Preparation and Recovery

Preparation and Recovery

You can take steps to help you prepare for and recover from mastectomy with or without reconstruction. This section covers the following topics:

What to expect after surgery	Risks and complications
Factors that affect recovery	Preparation and recovery tips

What factors affect recovery from mastectomy?

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 reconstructed breast. 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 damage to or the loss of a flap
• Pain (post-operative and long-term pain syndromes)

Long-term and late-onset effects and complications

Late-onset complications and long-lasting changes may occur after mastectomy with or without reconstruction, including the following:

• Lack of feeling in the breast or chest or sensation that occurs because nerves are severed when breast tissue is removed. The chest (with or without reconstruction) is usually permanently numb after mastectomy. Some options may be available to spare nerves during mastectomy or restore sensation after mastectomy. 
• Postmastectomy pain syndrome is a long-term complication of nerve damage during mastectomy that leads to persistent pain, tingling or phantom itching in the chest, armpit or arm. It is more likely to happen after radiation or when lymph nodes are removed during mastectomy. Treatment is available for this complication but might require a specialist. 
• 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 fix the pocket, remove the implant 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 recalled Allergan BIOCELL textured implants and expanders (see full list of devices here). Read more about BIA-ALCL here.

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

It is important to discuss the possible surgical risks and long-term complications with your surgeon to understand the seriousness and likelihood of these risks before making decisions about surgery and reconstruction. Consider getting a second opinion on the best way to resolve serious complications or unsatisfactory results. 

Tips to prepare for and recover from surgery

You can take steps to prepare for and recover from mastectomy with or without reconstruction. Before surgery, many people:

• prepare frozen meals or arrange for meal 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.
• ask their surgeon for a referral for post-operative physical therapy.

FORCE has a mastectomy checklist with a more complete set of tips written by experts and people who have undergone the procedure.