Recovery after breast reconstruction
Immediately after surgery, your reconstructed breast may be covered with dressings.
Alternatively, the wound may be held together with sticky plastic strips, which are left in place until the wound has healed.
Once the dressings are removed, you can gently shower the wound with clean water. Pat the wound area dry with a clean towel - don’t rub it. Once the wound has healed you can bathe or shower as normal. Wash with lukewarm water and unperfumed soap, and rinse the wound well.
At first, your new breast may be larger than your other breast. This is due to swelling, which can happen after surgery. Your breast will gradually get smaller over a few weeks or months.
How long you’re in hospital after your operation depends on the type of surgery you have and whether you have an immediate or delayed reconstruction. You’ll probably be in hospital for up to two days after implant surgery, but this may be longer if you’re having an immediate reconstruction.
After an operation using tissue from your back you may be in hospital for about 4-7 days. If your reconstruction is done using tissue from the tummy, you may be in hospital for seven days or more.
After any type of operation, you’re likely to experience some pain or discomfort. The level of pain women experience after breast reconstruction varies greatly. Many women need painkillers for a few weeks after surgery. Make sure you ask for pain relieving medicines if you need them. In general, if your pain is well controlled you’ll recover more quickly after surgery.
Your physiotherapist will give you exercises to help your recovery. At first you may have some discomfort when you move your arm on the side where you’ve had surgery. But it’s important you continue to use your arm and to do the exercises suggested by your physiotherapist. You’ll also be given specific exercises to do if you’ve had surgery to other areas, such as your back or tummy.
Work and everyday activities
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You’ll probably feel quite tired in the first week after you get home from hospital. It’s a good idea to have someone around who can help you for the first few days. After this you can start looking after yourself and gradually increase your level of activity - just do light tasks to begin with and slowly build up what you can do. Don’t do any strenuous housework, such as vacuuming, or move or lift anything heavy until your surgeon says it’s okay to do so.
How soon you can return to work depends on the type of work you do and on the type of operation you’ve had. In general, if your job doesn’t involve heavy manual work, you can go back to work sooner. But it’s important to remember that you’re likely to feel more tired than usual for a while. You may also find it difficult to concentrate fully at first.
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In general you can return to driving once you are able to use the gear lever and handbrake, and provided you could do an emergency stop or move the steering wheel suddenly if necessary. Some women are able to drive within a few weeks of their surgery, while others find it takes longer. Insurance companies often have their own guidelines about when you can drive again after an operation, so you should check this with your car insurance company.
It’s fine to have sex when you feel comfortable to do so. This will probably be a few weeks after your operation, but it may take longer. Just take things at your own pace and talk to your partner about any concerns you have. Your breast care nurse can also advise you.
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There are no set rules about when you can begin wearing a bra following breast reconstruction. This will depend on the type of reconstruction you’ve had and the advice of your surgeon.
Some surgeons recommend that women wear a bra soon after reconstruction, but others advise women not to wear one to begin with. They believe this encourages a more natural droop of the reconstructed breast and that wearing a bra makes little difference to the cosmetic results of surgery. Your surgeon or breast care nurse can advise you on what’s most appropriate for you.
If you’re advised to wear a bra to support the newly reconstructed breast, a soft supportive bra without underwires (such as a sports bra) will be more comfortable to begin with. If you have reconstruction with implants, you may be given a Velcro band to wear for several weeks. This sits on top of the implants and helps to make sure they stay in the correct position and don’t twist.
Looking after your skin
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Your wound may feel itchy as it heals but it’s important not to scratch the healing skin. The itching will reduce as the wound heals. It usually takes about six weeks for the wounds to heal fully.
Once your wounds have healed, most surgeons recommend you massage the skin and scars over your reconstructed breast and at the donor site (if you have one) with body oil or cream at least once a day. Massaging the skin will help to keep it supple and in good condition. If you have a breast implant, massage can also help reduce the risk of capsular contracture.
Massaging along the length of the scar(s) using moisturiser or massage oil helps prevent it from sticking to tissue underneath as it heals. It can also help to speed up the healing process and soften your scars. Your surgeon or breast care nurse can tell you what they recommend, and show you how much pressure to use when massaging.
To begin with, any scars you have will be red (or darker if you have dark skin), quite firm and may be slightly raised, but over time they will flatten and fade. Everyone’s skin heals differently. If you have dark skin or have fair, freckled skin, scars can take a bit more time to settle and may be more noticeable for longer. In general it can take from 18 months to two years for scars to fully settle and fade. If you have concerns about the how your scars are healing, talk to your nurse or breast surgeon. They can check that everything is healing as it should or, if there’s a problem, can tell you what can be done to help.