Possible complications after breast reconstruction

Many women who have had a breast removed because of cancer have reconstructive surgery. Techniques and implants| have improved so that complications don’t happen very often. However, there are still some risks with any type of surgery, and a few particularly with breast reconstruction. Being aware of these possible problems can help you to cope with them if they occur.

Problems which may occur include bleeding, infection, problems associated with having a general anaesthetic, collection of fluid under the wound (seroma), pain and discomfort, and excessive scar tissue (keloid scarring).

After any type of operation you are likely to have some pain and discomfort. Women vary greatly in how much pain they have after breast reconstruction. Many women will need painkillers for a few weeks or so after surgery. Make sure you ask for pain-relieving drugs if you need them. Research suggests that women with good pain relief recover more quickly after surgery.

You may find it uncomfortable to move your arm on the side where surgery has been done. This is particularly likely if you have breast reconstruction at the same time as surgery for breast cancer| and have some lymph nodes (glands) removed from your armpit. It's important that you continue using your arm and carry out the exercises suggested by your physiotherapist.

This is a possible complication following any type of surgery. If it happens, antibiotics can usually get rid of the infection. In a very few cases, infection may continue despite antibiotics. If an implant has been used, it may have to be removed in order to treat the infection successfully. In this situation, doctors generally advise waiting for a few months before having another implant inserted, or they may recommend that you have a different type of reconstruction.

Check your wound (incision line) regularly once you are back home after your operation. Tell your breast care nurse or doctor immediately if you have any of the following:

• increased redness or change in colour over the breast, around the scar area, or both.
• discharge (fluid being released) from the wound.
• a fever, with your temperature going above 38ºC (100.5ºF), or if you feel generally unwell.

After breast reconstruction surgery, it is normal for some fluid to collect in the area. You will have drainage tubes in place to drain away any fluid that may collect. These are long, thin, plastic tubes attached to vacuum drainage bottles. They are usually removed several days after your operation.

However, after the removal of the drains, a collection of fluid (a seroma), or blood (a haematoma), sometimes develops under the wound. The body may absorb these if the amount of fluid or blood is small, but if they are large they may need to be removed by a surgeon or nurse, using a small needle and syringe.