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Understanding BRCA & HBOC > Breast Reconstruction > Preparation and Recovery

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Preparation and Recovery

This section outlines the many options available and information about reconstructing breasts following mastectomy.

Preparing for surgery

Choosing a method of reconstruction is very personal. Each procedure has advantages and disadvantages. Not all surgeons perform all procedures, and often, surgeons recommend only the techniques they perform. The most important actions a woman considering reconstruction can take is to learn about her options, decide which is best for her, then consult with and choose a surgeon who is experienced and expert in the technique she prefers. The Breast Reconstruction Guidebook, our Post Mastectomy Photo Gallery and Show & Tell Book are great tools to help women decide which reconstruction options they

FORCE has a mastectomy surgery check-list to help women prepare for prophylactic surgery and reconstruction.

Surgical drains

Surgical drains are plastic devices used whenever surgery leaves the opportunity for fluid build-up, which could delay healing, cause discomfort or invite infection. Often surgical drains are placed at the time of surgery with mastectomy or as part reconstruction. The tubes remain temporarily after surgery, usually for a few days or weeks, and are removed once post-surgery fluid buildup has decreased.

Part of the drain is placed inside the body at the surgery site and can't be seen. This part consists of a soft plastic tube with holes for the fluid to drain out of. This part of a drain cannot be seen until it is removed.

The drainage tube with the holes connects with a longer tube--the Jackson-Pratt (JP) drain, which remains outside of the body. At the end of this tube is a bulb which has a lid on it that can be opened to drain the collected fluid. The amount of fluid build up is measured to determine when the drain can be removed. After the fluid is removed, the bulb is squeezed so that it creates a gentle vacuum and the top is placed back on. This allows gentle suction of fluid from the surgical site. (Picture of a surgical drain.)

Recovery

Recovery times after mastectomy and reconstruction vary by type of surgery, individual healing time, and other factors. The average recovery time after mastectomy and reconstruction is about 2-4 weeks. Recovery time for stage 2 surgery after a flap reconstruction and for exchange of implants after expansion is significantly shorter than stage 1 reconstruction. It's important to schedule yourself enough recovery time to allow your body to fully heal.  

Your doctor may recommend gentle exercises or refer you to a physical therapist to help with range of motion, decrease discomfort from expansion or improve healing. It is important to wait for clearance from your surgeon before resuming exercise and other activities. 

Surgical risks & complications

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

  • Infection or inflammation of breast requiring antibiotics or implant removal
  • Fluid build-up at the surgical site (seroma or hematoma)
  • Delayed wound healing
  • Blood loss
  • Blood clots
  • Pain (post-operative and long term pain syndromes)
  • Loss of implant or flap
  • tissue necrosis
  • Rupture, rotation or movement of implant requiring removal
  • Capsular contruction or hardening around implant
  • There is a very rare type of cancer known as "anaplastic large cell lymphoma" that has been associated with breast implants

It is important to discuss possible surgical risks with your physician. Understand the seriousness and likelihood of these risks prior to surgery. If you experience complications or you are unhappy with your surgical outcome, it is important to have a conversation with your surgeon and have them address all your concerns. Don't hesitate to get a second opinion on the best way to resolve serious complications or unsatisfactory cosmetic results.