ALERT CONTENT PLACEHOLDER

About the operation
DIEP Surgery incisions and placement of tissue 

This method is the state-of-the-art reconstruction that uses your own abdominal tissue to construct a new breast mound. The surgeon will remove excess abdominal skin and fat from the lower part of the abdomen along with blood vessels and attach this tissue to the blood vessels in the chest area. The blood vessels are so small that the surgeon must use a microscope to reconnect them. This will allow blood to be directed to the new tissue on the breast area.

The surgeon will then sculpt the tissue to fit the remaining chest area left from the mastectomy. The advantage of this operation is that the muscles from your abdomen stay together. This keeps the abdominal wall stronger after your surgery.

What tests will I need before the operation?

Your surgeon's office will arrange a CT scan of your abdomen to map out the blood vessels.

How long will I need to stay in the hospital?

For one side breast reconstruction, you can expect to stay in hospital for 3 days, not including the day of the operation. For breast reconstruction on both sides, you can expect to stay in hospital for 4 days, not including the day of the operation.


Stop smoking before your surgery

Learn how smoking and tobacco can affect your recovery after surgery, and how quitting can improve your health.

Download a printable version of the full guide:
Breast Reconstruction Surgery Guide

Pre-admission Visit

You will have an appointment at the Pre-Admission Clinic within 2 weeks before your surgery. This visit is very important to assess your health and help you prepare for your operation and recovery. Depending on your needs, this visit may take from 2 to 5 hours.

On the day of your Pre-Admission visit, take your medications and eat as usual, unless you were given other instructions.

Pre-Admission Clinic
Toronto General Hospital
Eaton Building – Ground Floor, Room 400
Maps & location iconTGH Maps & Directions 

What should I bring to my pre-admission appointment?
  • Your health card (OHIP card). If you do not have an OHIP card, please bring another form of government-issued photo ID, such as a driver's license or passport.
  • Your health card and any other insurance cards. You will need the policy number of your extended health insurance, if you have any.
  • Your spouse/partner, a trusted friend or a family member to offer you support and be a second set of ears.
  • All the medications you take in their original containers. This includes prescription medications, over-the-counter medicines, vitamins, supplements and herbal or natural products.
  • A copy of your power of attorney for personal care and/or advanced directives.
  • A list of any questions that you may have about the operation and recovery.
  • The name or phone number of your pharmacy, as well as any medical specialists that you have seen in the past 3 years. If you have had a cardiac stress test, echocardiogram and/or a pulmonary function test in the past 3 years, it would be helpful to bring a copy of the final report with you to this appointment.
What happens during my pre-admission visit?
  • You will have blood tests and routine skin swabs. The swabs are taken from your nose and other areas of your body to check for germs that can cause infections.
  • You may also need an ECG to check your heart and chest x-ray to check your lungs.
  • You will meet many health care providers during your pre-admission visit. Please feel free to ask them any questions that you may have:
    A pre-admission nurse will review your health history and give you information to prepare you for your operation, including directions for cleaning your skin, eating before operation, taking your medications, and pain management.
    A pharmacist will review your medications.
  • Depending on your needs, you may also meet:
    An anesthetist who will review your health history, discuss your anesthetic plan and pain relief after operation.
    A member of the medicine team, if you have other complex health problems.
    A Clinical Nurse Specialist (CNS), or Nursing Coordinator, who specializes in the care of patients having your specific operation. They will review any preparation that is required before your operation, plans for discharge home after operation and specific instructions regarding your recovery.
Day Before Your Operation
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Stop eating food by midnight on the night before your operation. Your stomach needs to be empty.


What should I do the day before my operation?
  • STOP eating food at midnight on the night before your operation.
  • You may drink clear fluids up to 5 hours before your operation.
  • Examples of clear fluids you can drink:
    • Apple juice
    • Beef or chicken broth (no noodles or vegetables)
    • Orange juice (without pulp)
    • Grape juice
    • Jell-O or popsicles
    • Cranberry juice
    • Pop (such as ginger ale, 7-Up, Coke)
    • Lemonade
    • Water
    • Coffee or Tea (no milk)
Day of Your Operation

Arrive 2 hours before your scheduled operation time:

Surgical Admission Unit (SAU)
Toronto General Hospital
Peter Munk Building – 2nd Floor
Maps & location iconTGH Maps & Directions

All hospital entrances are open by 6 am. However, Elizabeth St. and University Ave. are easiest to access.

What will happen on the morning of my operation?
  • We will prepare you for the operation.
  • If you did not see the anesthetist in the Pre-Admission Clinic, you will meet them before your operation.
  • We will mark the area where we are doing your operation.
  • We will give you a small needle with Heparin, a medication to help lower the chance of developing blood clots.
  • We will give you an intravenous (IV) drip. This is a small needle that we put in a vein in your arm. We use it to give you one or all of the following: fluids, antibiotics or pain medications.
After Your Operation

On this page, you can read all about what to expect during your hospital stay. Or, just click on one of the links below, to get the answer you want right now.


What will happen right after my operation?
  • You will wake up in the Post Anesthesia Care Unit (PACU)​ and stay there for 1 to 2 hours.
  • Once you are ready to leave the PACU, you will be moved to the Breast Restoration and Plastic Surgery Inpatient Unit. For the first 18 to 24 hours, you will be in the Step-Down Unit for close observation.
  • You will be attached to some or all of these tubes:
    • IV – We usually take the IV out as soon as you can tolerate an oral diet.
    • Oxygen – Oxygen helps you breathe. This will be delivered through nasal prongs.
    • Catheter – We will insert a Foley catheter into your bladder in the operating room once you are asleep. This will help drain your urine to prevent your bladder getting distended. This will be removed the next day (within 24 hours).
    • Patient Controlled Analgesic (PCA) – This is a pain pump that is attached to the IV initially after operation. You will have a button, where you can press to self-administer pain medication.
  • The nurses will give you a medication through the IV (antibiotics, anti-nausea).
  • Once you are eating and drinking, we will prescribe pain pills that can be taken by mouth as needed and the PCA will be disconnected.
How will I feel after my operation?
  • Initially after your operation you may feel drowsy and tired.
  • You may experience some pain at your surgical sites and/or nausea. We will manage your symptoms with medications.
  • You may feel some tightness in your abdomen.
How can I take care of myself after my operation?
  • After a breast reconstruction operation, it is normal to feel stiff in your back, chest, shoulders and arms.
  • It is important to do range of motion exercises post-operatively to encourage circulation.
  • The following day after your operation you will be up to chair and moving slowly.
  • At the end of your hospital stay you will be able to do light activities of daily living (e.g., walking, toileting, getting dressed, personal hygiene).
How long will I stay in the hospital?

You can expect to be in the hospital for 3 to 4 days. Your health care team will talk to you about your stay once you're out of the PACU.

Download a printable version of the:
Functional rehab after breast reconstruction surgery
Back at home
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Please monitor the surgical sites for signs of infection (increasing redness, pain, fever). If you are concerned about the surgical site, please contact your surgeon's office or return to the emergency department at the hospital where you had the operation.


How can I expect to feel as I recover?

It takes time to heal and recover. Each person recovers at their own pace. How long it takes for you to recover depends on your age, health and attitude. Your family doctor can help you to manage any symptoms you may have.


How can I take care of myself when I go home?

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  • There are no dietary restrictions; you may eat what you can tolerate.
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  • Avoid heavy lifting; do not lift anything more than 10 lbs.
  • Do not push heavy objects.
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  • You will be given a prescription upon discharge from hospital; please take your medications as directed.
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  • DO NOT drive when you are still taking pain medications.
  • You may start driving once you are able to check your blind spot safely and you must feel comfortable to make a sudden jerky movement in case of an emergency.
Who do I call if I experience complications?

Go to your nearest emergency department if you see these signs of infection:

  • Your temperature goes higher than 38°C (100°F) and lasts longer than 24 hours.
  • If you feel chills.
  • Bright red, hot and swollen incisions and skin.
  • White fluid or pus or pus that smells bad.
Who do I call with general post-operative questions?

The Nurse Coordinator is your first place to call for post-operative questions:

Agnes Wisniewski RN, BScN, MN: 416 340 4800 ext. 5161

You can also call your surgeon's office for more information.

Download a printable version of the post-operative booklet:
Going Home after DIEP Surgery
Follow-up appointments

Before you leave the hospital you will be reminded to call your surgeon's office to schedule a follow-up appointment:

Your first appointment

When
About 3 weeks after the surgery.

Where
There are two clinics associated with the Breast Reconstruction Program.
Princess Margaret Cancer Centre | Maps & location icon Maps & Directions
2nd Floor, M. Lau Breast Centre.

Toronto General Hospital | Maps & location icon Maps & Directions
7th Floor, Plastics Clinic

What to Expect
Your surgeon will assess your surgical sites for their healing progress and speak to you about your recovery. Your surgeon will let you know when you should return for a second follow-up during this appointment. You will be required to call the office to schedule this.

What to Bring
You will need to bring your health card to your appointment.

Directory

To make or change appointments, call your surgeon's office.

Maureen James for Dr. Siba Haykal
Phone: 416 340 4327
Email: maureen.james@uhn.ca

Katrina Aquino for Dr. Stefan Hofer
Phone: 416 340 3449
Email: katrina.aquino@uhn.ca

Mary Cabaron for Dr. Anne O'Neill
Phone: 416 340 3143
Email: mary.cabaron@uhn.ca

Camille Garcia for Dr. Toni Zhong
Phone: 416 340 3858
Email: camille.garcia@uhn.ca


My contacts
Who do I call if I experience complications?

Go to your nearest emergency department if you see these signs of infection:

  • Your temperature goes higher than 38°C (100°F) and lasts longer than 24 hours.
  • If you feel chills.
  • Bright red, hot and swollen incisions and skin.
  • White fluid or pus or pus that smells bad.
Who do I call with general post-operative questions?

The Nurse Coordinator is your first place to call for post-operative questions:
Agnes Wisniewski RN, BScN, MN: 416 340 4800 ext. 5161


How do I reach my surgeon's office?

Dr. Siba Haykal
Phone: 416 340 4327
Email: maureen.james@uhn.ca

Dr. Stefan Hofer
Phone: 416 340 3449
Email: katrina.aquino@uhn.ca

Dr. Anne O'Neill
Phone: 416 340 3143
Email: mary.cabaron@uhn.ca

Dr. Toni Zhong
Phone: 416 340 3858
Email: camille.garcia@uhn.ca

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