Recovery after breast reconstruction - after risk-reducing mastectomy

Immediately after

Immediately after the operation you will have dressings on your reconstructed breast(s) and on the areas from where the flap has been taken (if you have had surgery that involves this). You will also have small drainage tubes leading out of the wounds and attached to small containers to collect any excess blood/fluid. Wearing a nightdress/pyjamas that fasten at the front is a good idea until the drainage tubes/drip have been removed.

The drainage tubes will be removed once the drainage has slowed and the surgeon advises that this can be done (2–5 days). Removal of the tubes can be a little uncomfortable, but you will feel a lot more comfortable once they are taken out.

You will need to wear surgical stockings (thick, white elastic stockings) before and after the surgery, until you are able to move around normally again. This is to prevent blood clots forming in your legs. You may find it more comfortable to wear a nightdress, rather than pyjamas, with the stockings.

An antibiotic is often prescribed to lower the chance of infection while the drainage tubes are in place.

You will probably feel quite sore after breast reconstruction; this is mainly because muscles have been moved. You will be given painkillers; it is important to tell the staff if you are in pain – pain can usually be well controlled and it will decrease as time passes.

Advice about baths and showers after breast reconstruction varies so it is best to discuss this after surgery with your surgeon and breast care nurse. General advice is:

• have showers rather than soak in a bath
• wash with lukewarm water and unperfumed soap, rinsing the wound line well
• don't use anti-perspirants, perfumes or any product that contains alcohol in the area
• pat the wound dry with a towel – do not rub it.

Your recovery time will depend on the type of surgery you have had and your general well-being, and so will your length of hospital stay, which could be as long as 7–10 days.

Massaging the skin

Once the scars have healed, surgeons generally advise that women should massage the skin over the reconstructed breast daily with body oil or cream. Your breast care nurse will advise you about what sort of oil or cream to use. This keeps the skin supple and in good condition.

The massaging action may also reduce the risk of capsular contracture (formation of a tough, fibrous coat) around an implant.

See information on...

Breast cancer

Breast reconstruction

Wearing a bra

Some surgeons advise women to wear a support garment, usually a firm, supportive bra, for several weeks after certain types of reconstructive surgery. They may recommend wearing this at night as well as during the day. Other surgeons consider this is unnecessary and suggest wearing a normal bra, or no bra at all. It is important to discuss this with your surgeon.

Arm movement

Immediately after surgery, a physiotherapist will show you how to do suitable arm exercises. You will probably be given different exercises to do before and after having the drainage tubes removed. It is very important to do these to get your arm moving as well as possible.

It may take several weeks or longer after reconstruction before you can fully move your arms without discomfort. The recommended exercises will be increased as you recover. Again, these will depend on the type of surgery you have had. Washing, especially your hair, won't be very easy at first, so you may need to have help from a relative or friend.