible side effects of the patch. That light headed and dizzy feeling subsided soon after I removed the patch.
Breathing Tube
It is common practice to have intubation for breast reconstruction surgery. This is the breathing tube that is placed down your throat to monitor your respiration while you are under anesthesia. During fat grafting, depending on where the fat is taken for liposuction, it is very common to be turned on the table. The plastic surgeon places the cannula in various parts of your body. It is commonly take from the outer thighs or flank area so it makes sense that you will have to be turned on the table. You will likely wake up with a raspy voice from having this tube placed down your throat.
Other Side Affects and Precautions of Anesthesia
I also experienced red-rimmed eyes for a period of about 48 hours. This could just be my sensitivity to dry-eyes. I have to use drops daily on a regular basis but my eyes were unusually red-rimmed after waking up. Some moisturizing drops can help with this.
Give yourself a few days for the effects of the anesthesia to completely wear off. You should avoid driving until these side effects are gone and you are completely off all pain medication. Your thought processes and clarity of mind will be affected and you are cautioned not to drive or drink alcohol until your body is clear of the anesthesia drugs. I remember the day after surgery having to think hard to complete an intelligible sentence but the affects were short-lived. Yes, I was getting a lot of snickers from friends and family over this! I personally think one of the best remedies for this is to take lots of deep, cleansing breaths to re-oxygenate your system. Go for walks, drink lots and lots of water to re-hydrate, and eat healthy meals. I had surgery Monday and flew home by myself on Thursday. I believe the rest, healthy meals, cleansing breaths and re-hydrating all helped in clearing my head of the side effects of anesthesia during this phase of my breast reconstruction.
This photo of my anesthesiologist and me exemplifies the confidence and comfort she gave me even with all the risks and side effects that she clearly explained to me prior to putting me to sleep for the fat grafting portion of breast reconstruction.
One other anesthesia-related comment (and you alluded to it): I was given a spirometer, I think it’s called, before my partial mastectomy and mammoplasty (mastopexy). After I used it to set the depth of my inhalations (“keep the ball between these two lines”), I was instructed to use it after the surgery was over. Even before they got me out of bed to walk. Several times an hour (like 6). Even after I got home! If I skipped it, my lungs would feel heavy and congested.
My non affected breast’s mastopexy anesthesia a few months later had a whole different effect on me. As Terri mentioned, you don’t want to vomit, so as I was being wheeled to my room I felt an overwhelming need to do so and was quickly given a bag and IV phenergan (they stopped pushing the bed to do so -and I became very irritated about that-go figure). At the same time I exploded with heat, at least 5x as bad as my worst hot flashes. That just showed me how anesthesia drugs mess with your brain.
One more comment regarding anesthesia and mouth dryness: after my partial mastectomy my mouth was dry for 2 days to the point that I couldn’t be understood when I tried to speak. After consuming gulps of water for hours I gave up and would just swish and spit. It’s the effect of a drug they give you coming out of deep anesthesia. Annoying but not critical. Also annoying that (I don’t remember) anyone telling me to expect that. I had to ask a cousin who is an anesthesiologist.
Hi Connie. Thanks for sharing your experience. I wrote a blog, http://diepcjourney.com/2015/07/19/postoperative-diep-flap-recovery/, about phase one recovery that included some of the very items you spoke of. The fat grafting recovery was much quicker and with less side affects. That dry mouth is really unpleasant. I took the patch off after two days just so I could eat!
I always appreciate hearing from you! ~Terri