For patients who have undergone breast reconstruction following mastectomy, rehabilitation treatment includes the following main points:

1. Rehabilitation Exercise

A. Two days to two weeks after surgery

It is recommended that the surgery side of patients' shoulder should be temporally immobilized to avoid injuring the blood vessels connected during the microscopic surgery. But in order not to cause muscular fatigue and cramps because of the long time inactivity, the patients could exercise their hands and elbows such as in clenching the fists and straighten out their hands, while, the elbows could be gently bended and again straightened. This has to be done slowly and carefully as recommended by the therapist, by doing so it will help to increase the blood circulation of the upper half in the surgical side. If possible perform this exercise ten times every hour, but paying particular attention not to exercise too much or too fast so as not to affect the blood vessels just connected.

B. Two weeks to four full weeks after surgery

The shoulder on the reconstructed side can be slightly raised up; the movement should be slow, the range of motion is at the discretion of the patients as long as it is not painful. If the incision is not stretched suddenly and forcefully apart, most patients can return to normal activity range of the shoulder four full weeks after surgery. Currently, the breast reconstructive surgery performed in Chang-Gung Memorial Hospital is world-wide recognized as the best and it actually has a high success and low complication rates.

C. One month after surgery

At this stage, the patients should continue to follow up the rehabilitation movements of the shoulder where the reconstruction was performed (on the reconstructed side). There are three main suggested movements: up and down, back and forth, and right and left. Each movement should be done 10 to 20 times per hour, the strength and endurance of the muscles in the shoulder will be slowly recovered to the condition before the surgery.

2. Management of Scars

A. Two days to two weeks after surgery

The patients can start by slightly patting the wounds on the abdomen so as to reduce the sensitivity of the wounds and to effectively relieve pain. ( Do not rub it. ) In the meantime, patients should wear girdles.

B. Two weeks to four full weeks after surgery

The patients can start to slightly pat the wounds on the chest so as to reduce the sensitivity of the wounds and to effectively relieve pain. The wounds on the abdomen can be slightly pressed about five minutes per hour to soften the scars. The time and force used should not be too much, nor can the patients rub them, or it may cause the incision to swell and hurt. After the doctor takes out the stitches from the incision on the chest, adopt the same method to soften the scar.

C. One month after surgery

Continue pressing the scars every day for about a year. If the scars are properly taken care of, they will fade substantially over time and heal completely. Besides, the patients' cardio- respiratory functioning will improve to a satisfactory degree because the breast tissues are soft and elastic. It does not require the patients too much time to take care of the scars, soon they will be as flat as the surrounding tissue and they will be less noticeable with time.

3. Points about Daily Life and Activities

A. Two days to two weeks after surgery

Within five days after surgery, the patients should rest in bed; when coughing or sneezing, the wounds in the abdomen should be pressed with both hands so as not to rupture the sutures. Three to five days after surgery, the patients can get off bed and walk around according to the patients' physical condition, but not for a long period of time.

B. Two weeks to four full weeks after surgery

Generally, the patients will go back home for rest. And they can now move around the house or take a walk, but should avoid doing housework and carrying heavy things. Keep regular hours and consume enough healthy foods, especially rich in protein and vitamin C, to facilitate the recovery of the wounds. Smoking and second-hand smoking should be avoided, as they would affect the stability of the blood vessels. Excessive caffeine, which may be a hindrance to full flap recovery should also be avoided, other substances not permitted will include, foods containing caffeine such as coffee, tea, coke and chocolate etc.

C. One month to three months after surgery

The patients can now return to some of their basic daily activities such as washing up, eating, getting dressed and undressed, but before then they should gradually proceed carefully and never in haste to avoid injuries of the tissues and continuous sequala later on, which will be difficult to deal with. If they have small children, they should avoid embracing them or carrying them. Overall they can perform simple housework and drive, but should not carry heavy things.