TRAM Breast Reconstruction: After Your Surgery

These discharge instructions will give you general information on caring for yourself once you leave the hospital after Transrectus Abdominal Muscle Flap (TRAM) Breast Reconstruction. Please read these instructions and refer to this sheet in the next few weeks. Your doctor may also give you specific information. If you have any problems or questions after discharge, please call your doctor.


You should rest as much as possible during your first two weeks at home. Take a walk once or twice each day, if the weather is good.  You will not be able to do any strenuous activities for six weeks. Your doctor will tell you when you may go back to activities that take a lot of strength, like driving and sports. After any drains are removed, you may do light housework. You should avoid heavy lifting, carrying, or pushing (nothing heavier than five pounds). Take many rest periods throughout the day. You may find that you tire more easily than usual.


You can go back to your normal diet as soon as you leave the hospital. Make sure to drink plenty of fluids (six to eight glasses a day). Try to eat a well-balanced diet. Daily portions of food from the meat, dairy, bread, and fruit and vegetable groups are necessary for your good health.


You may wash your hair and sponge bathe.  Ask your doctor when you can shower.  Do not tub bathe for four weeks. Your surgery has decreased your ability to feel very hot or very cold temperatures on the skin where the surgery was done. Always test the water temperature before you stand in the shower or enter the tub.

Pain control

You will probably have some mild discomfort after surgery. Take pain relievers as prescribed. You may need a stool softener because some pain medications can cause constipation. If none were prescribed or if your discomfort is mild, you may take over-the-counter pain relievers such as acetaminophen (Tylenol) or ibuprofen (Motrin). Do not take any product containing aspirin.  Call your doctor if your pain gets worse.

Incision care

Ask your doctor about specific care for your incision. You will not need a dressing (bandage) for your incision unless it is draining or irritated. Check your incision daily for increased redness, drainage, swelling, or separation of skin. Call you doctor if you see any of these symptoms.

Drain care

If you have a drain, refer to instructions provided for “Surgical Drain Care.”

Arm and hand care

If you had an axillary node dissection (removal of lymph nodes from under your arm), you will need to follow specific instructions for arm and hand care. Since the lymph nodes under your arm were removed, there may be a greater chance for swelling in the arm. The chance of swelling is also increased by infection.

The following tips may help reduce the risk of arm swelling:

  • If possible, do not use that arm to have your blood pressure taken. If you need to have blood drawn, or injections, use the other arm.
  • Use hand lotion to soften cuticles instead of cutting them.
  • Be careful when shaving your underarms. Use an electric shaver if possible. You may use deodorant after your incision has completely healed. Until then, clean under your arms with hydrogen peroxide or soap and water.
  • Be careful when cooking, sewing, and gardening to avoid burns or needle or thorn pricks.
  • Do not weigh your arm straight down with a package or your purse.

If your doctor wants you to do arm exercises after surgery, you will see a physical or occupational therapist to show you how. Your doctor may want you to wait to exercise your arm.


Please remember to call your doctor’s office for a follow-up appointment.

When to call your doctor

If you feel feverish or have shaking chills, take your temperature. If your temperature is 100.4 F (38 C) or above, call your doctor. You should also call the doctor if you have increased redness, drainage, swelling, or separation of skin at your incision site.