What to Expect After the Operation
Get Well Soon
Helping you make a speedy recovery after a mastectomy
What to expect after the operation
There will be some variation both in the extent of each individual patient’s surgery and their body’s response to it; patient recovery programmes may therefore vary.
Your scar will usually be discussed with you before your operation. The scar is often horizontal or diagonal on the chest wall, starting from the inner part of the breast to the outer curve of the breast. It is usually placed within the bra line so is not visible when you are wearing clothes. If you want to see some pictures or photos of mastectomy scars before your operation, ask your breast care nurse or surgeon to show you some.
Scars may be raised, red or swollen at first, but should gradually settle and will fade over time.
For some women it can take time to want to look at the scar, this is a common anxiety. Take your time; wait until you feel ready to do so.
After your operation, the scar will be covered with a waterproof dressing. It is wise to keep the dressing dry for the first 48 hours and leave your scar covered for 7–10 days. After the first 48 hours, you may bathe and shower as normal, but try not to soak the dressing.
Wounds can weep a little and the dressing may need to be changed. If this is the case, either the ward staff, your local dressing clinic, or your breast care nurse will be able to advise you on how this will be managed.
Once your dressing is removed, avoid rubbing soap or shower gel directly onto your wound. Pat the scar dry with a soft towel. Do not pick any scabs that form as they are protecting the new tissue growing underneath.
Most mastectomy scars have dissolvable stitches that do not need to be removed. However, if you have stitches that do need to be removed, this is usually done around 7–10 days after your operation, by a nurse in your own home, or by a practice nurse at your local treatment centre. Your hospital should already have given you advice about how your wounds are closed and how to care for them.
You may have a drain (plastic tubing) placed under the wound to direct any bruising or fluid following the operation into a bag. This usually stays in place for 1–2 days, after which the drain and bag can be removed either before you go home or when you are at home by the district nurse. Many surgeons do not use drains so don’t worry if you don’t have one.
Swelling or heaviness of the breast
In the first few weeks after surgery, sometimes clear or pink-stained fluid can collect under the skin as a swelling (seroma). You may also develop bruising, which will slowly fade, although sometimes a hard, tense bruise can form (haematoma).
If either a seroma or a haematoma does develop, it can be uncomfortable and give you a heavy feeling. Both of these can be dealt with in a straightforward way. Contact your breast care nurse and she will be able to advise you; otherwise, speak with your GP or with NHS Direct for further advice.
At first you may not experience any pain as your surgeon may have put some local anaesthetic in your wound during surgery. As this wears off you may feel mild pain, which will respond to simple painkillers; take these as prescribed for as long as you need them. You will be given some to take home with you for the first week or so. You may get some tingling or tightness around the scar – this will settle over a few weeks. Sometimes, after about 6–8 weeks (or longer), you can develop scar tissue in the armpit (axilla), which forms a tight band. This is called “cording” or “banding” and can feel like a guitar string. It is harmless, and is likely to get better over time if you massage and stretch the band.
Feeling tired or emotional
If you feel tired or emotional in the days and weeks after your operation, try not to worry – this is a quite normal reaction that many women experience. A diagnosis of breast cancer can provoke a wide range of feelings and emotions; these can be frightening and difficult to deal with. Your breast care nurse specialist, surgeon and GP will be able to offer you sources of help and support.
As your levels of physical activity improve, you will steadily start to feel less tired and as time goes on you will feel less anxious. You will need to rest in short but frequent periods, though.
Wearing clothes after a mastectomy
When you go home (this can be as soon as the same day of your operation if you have had a day-case mastectomy, otherwise within 1–2 days of the operation), you will be given a temporary external prosthesis (a “softie”) to wear in your bra. This is very light so will not put pressure on your wounds. At about 6–8 weeks following your surgery, when your mastectomy wounds are healed, you will be given a permanent prosthesis. This will usually be fitted by one of the breast care nurses.
Some painkillers, such as those containing codeine, may cause constipation, so it’s important to get plenty of fibre in your diet while you are recovering. Fresh fruit and vegetables will help to keep your bowels moving regularly. Lactulose may also be useful.