What happens after breast surgery?

What happens after surgery depends on the type of operation you have had. Many people now have breast surgery as a day case or go home the following day. If you have breast reconstruction at the same time you are more likely to be in hospital for 2 to 7 days.

When you wake up

After your operation you go to the recovery room before moving back to your ward. Here you gradually wake up from having a general anaesthetic . You are closely monitored by the theatre nurses until you are awake enough to leave the recovery room.

You may be wearing a mask or have small tubes into your nose (nasal cannula) to give you oxygen. You might feel dizzy and sluggish to begin with.

You have a blood pressure cuff on your arm and a little clip on your finger to measure your pulse and oxygen level.

Once you are more awake you go back to the ward. The nurses will continue to measure your blood pressure and check your dressings regularly.

Drips, drains and tubes

When you wake up, you might have several tubes going into your body. Your nurse will explain what they are for.

You may have:

• a drip (intravenous infusion) to give you blood transfusions or fluids until you are eating and drinking again
• one or more tubes coming out near your wound to stop fluid and blood building up there
• a tube into your bladder (catheter) to collect urine, if you’ve had a longer operation such as breast reconstruction

If you have wound drains, they stay in until they start draining only small amounts of fluid or stop draining fluid. This is usually about 2 to 5 days after your operation.

You can go home with a drain still in. Your nurse will give you written instructions on how to take care of it. A district nurse will come to your home to check it. Or you might need to go back to the hospital every few days.

Not everyone will have a drain so don’t worry if you don’t have one.

Your wound

You usually come back from theatre with a dressing over the wound.

Some surgeons use a waterproof dressing that stays in place until you go back to the hospital for your first outpatient appointment. Others prefer to have a look at the wound after a day or so.

Some surgeons use stitches that dissolve slowly during the couple of weeks after your operation. So you don’t need to have the stitches taken out. Or you might have stitches that need to come out after about 7 to 10 days. You usually go back to the outpatient clinic for the nurse to do this.

Some surgeons also use glue to seal the wound. Do not pick this it will gradually flake off over time.

Most people find that their wounds take about 2 to 3 weeks to heal. The area may be bruised and swollen at first. This will get better and the scar will look lighter and flatter in time.

Showering and bathing after breast surgery

The advice about when to shower and bath varies between hospital. So, its important to follow the instructions your healthcare team give you.

You can usually shower after 48 hours if you have a waterproof dressing. But it is important not to soak the dressing. It is only meant to be splash proof. This dressing usually needs to stay in place until your first follow up appointment in clinic.

Bathing is generally advised against until the wound is properly healed. Your breast care nurse and surgeon will let you know when you can have a bath.

Before you go home your nurse gives you information about how to care for the wound and who to contact if you have any problems.

Pain and pain control

It’s normal to have pain and discomfort for the first week or so around the wound site. You may also have pain in your armpit (axilla) if you had surgery to your lymph nodes . 

Some people have a tingling feeling or tightness around the scar. This usually gets better, but it can take a few weeks.  

Your doctors and nurses will give you painkillers. Tell them as soon as you feel any pain. They need your help to find the right type and dose of painkiller for you. Painkillers work best when you take them regularly.

Immediately after surgery you might have painkillers through a drip into the bloodstream that you control. This is called PCA or patient controlled analgesia.

Your surgeon might put a long acting local anaesthetic into the wound while you are still in theatre. This can help to control pain for a long time afterwards.

You will have painkillers to take home. Follow the instructions your nurse gives you about when and how often to take them. Contact your healthcare team if you still have pain or if your pain gets worse.

Eating and drinking

You drink sips of water to begin with. If you manage this, you can then move on to other drinks such as tea.

Your nurse will remove your drip once you are drinking well without feeling or being sick.

You can start eating when you feel up to it. This is often within a few hours of your operation. It can be helpful to have plain, bland foods at first. Strongly flavoured foods are more likely to make you feel sick.

Getting up

Your nurses will help you to get up as soon as possible after surgery. You might feel a bit dizzy at first. Later the same day or the morning after the operation, you are usually walking around by yourself. But you will feel tired.

It might take a bit longer if you have had breast reconstruction, especially if you had some tissue taken from your tummy (abdomen). 

You are less likely to get a chest infection or a blood clot if you are moving around.

Exercises after surgery

Your nurse or physiotherapist will help you to begin your arm and shoulder exercises. You will also have other exercises if you have a breast reconstruction. The exercises depend on the type of reconstruction you have. It is important to continue with these when you go home.

These exercises stop you from getting stiff, particularly in your shoulder. Your nurse will let you know how long to continue them.

It helps to have painkillers before you start trying to do them.

Wearing a bra and artificial breast shape

After breast cancer surgery, you can wear a comfortable non underwired bra. You can wear this at night to help support your breast.

If you’ve had a mastectomy without reconstruction, your nurse will give you a lightweight, artificial breast shape (prosthesis) that you can wear inside your bra. It's very soft and will not put pressure on the wound.

Making progress

During the first few days after your operation you will start to feel better and less sore. You might find things slightly easier once your wound drain is out.

Going home

Depending on the type of operation, many people go home the same day as their operation or the day after. If you’ve had breast reconstruction, you are likely to be in hospital for a few days.

When you get home, you need to take things gently at first. You might feel very tired, so have plenty of rest and try to eat a well balanced diet. It may take quite a few weeks for some people to get their energy back, for others it may be quicker.

Don't lift or carry anything heavy, or drive, while your scars heal up. After breast conserving surgery this is likely to be after about 2 weeks. After a mastectomy, it might take longer.

Check with your surgeon or breast care nurse when it is okay to do heavier work (such as vacuuming or shopping) with your affected arm. But do carry on with your arm exercises and some light exercise. It will help you to get better more quickly. 

What you can manage to do will vary, depending on how much surgery you've had. Some people find even filling a kettle too heavy at first. The main thing is to take it carefully and stop if you feel any strain.

You are likely to feel emotional for a while after having your operation. Talk to your partner, friends or relatives about how you feel. Your breast care nurse will also help support you.

Follow up appointments

You have follow up appointments to check your recovery and sort out any problems. They are also your opportunity to raise any concerns you have about your progress.

You usually see your surgeon one to two weeks after your operation. They examine you and check your wound is healing well.

Your surgeon will explain the results of your surgery and talk about any further treatment you might need.

You'll have contact details of your breast care nurse or the ward if you need to contact someone before your follow up.