Recovery after breast reconstruction - after risk-reducing mastectomy
Immediately after surgery, your reconstructed breast(s) may be covered with dressings that the nurses will change regularly.
Alternatively, the wounds may be held together with sticky plastic strips, which should be left in place until the wounds have healed.
Once the dressings are removed, you can gently shower the wounds with clean water. Pat the wound areas dry with a clean towel – don’t rub them. When the wounds have healed you can bath or shower as normal. Wash with lukewarm water and unperfumed soap, and rinse the wounds well.
At first, your new breasts may be larger due to swelling, which can happen after surgery. Your breasts will gradually get smaller over a few weeks or months.
Your surgical team will let you know how long you can expect to be in hospital for after your operation. This will depend on the type of surgery you have and whether you have immediate or delayed reconstruction.
After an operation using tissue from your back you may be in hospital for about 4–7 days.
If your reconstructions are done using tissue from your tummy, you may be in hospital for seven days or more.
If you have implant-based surgery, you may be in hospital for a few days but this will be longer if you have immediate reconstruction with implants.
After any type of operation, you will 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.
Some painkillers may cause constipation so you may need to take laxatives. Your doctor can prescribe these for you or you can get them from your local chemist.
Your physiotherapist will give you exercises to help your recovery. At first you may have some discomfort when you move your arms. But it’s important you continue to use your arms and 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 few weeks 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. If your job doesn’t involve heavy manual work, you may be able to 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.
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 enough 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.
You can find out more about the effects of breast surgery on your sex life.
There are no set rules about when you can begin wearing a bra following breast reconstruction. This will depend on the type of reconstructions you’ve had and the advice of your surgeon.
Some surgeons recommend that women wear a bra immediately after reconstruction. Others advise women not to wear one to begin with because they believe this encourages a more natural droop of the reconstructed breasts, 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 your newly reconstructed breasts, 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. You should wear this night and day.
If you have lipomodelling you should wear a bra for 24 hours a day. This helps to stop any movement and allows the grafted fat time to develop a new blood supply.
Looking after your skin
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Your wounds may feel itchy as they heal but it’s important not to scratch them. The itching will reduce as the wounds heal. 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 breasts 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 breast implants, massage can also help reduce the risk of capsular contracture.
Massaging along the length of the scars using moisturiser or massage oil helps prevent them 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. If they don’t then your surgeon can prescribe ointments to reduce swelling and redness.
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 how your scars are healing, talk to your nurse or breast surgeon. They can check that everything is healing as it should be or, if there’s a problem, they can tell you what can be done to help.