Preparation and recovery

There are steps that you can take to prepare for mastectomy and reconstruction and help with recovery. Average recovery time after mastectomy and reconstruction is about 3-4 weeks, but may be up to 6-8 weeks. During that time, there may be restrictions against driving and activities that involve lifting or raising the arms up over the head. Before surgery, many people will:

• prepare frozen meals or arrange for delivery to minimize the need for cooking
• move frequently used items to lower shelves 
• arrange for rides to follow-up appointments or to pick up children from school
• purchase pillows to improve comfort while resting or sleeping

Compared to mastectomy with reconstruction, recovery from mastectomy alone is quicker, less uncomfortable and less likely to have complications. Most people remain in the hospital overnight.

Most of your chest will be numb and may feel heavy. You may feel a pulling sensation under your arms as you recover; this will improve as your chest heals. It's important to take pain medications as prescribed, and tell your doctor if the medications are not controlling your pain.

Physical therapy may help to restore range of motion, decrease discomfort and reduce buildup of scar tissue. You can ask your surgeon for a referral for post-operative physical therapy.

FORCE has a Mastectomy Tip Sheet written by experts and people who have undergone the procedure. 

Surgical risks and complications 

Every surgery has potential risks; some are more serious than others. Some mastectomy and reconstruction risks can affect recovery. Others can affect the type of scarring and appearance of the breast reconstruction. Some possible risks include:

• Infection
• Fluid build-up at the surgical site (seroma or hematoma)
• Delayed healing
• Blood loss
• Blood clots
• Blood supply issues that cause the loss of a flap
• Pain (post-operative and long term pain syndromes)

Long-term complications

There are also late-onset or long-term complications that can occur with mastectomy and reconstruction. These include:

• Lack of breast or chest feeling or sensation occurs because nerves are severed when breast tissue is removed. Most chests (with or without reconstruction) are permanently numb after mastectomy. Some options may be available to spare nerves or restore sensation after mastectomy. 
• Long-term pain syndromes are rare, long-term complication of nerve damage during mastectomy that leads to persistent pain in the chest area. It is more likely to happen when lymph nodes are removed during mastectomy. Treatments are available for this complication. 
• Capsular contraction (hardening of the scar tissue around an implant) can occur at any time after implant reconstruction. Treatment usually involves removing and replacing the implant.
• Implant movement or rupture requires additional surgery to remove or replace an implant
• Breast Implant Associated Anaplastic Large Cell Lymphoma or BIA-ALCL is a very rare cancer that has been linked to breast implants. Although the cancer is rare, the FDA issued a recall of Allergan BIOCELL textured implants and expanders (see full list of devices here). Read more about research and policy on BIA-ALCL.

Some experts believe that breast implants may increase the risk for certain immune-mediated diseases, but the research has not provent a link. More research will be needed to learn if there is a link between breast implants and these illnesses. 

It is important for you to discuss possible surgical risks and long term complications with your surgeon to understand the seriousness and likelihood of these risks before making a decision about surgery and reconstruction. You can get a second opinion on the best way to resolve serious complications or unsatisfactory results.