Possible problems after breast reconstruction - after risk-reducing mastectomy
You may not have any problems after surgery. But it can help to know what the more common problems are so that, if you do have any, they can be detected and treated early.
Once you’re home after your operation, check your wounds regularly. Tell your breast care nurse or doctor immediately if you have any possible signs of infection such as:
increased redness or change in colour over the breasts, around the scar areas, or both
discharge (fluid being released) from the wounds
a fever (a temperature above 38°C or 100.4°F)
feeling generally unwell.
Your doctor can prescribe antibiotics if needed.
Bruising to the breast and donor site is very common after the operation and usually goes away after about three weeks.
Sometimes, after the operation, there can be bleeding and a build-up of blood (a haematoma) in the breast or donor site.
This usually occurs in the first 24 hours after surgery and can cause swelling and pain. Sometimes another operation is needed to stop the bleeding.
Fluid under the wound (seroma)
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After your surgery, it’s normal for some fluid to collect in the area around the wounds (a seroma). You will have drains in place to take away this fluid. These are long, thin plastic tubes attached to vacuum drainage bottles. They are usually removed several days after your operation.
However, after the drains are taken out, more fluid sometimes collects under the wound. This may need to be drained by a surgeon or nurse, using a small needle and syringe.
Usually, pain gradually reduces in the weeks following surgery. But occasionally women continue to have pain for months or even years after the operation.
Pain that continues for a long time is called chronic pain. There are several different causes of chronic pain, and many of these can be treated.
If you have pain that doesn’t get better, talk to your breast surgeon. They can do tests to find out the cause or recommend a treatment that may help.
Most scars following breast reconstruction heal normally and gradually fade with time. However, a small number of women may develop a keloid scar.
These are caused by an overgrowth of tissue along the scars. They are wider than normal scars and often a different colour from normal skin. They are also raised above the normal skin.
If you are worried about your scars after your surgery, talk to your surgeon.
What if I am not happy with the results of my reconstruction?
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The way you feel about your breast reconstruction will depend partly on what you expect from the surgery. Make sure you discuss your expectations with your surgeon before you decide to go ahead.
It’s important to wait for several months for the skin and muscle to stretch, and for the reconstructed breasts to settle into their final shape, before deciding how happy you are with the result. Full healing can take about a year.
While many women are satisfied with the results of their reconstruction, a few may be disappointed with their appearance.
If you have concerns, discuss them with your surgeon or breast care nurse. Your surgeon may already have plans for an operation to improve the final result.
If you’re still unhappy following discussions with your surgeon you can, if you wish, ask to be referred to another surgeon for a second opinion either at the same hospital or a different hospital.