What to Expect When Recovering from Breast Surgery

By Constance M. Chen, MD, MPH

Hundreds of thousands of women undergo breast surgery every year. Whether these procedures are reconstructive, cosmetic, or therapeutic, surgery itself is traumatic to the body. The body’s reaction to surgery depends on many factors. Most important are the patient’s overall health, type and location of the surgery, and the aftereffects of anesthesia. Before surgery, each woman should discuss with her surgeon both the expected effects of the procedure she will undergo and the individual factors that might affect her recovery. Knowing what to expect and preparing for her recuperation will help ease her return to normal activities.Reconstructive breast surgery replaces a breast lost to mastectomy or rebuilds one disfigured by breast-conserving surgery such as lumpectomy. Breast reconstruction may be via implants or via a woman’s own tissue from another part of her body – often the abdomen – to fashion a soft, warm, natural breast much like the one she lost. Recreating a breast after lumpectomy depends on the degree of deformity and might range from implants to some sort of natural tissue breast reconstruction such as fat grafting or flap reconstruction. Cosmetic breast surgery includes breast augmentation with implants, breast reduction, and mastopexy, or breast lift. Therapeutic breast procedures include cancer surgeries such as mastectomy, lumpectomy, and biopsy as well as surgery for other conditions such as a breast abscess. After surgery…Surgery induces some common and predictable responses at the surgical site and throughout the body. I offer some suggestions on what to expect in the days and weeks on the road to recovery. Immediately after waking from anesthesia, you will be groggy. Some women experience post-operative nausea and/or vomiting that usually wears off in a couple of hours or days. If you are not staying overnight in the hospital, you will need a ride home.Surgical drains may be in place after mastectomy or reconstructive surgery and will be removed either in the hospital or in the doctor’s office a week or so after discharge. You will be instructed before leaving the hospital on how to manage the drains and how to keep them secure and discreet.Pain is most likely in the first few days and your doctor may prescribe medication to control pain. After that, over-the-counter painkillers generally suffice. Post-surgical swelling is common along with bleeding and bruising at the surgical site and swelling may be apparent elsewhere. Your surgeon will advise on dressings and whether or not ice and elevation are appropriate.Easing into light daily activity will be easier after a couple of weeks and some women can resume a desk job. Over the next few weeks, soreness and swelling will diminish and by six-to-eight weeks, most women are fully recovered and can resume regular activity. Promoting healing…I emphasize the importance of following your doctor’s instructions while recovering and offers tips to make you as comfortable as possible and promote healing.

• Wear loose, comfortable clothing that slips on easily and closes in the front. Zippered closures are often easiest to avoid fumbling with buttons. Avoid restrictive clothing and anything that requires you to lift your arms over your head. 
• Your surgeon will discuss whether and when to wear a bra and whether you should wear a compression garment at first to reduce swelling or avoid compression to keep the tissue alive. When you’re ready for a regular bra, look for one that is made of soft, breathable fabric and closes in the front. Avoid underwire bras that dig into your skin. Consider a post-surgical camisole that has pockets to hold drains.
• Try sleeping in a recliner or lying on your back with pillows under your knees. 
• Don’t lift, carry, or push anything heavy – including a child – in the first few weeks after surgery.
• Eat a nutrient-rich, well-balanced diet rich in lean protein to repair damaged tissue; iron, found in liver and green leafy vegetables, to replenish red blood cells; fluids from 6-8 glasses of water a day to reduce swelling; and fiber from beans and grains to stimulate a gastrointestinal system made sluggish by anesthesia. Get energy from food rather than supplements.
• Avoid all products that contain nicotine – including cigarettes, patches, gum, chewing tobacco, and lozenges. Nicotine inhibits the body’s ability to heal.
• Get moving! The body gets debilitated quickly. Even gentle stretching is helpful to stimulate the muscle fibers and overcome stiffness. After the immediate healing period, exercise also gets your heart rate up so that the blood is moving and your lungs fill with oxygen.

Your doctor will let you know when various activities are safe after surgery, such as driving. But remember that every patient reacts differently and estimated time frames don’t apply to everyone. Our goal is to ensure that every woman understands her treatment and recovery as well as possible. It’s vital to her physical and emotional healing that patients have comprehensive, accurate information about what to expect. Constance M. Chen, MD, is a board-certified plastic surgeon with special expertise in the use of innovative natural techniques to optimize medical and cosmetic outcomes for women undergoing breast reconstruction. She is Clinical Assistant Professor of Surgery (Plastic Surgery) at Weill Cornell Medical College and Clinical Assistant Professor of Surgery (Plastic Surgery) at Tulane University School of Medicine. www.constancechenmd.com