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After Breast Reconstruction What To Expect
As a breast reconstruction patient, you’re going through an intense and emotional time. You’re losing your breast(s) and starting over again. This can be a scary process, but it’s also an opportunity to start fresh and learn how to take care of yourself in new ways.
You’ll have to juggle a lot of different feelings as you go through this transition. You may be worried about how others will react to your new body and the way you look now. You might be scared that your scars will be too visible or that they’ll hurt when you touch them or put on clothes. You might feel really excited about what’s happening with your body, but also nervous that something won’t go according to plan—or worse, that nothing will happen at all!
We hope that this blog helps answer some questions about problems with breast reconstruction after mastectomy and recovery time for second stage breast reconstruction
Expectations After Breast Reconstruction
Your Recovery
Breast reconstruction is surgery to rebuild the shape of your breast after you’ve had part or all of your breast removed because of cancer. You may have had a tissue expander or an implant placed during the surgery. If an expander was placed, salt water (saline) or air was added to it to start stretching your skin.
Right after the surgery, you will probably feel weak, and you may feel pain for 2 to 3 weeks. You may have a pulling or stretching feeling in your breast area. You can expect to feel better and stronger each day, although you may need pain medicine for a week or two. You may get tired easily or have less energy than usual. This may last for several weeks after surgery.
You will likely have several drains near your incision. These help with healing. The drains will be removed when the fluid buildup slows. Drains are usually removed in the first few weeks after surgery.
Stitches usually are removed in 5 to 10 days.
If you had an expander placed, you will need to regularly see your doctor every couple of weeks. During these visits, more salt water will be added to the expander. Or if you have an expander that uses air, you may need to add air at home. After several months, this will stretch the skin enough to cover the implant.
Your new breast may feel firmer and look rounder or flatter than your other breast. The new breast may not have the same shape as your breast did before it was removed. Breast reconstruction with an implant won’t restore normal feeling to your breast. It may take several months for your breast to heal.
This care sheet gives you a general idea about how long it will take for you to recover. But each person recovers at a different pace. Follow the steps below to get better as quickly as possible.
How can you care for yourself at home?
| Activity | Details |
|---|---|
| Rest | Rest when you feel tired. Getting enough sleep will help you recover. |
| Lifting Restrictions |
|
| Pain Management |
|
| Driving and Sexual Activity |
|
| Showering | You can take your first shower the day after the drain near your incision is removed (usually in about 1 week). |
| Bathing | Do not take a bath or soak in a hot tub for about 4 weeks. |
| Returning to Work | You will probably be able to go back to work or your normal routine in 3 to 6 weeks, depending on the type of work and any further treatment. |
| Diet | Details |
|---|---|
| Normal Diet | You can eat your normal diet. |
| Upset Stomach | Try bland, low-fat foods like plain rice, broiled chicken, toast, and yogurt. |
| Fluid Intake | Drink plenty of fluids (unless your doctor tells you not to). |
| Bowel Movements |
|
| Medicines | Details |
|---|---|
| Restarting Medicines | Your doctor will inform you if and when you can restart your medicines. |
| Aspirin and Blood Thinners | Ask your doctor if and when to start taking aspirin or other blood thinners again. |
| Pain Medicines |
|
| Antibiotics | Take antibiotics as directed; do not stop just because you feel better. |
| Incision Care | Details |
|---|---|
| Follow Instructions | Follow your doctor’s specific instructions on incision care. |
| Special Bra | You may need to wear a special bra to hold bandages in place; your doctor will advise when to stop wearing it. |
| Underwire Bra | Do not wear an underwire bra for 1 month. |
| Cleaning |
|
| Drain Care | Details |
|---|---|
| Drain Management | Your doctor will provide instructions on how to care for any drains near your incision. |
| Exercise | Details |
|---|---|
| Walking | Try to walk each day, gradually increasing the distance. |
| Avoid Strenuous Activities | Avoid activities like bicycle riding, jogging, weight lifting, or aerobic exercise until cleared by your doctor. |
| Elevation | Details |
|---|---|
| Arm Positioning | Prop up the arm on the side of your surgery on a pillow to keep it above heart level and reduce swelling. |
| Follow-Up Care | Details |
|---|---|
| Appointments | Make and attend all follow-up appointments; contact your doctor or nurse if you have problems. |
| Test Results | Know your test results and keep a list of your medications. |
| Risks | Details |
|---|---|
| Infection | Infection can occur after surgery, especially in the first couple of weeks. Implants may need to be removed until the infection clears. |
| Capsular Contracture | Scar tissue can form around breast implants, causing hardness and distortion. Treatment may involve surgery to remove scar tissue or replace the implant. |
| Smoking Risks | Smoking narrows blood vessels, delays healing, and increases the risk of complications. Quitting smoking before surgery is advised. |
| Recovery | Details |
|---|---|
| Post-Surgery Feelings | You may feel tired and sore for a week or two after surgery. |
| Hospital Stay | Most likely, you will go home within a few days, possibly with drains in place. |
| Drain Management | Learn how to empty drains before leaving the hospital; your doctor will decide when they can be removed. |
| Support Garments | Ask your doctor about the type of support garments you should wear. |
Breast Reconstruction
Breast reconstruction is a surgical procedure that can restore balance between the two breasts after a mastectomy due to breast cancer. The amount of reconstruction depends on the mastectomy and the tumor’s size and location. It is not considered a cosmetic procedure, but it can provide psychological benefits and contribute to overall wellness. The best time for breast reconstruction depends on the individual’s needs, medical conditions, and cancer treatment.
There are different reconstruction options, including implants, TRAM flap procedures, and latissimus dorsi flap. Implants involve stretching the skin with a tissue expander and inserting a silicone-gel or saline implant. However, implants can rupture, causing pain and infection. TRAM flap procedures use tissue from the abdomen to create a mound to reconstruct the breast, cutting away stomach muscles, fat, and blood supply. The procedure lasts from 4 to 8 hours and typically takes about 5 days in the hospital.
TRAM flap is not suitable for everyone, as it may not be suitable for those with numerous prior belly surgeries, thinness, core strength concerns, or pregnancies. Other less common tissue flap procedures include latissimus dorsi flap and latissimus dorsi flap.
Aesthetic flat closure (AFS) is a surgical repair procedure that corrects contour deformities after a mastectomy, often done as a second procedure or with fat grafting. It can be done at the time of mastectomy or as a second procedure. Flap surgery is more involved and can lead to complications such as bleeding, infection, or poor healing.
Nipple reconstruction is another option, which allows new tissue to heal and settle into place after breast reconstruction. It can be done outpatiently with local anesthesia or after breast reconstruction. A prosthetic nipple is another option, which is made from a copy of the natural nipple and colored the areola.
Breast reconstruction surgery takes about 2 hours, with preparation taking 2 hours and reconstruction taking 1 to 6 hours. Recovery from the surgery may involve discomfort, IV fluids, urinary catheters, and drains at the incision sites. The hospital stay depends on the type of operation and recovery process.
After breast reconstruction, patients may experience soreness, swelling, and bruising for 2 to 3 weeks. They should follow up with medications, showering, bathing, and wound care. Most women return to regular activities within 6 to 8 weeks.
Breast reconstruction doesn’t change the chance of cancer coming back and doesn’t interfere with treatment. However, there are possible side effects, including infection at the surgery site, pain and discomfort, itching, numbness or tingling, and fluid collection under the wound.
Problems With Breast Reconstruction After Mastectomy
Surgery of any kind carries hazards. Breast reconstruction has the following risks:
Bleeding
fluid buildup near the operating table (called a seroma)
Infection
Clots of blood
a lot of scar tissue
Recovery Time For Second Stage Breast Reconstruction
The average surgery lasts between 2-4 hours, and the recuperation time is between 1-6 weeks. Although we advise avoiding any sort of intense activity for six weeks, modest activity can frequently start after four (consult with your doctor).