What happens after surgery?

Your breast care nurse will give you advice and support for recovery after your operation.

After your operation, you will be encouraged to start moving around as soon as you can. Your wound will have a dressing on it and you may have a plastic drainage tube attached to a bottle that fluid from the wound drains into (drain). You’ll be given help with these and advice about how to look after them.

At first, your breast area will be swollen and bruised but this should improve in a few weeks. Your shoulder and arm may feel stiff, but you’ll be shown how to do exercises than will help with this.

If you don’t have an immediate breast reconstruction, you will be given a soft, lightweight false breast (prosthesis).

You may have some side effects such as numbness, tingling or fluid build up. Some women have side effects of surgery for some months after their operation. Speak to your breast care nurse if anything is worrying you.

After your operation

You will be encouraged to start moving around as soon as possible after your operation. This can help reduce the risk of complications.


Your wound

You will have a dressing covering your wound, which may not be removed for the first few days. The nurses will let you know how to look after it before you go home.

How long it takes to heal depends on the operation you had. If you only had a small area of tissue removed, your wound will usually heal quickly. If you don’t have stitches that dissolve, you will probably have your stitches removed about 7 to 10 days after your operation.

Wound infection

This can be a complication of surgery. Signs of infection can include warmth, redness, swelling around the wound or discharge coming from it. You may also feel unwell with a fever. Tell your nurse or doctor if you get any of these symptoms, even after you go home.


Drains

You may have a long, thin plastic drainage tube attached to a bottle that fluid from the wound drains into. It is usually left in until it stops draining, which may take a few days. You can go home with the drain. A practice nurse or a district nurse may check it when you are at home. Or you might have it checked and removed at the hospital.


Fluid collecting around the wound (seroma)

Fluid can build up in the area around the wound. This is called a seroma. It usually goes away within a few weeks. Sometimes your nurse or doctor may need to drain it off with a needle and syringe.


Pain

You will probably have some pain around the wound and in your armpit if you had lymph nodes removed. This may last a few days. The nurses will give you painkillers to take regularly until it settles down. After a mastectomy, you may need to take them for a week or two. Let your doctor or nurse know if the painkillers are not helping. They can prescribe stronger ones for you to try.


Stiff shoulder or arm

After a mastectomy or having lymph nodes removed, your shoulder or arm may feel sore or stiff.

It’s important to do the arm exercises that your physiotherapist or nurse shows you. This will help improve the movement in your shoulder and arm, and reduce the risk of long-term problems. You should start the exercises the day after your operation and gradually build up what you can do.

Breast Cancer Care have a leaflet about these exercises after breast cancer surgery.


Numbness and tingling in the upper arm

You may have this if nerves in your breast and armpit are injured during the operation. This is more likely if you had all the lymph nodes removed. It may slowly improve over some months but can sometimes be permanent.


How your breast looks

It is common to have swelling and bruising after your operation.

It should improve after a few weeks, but let your breast care nurse know if it doesn’t. Wearing a crop top or sports bra might feel more comfortable until the swelling goes down. If you had a sentinel lymph node biopsy (SLNB), you may see the blue dye in your skin for a while, but this is normal.

Scars

Before your operation, your surgeon or breast care nurse will explain where the scars will be. Scars from breast conserving surgery are usually small. Depending on where the surgeon makes the cut, the scar may be in the area where the cancer was, or a small distance away.

A mastectomy scar is across the skin of the chest and into the armpit. After surgery to the lymph nodes, the scar is in the armpit and shouldn’t be noticeable from the front.

To begin with, your scar will be red if you have white skin, or darker if you have dark skin. It will also be firm and slightly raised. Over time, it will flatten and fade. Everyone’s skin heals differently. If you have dark skin or fair, freckled skin, scars can take longer to settle and may be more noticeable for longer.

If you are worried about your scar, talk to your breast care nurse or surgeon.

I am able to view my scar as a positive sign that I survived. I still feel confident and able to dress exactly as I did before.

Janet


Coping with a changed appearance

The first time you look at your breast or chest after surgery you may want to have someone with you, or you might prefer to be alone. Your breast care nurse will talk to about this and help support you.

At first, the area will look swollen and bruised, but this will settle in a few weeks. In time the scar becomes less obvious.

Changes to your appearance can cause concerns about your body image. This is the picture in your mind of how your body looks and works. These concerns can make you feel less confident or less feminine and may affect your sex life.

Some women find that breast reconstruction helps give them back their confidence and feelings of femininity.


Breast prosthesis

If you have a mastectomy and don’t have breast reconstruction, your nurse will give you a soft, lightweight prosthesis (false breast) to wear inside your bra. It’s often called a ‘cumfie’ or ‘softie’. You can wear it straight after your operation.

When your wound has healed, you can choose a permanent prosthesis made of soft plastic (silicone). It will be matched to the size and shape of your other breast and your skin colour. Many women find their confidence gradually improves as they get used to it.

You can get different types of prosthesis from the NHS. Breast Cancer Care can also give you a list of suppliers.

I was totally bowled over by how realistic prostheses are. I mean, they feel just like real flesh.

Cheryl


When you get home

Your recovery will depend on the type of operation you have.

Try to get plenty of rest and eat well. Do some light exercise, such as walking, to help build up your energy. You can gradually increase the amount you do. Carry on with the exercises you were shown in hospital. Follow the advice you were given by your breast care nurse.

Depending on the operation you had, you may need to avoid lifting or carrying anything heavy for a few weeks.

Some insurance policies give specific time limits for not driving after surgery. Contact your insurance company to let them know you have had an operation. Most women are ready to drive about four weeks after their operation. Don’t drive unless you feel in full control of the car.

You will be given a clinic appointment to see the surgeon and breast care nurse to check your wound is healing properly. They will also tell you about the tissue removed during surgery (pathology), the stage of the cancer and any further treatment you need.


Late effects of surgery

Some women may have problems with the effects of surgery for months or longer after their operation. Tell your breast care nurse if you develop any of these or if you are worried about them.

Cording

This feels like a tight cord running from your armpit down the inner arm, sometimes to the palm of your hand. It usually happens after surgery to remove one or more lymph nodes. You may notice it weeks or months after surgery. It usually gets better on its own over a few months. Some women may need physiotherapy and massage.

Pain and changes in sensation

Sometimes women continue to have numbness, tingling or pain in the upper arm because of injury to the nerves during surgery. Your doctor can prescribe low doses of a drug that treats nerve pain.

Changes to your arm or shoulder movement

Arm and shoulder movement and strength usually improve after surgery. Doing exercises helps reduce the risk of long-term problems. If you have problems, ask your doctor for a referral to a physiotherapist. If moving your shoulder or arm is painful, your doctor can prescribe you some painkillers.

Lymphoedema

Surgery or radiotherapy to the lymph nodes in the armpit can cause swelling of the arm (lymphoedema). If you notice any swelling, speak to your breast care nurse or doctor. Treatment can be more effective the earlier it begins. We have more information on reducing the risk of lymphoedema.

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