Healing & Recovering after Breast Reconstruction Procedures
When you have breast reconstruction surgery — to rebuild your breasts after a mastectomy or for another reason—our dedicated surgeons will be there to help you with every stage. This includes seeing you through recovery so you can get back to enjoying daily life and feel good about your results.
Breast Reconstruction Surgery Procedures
Your breast reconstruction may include one or more procedures. Your plastic surgeon will help you decide which procedures are best for you.
- Breast tissue expander placement&Բ;— If you choose to have tissue-based/flap or implant-based reconstruction, your surgeon may place a tissue expander first, if needed for either of these procedures. A tissue expander will gradually expand your chest wall skin and/or muscle before your final reconstruction. We sometimes put a tissue expander in place at the same time as a mastectomy. However, we may also do it as a separate procedure.
- Tissue-based/flap reconstruction&Բ;— In this procedure, your surgeon will use tissue from another part of your body to reconstruct your breasts. The most common areas to take tissue from are your lower abdomen (belly), back, thighs, and buttocks.
- Implant-based reconstruction&Բ;— In this procedure, your surgeon will use either saline or silicone implants to reconstruct your breasts. We typically perform this surgery in stages, which first requires the placement of a tissue expander. However, in some cases, we can place an implant immediately after a mastectomy is performed using the same anesthetic.
As you decide between or prepare for any of these breast reconstruction procedures, it’s important to know what to expect during healing and recovery.
Breast Reconstruction Risks
Most women will not have complications (problems) during their breast reconstruction procedures. However, risks that may occur soon after each procedure include:
- bleeding,
- infection,
- fluid build-up (seroma), and
- wound reopening (dehiscence).
Hospital Care After Breast Reconstruction
The length of your hospital stay after surgery depends on the procedures you have to reconstruct your breasts.
- For tissue expander placement, you will go home the day after surgery.
- For tissue-based/flap reconstruction, you will be in the hospital for one to four days after surgery.
- If we are exchanging your tissue expanders for breast implants, you will go home the same day of surgery.
Before we discharge you, we will make sure that your pain is under control and give you a prescription for pain medication, if needed. If you have tissue expander placement and tissue-based reconstruction, we will also prescribe antibiotics to prevent infection while your surgical drains are in place. Your surgical drains will keep extra fluid away from your surgical area and stay in place for two to three weeks after both of these procedures. Learn more about breast surgical drain care and management after surgery.
Symptoms After Breast Reconstruction
After tissue expander placement or your final reconstruction, you may experience the following symptoms:
- minor swelling and bruising for up to eight weeks,
- discomfort, muscle spasm, and mild to moderate pain,
- crusting along incision lines,
- itching and shooting electrical sensations as nerves heal,
- numbness or lack of sensitivity for a few months or long term,
- scar redness, which usually lightens within three to six months
- tightness across your chest, and
- upper body weakness.
These symptoms are completely normal signs of healing. With a tissue expander in place, you may also have a contour that’s not yet smooth.
Find a Breast Plastic Surgeon
Breast Reconstruction Recovery
What to Wear After Breast Reconstruction
You will wear a surgical bra for three to four weeks after surgery if you have implant-based reconstruction or tissue-based reconstruction using a latissimus flap.
Physical Activity
For at least three to four weeks after your breast reconstruction procedures, you should avoid:
- strenuous activity,
- repetitive arm motions, and
- lifting, pulling, or pushing anything over 10 pounds. This will help you avoid bleeding, bruising, or swelling too much.
As you heal, your surgeon may clear you to:
- start stretches for your upper body three to four weeks after surgery.
- gradually return to normal daily activities.
- four to six weeks after tissue expander placement or implant-based reconstruction
- six to eight weeks after tissue-based reconstruction
- add strenuous exercise.
- six weeks after tissue expander placement or implant-based reconstruction
- six to eight weeks after tissue-based reconstruction
Physical Therapy after Mastectomy and Reconstruction
Most people do not need physical therapy during breast reconstruction recovery. However, you may start it three to four weeks after surgery, if needed.
How to Sleep after Breast Reconstruction Surgery
For at least one week after your procedures, you should rest and sleep on your back with extra pillows to prop you up. This will help with swelling.
Do not sleep on your stomach until your surgeon says it is okay. If you want to sleep on your side, you should:
- alternate sides at first to help with any swelling.
- wait until three to four weeks after surgery or when it is comfortable, but only if your drains have been removed.
Showering & Bathing
You can shower daily once you return home from the hospital. You should not soak in a bathtub, pool, or hot tub until your incisions (cuts) heal or your surgeon says it is okay.
Returning to Work & Driving after Breast Reconstruction Surgery
In general, you should not drive until you:
- are off of any prescription pain medications for at least 24 hours,
- can safely operate a vehicle in traffic, and
- have your drains removed, if you have them.
Most people are ready to drive and return to work around:
- four to six weeks after tissue expander placement,
- four to six weeks after tissue-based reconstruction, and
- two weeks after implant-based reconstruction.
For work that requires heavy lifting, it may take longer or require temporary restrictions. Before you drive or return to work, it is best to get your doctor’s approval at a follow-up visit.
Flying after Breast Reconstruction Surgery
Air travel is generally safe after tissue expander placement and breast reconstruction. However, you should wait until your drains are taken out, if you have them.
Breasts after Reconstructive Surgery
How Long Does It Take for Implants to Drop?
If your reconstruction includes breast implants, expect them to settle into place within three months after surgery. It will be a gradual process.
In general, your breasts may not have the same shape after reconstruction as they did prior to mastectomy. It’s also common for your breasts to feel firmer.
Breast Implant Scars & Breast Reconstruction Scars
Your scars will start to fade within one to two years. Although, they may always be noticeable. Your surgeon can share ways to help your scars fade and soften.
Breast Sensation
When a surgeon removes breast tissue during a mastectomy, the process will cut delicate nerves. Therefore, you may not have normal sensation in your breasts. There are some reconstructive techniques that we can use to help restore sensation to your reconstructed breast. Your surgeon will discuss these with you.
Follow-Up Appointments & Other Procedures
After Tissue Expander Placement
Your surgeon will want to see you every week for about three to four weeks after tissue expander placement. It usually takes two to three weeks before we begin filling the tissue expander more—to gradually stretch your skin for breast reconstruction.
You may be ready for the final stage of breast reconstruction surgery three to four months after tissue expander placement. However, it may be longer if you need chemotherapy and/or radiation treatment first.
After Tissue-Based or Implant-Based Reconstruction
Your surgeon will want to see you every one to two weeks for the first two months after breast reconstruction surgery. After the initial two months, you will likely have follow-up visits on an annual basis.
Three months after your breast reconstruction, you may be able to undergo other procedures to fine-tune your results and reconstruct your nipples, if you choose.
Make an Appointment with Our Plastic Surgeons
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We recommend that you consult with a plastic surgeon to discuss breast reconstruction surgery prior to undergoing a mastectomy. Our focus is to provide the knowledge you need to choose the best course of reconstructive treatment for you. If you already had a mastectomy, we are more than happy to speak with you at this stage as well.
Call our office at 801-581-7719 to schedule an appointment with one of our plastic surgeons who specialize in breast reconstruction.
Insurance Coverage
Many states require all health insurance providers, including Medicaid, to pay for reconstructive surgery after a mastectomy. We will contact your insurance company to determine your eligibility and request approval to cover your breast reconstruction.
Breast Implants and the Risk of ALCL
Recently the Food and Drug Administration (FDA) has identified a possible association between textured breast implants and development of a rare form of cancer called anaplastic large cell lymphoma (ALCL).
The majority of the data suggests the cancer risk is associated with breast implants that have textured surfaces rather than those with smooth surfaces. The risk is low and thus far only a small percentage of patients with textured implants have been found to have ALCL in the United States. Nevertheless, out of an abundance of caution the FDA has recalled a specific brand of textured implants.
The Division of Plastic Surgery at U of U ǿմý has stopped using all brands of textured implants in light of the recent concern of developing ALCL. Please note that the recall of these implants does not mean that the implants need to be removed. If you have concerns or questions regarding the recall please refer to the FDA website or speak with your doctor.
Hear From Our Patients
After being diagnosed with breast cancer, Terri Jones had a plan. “When it got to the idea of reconstructive surgery, all I knew is that I didn’t want anything foreign in my body,” Jones said. “I didn’t want implants and I thought that meant I wouldn’t have reconstruction at all.” After speaking to a friend who had breast cancer, Jones learned there are many more options when it comes to breast reconstruction than she realized. This meant she could make a choice right for her.
