What happens after breast reconstructive surgery?

After surgery, you will have some pain to begin with. The nurses will give you pain-relieving medicine to help. There will be some swelling in the reconstructed breast(s). This gradually reduces over a few weeks.

Depending on the type of surgery you’ve had, you may be in hospital for up to 7 days. You’ll feel tired when you get home and will need some help at first. Gradually build up what you can do. Ask your surgeon or breast nurse if you’re unsure about what you can do and when.

Your wounds will take about six weeks to heal fully. They may feel itchy during this time. After this you may be shown how to massage the scars to help keep your breast(s) and skin supple. Over time scars will flatten and fade.

Your breast care nurse can show you how to check your breasts after surgery. Any changes in your breast(s) will usually be caused by things other than cancer but it’s important to tell your doctor or nurse if you find anything that concerns you.

Recovery after breast reconstruction surgery

Immediately after surgery, the reconstructed breast(s) may be covered with dressings. Alternatively, the wound may be held together with sticky plastic strips, which are left in place until the wound has healed.

Your surgeon or nurse will tell you whether you should keep the area dry or if you can gently shower the wound with clean water. Pat the wound area dry with a clean towel – don’t rub it. Once the wound has healed you can bath or shower as normal. Wash with lukewarm water and unperfumed soap, and rinse the wound well.

Your new breast(s) will be swollen to begin with. Your reconstructed breast(s) will gradually get smaller over a few weeks or months as the swelling goes down.


Warmth

If you have breast reconstruction using your own tissue, the new breast(s) will need to be kept warm for the first few hours after the operation. Warmth improves blood circulation to the tissue. You may have a special blanket called a ‘bair hugger’, which circulates warm air over you, or you may have a thick gauze pad over the flap to keep it warm.


Pain or discomfort

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.


Going home

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 on whether you have immediate or delayed reconstruction. If you have implant-based surgery, you may be in hospital for up to three days. 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 up to seven days.


Work and everyday activities

You’ll probably feel quite tired in the first week 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. In general, if your job doesn’t involve heavy manual work, you can 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.


Driving

You can usually start driving again once you’re 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.


Your sex life

It’s fine to have sex when you feel comfortable 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. There’s more information about the effects of breast reconstruction on your sex life.

Sex after breast surgery

Having breast surgery may affect your sex life and how you see yourself as a woman (self image). This often gradually improves with time. Try not to think that sex can’t be as important in your life as it was before the surgery. There will often be a period of adjustment for you and your partner, and with time most difficulties can be overcome.

You may feel insecure and worry whether or not your partner will still find you sexually attractive. Partners are often concerned about how to express their love physically and emotionally after a woman has had breast surgery. They may not have a problem with your changed appearance, so it can help to try to discuss it if you feel that there’s awkwardness between you.

Cuddles, kisses and massages are affectionate and sensual ways of showing how much you care for someone, even if you don’t feel like having sex. You can wait until you and your partner feel ready – there’s no right or wrong time. If you feel very self-conscious, making love while partly dressed or keeping the lighting low may be better for you.

If you’ve had breast reconstruction this will create a breast shape but the sensations in the breast and the nipple will not be the same as before the original breast surgery. This can affect sexual arousal if you were previously aroused by having your breasts touched. Although this can take time to adjust to, with the support of your partner you will still be able to enjoy a fulfilling sex life.


Wearing a bra

If you’re advised to wear a bra to support your newly reconstructed breast(s), 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 day and night.


Looking after your skin

Your wound may feel itchy as it heals but it’s important not to scratch the healing skin. The itching will reduce as the wound heals. It usually takes about six weeks for it to heal fully.

Once your wounds have healed, most surgeons recommend you massage the skin and scars over your reconstructed breast(s) 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. Massaging along the length of the scar(s) using moisturiser or massage oil helps prevent it 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. 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 the how your scars are healing, talk to your nurse or surgeon. They can check that everything is healing as it should or, if there is a problem, can tell you what can be done to help.


Checking your breast after breast reconstruction

Mammograms

You won’t usually need to have screening tests of the reconstructed breast(s) after a mastectomy. But, if you had breast reconstruction after breast conserving surgery (only part of breast removed) you will continue to have mammograms on that breast. Breast implants hide part of the breast during mammography, but experts believe that mammograms are still useful to assess the overlying breast tissue. Your doctor can advise on how any possible recurrence of cancer can be found.

Self-examination

It’s important to check your breast(s). If you have not previously done this, ask your nurse to show you. They can also give you leaflets which show you how to check your breasts. Your doctor will also regularly examine your breasts after your reconstruction.

Things to look out for include:

  • breast tissue that feels different (eg harder or tighter)
  • a change in the appearance or shape of the breast
  • a change in skin texture – puckering, dimpling, rash, thickening
  • a visible lump or bulge
  • a lump or lumpy area you can feel in the breast or armpit
  • changes in the nipple
  • a rash or swelling on the nipple or the areola (the dark area around the nipple)
  • swelling of the upper arm
  • unusual pain or discomfort (different from tenderness before your period).

These changes can be caused by things other than cancer but it’s important to tell your doctor or nurse if you find anything that concerns you.

Your surgeon will examine you and arrange some tests. These can include ultrasound, MRI scan or a biopsy to check out anything unusual.


Back to Having breast reconstruction

What is breast reconstruction?

If you have had or are about to have breast reconstruction, we have information about what to expect.

Making your decision

An important part of making your decision about breast reconstruction is having realistic expectations about the result.

Your feelings

Breast reconstruction surgery can cause many different emotions. It can take time to adjust to your new breast(s).

Talking to your surgeon

Your reconstruction surgeon will explain what types of operation can be done and answer any questions you have.

Potential problems with breast reconstruction

If you have any problems after breast reconstruction surgery, contact your breast care nurse or surgeon for advice.