Possible complications after breast reconstruction - after risk-reducing mastectomy

However, there are still some risks connected with any type of surgery| and a few particularly with breast reconstruction. Being aware of these possible problems will help you cope with them if they occur.

Immediate problems Back to top

Pain and discomfort

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 initially after surgery, particularly if you’ve had reconstruction at the same time as the risk-reducing surgery. It’s important to continue using your arm, and to carry out the exercises suggested by the physiotherapist.

Wound infection

This can be a complication following any type of surgery.

You may be given a course of antibiotics after your operation. If not, and infection occurs, antibiotics can usually get rid of it. 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 wounds (incision lines) regularly once you are home after your operation. Tell your breast care nurse or doctor immediately if you have any of the following:

• increased redness or a 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 38°C (100.4°F), or if you feel generally unwell.

Collection of fluid under the wound

After breast reconstructive surgery, it’s normal for some fluid to collect in the area. You may have drainage tubes inserted into the wound to drain away any fluid. These are long thin plastic tubes attached to vacuum drainage bottles. They are usually removed several days after your operation.

However, after they are removed, a collection of fluid (a seroma), or blood (a haematoma), can sometimes develop under the wound. Your body may absorb these if they are small, but if they are large, they will need to be drained by a surgeon or nurse using a small needle and syringe (aspiration).

Tissue failure

If reconstruction is done using flaps of fat, skin and possibly muscle, there is a small chance that the blood supply to part of the flap or all of it, will not survive. Without an adequate blood supply the flap, or part of it, will die. You may need another operation in this situation, either to remove the affected area or to try to improve the blood supply. You may also need long-term dressings until the area has healed. Your surgeon will then talk to you about other options for reconstruction. This complication is more common with TRAM flaps| or free perforator flaps| than after an LD flap.

Itching

As the wound heals it may itch. This may be very uncomfortable, but it’s important not to scratch the healing skin. The itching will reduce as the wound heals.

Tingling and numbness

After immediate breast reconstruction (carried out at the same time as the prophylactic mastectomy), you may feel tingling sensations down your arms. You may also have some numbness in the upper and inner arm. This is an effect of the mastectomy surgery on the nerves in that area. It may gradually fade over time, but may last up to a year after surgery and can sometimes be permanent.

Difficulty moving

If your reconstruction involved taking tissue from your abdomen, you will find bending and stretching uncomfortable for a few weeks after surgery. Supporting your wound with your hands when you bend should help.