A Young Woman’s Guide To Breast Surgery

After the operation – what to expect

Laser surgery is carried out under a local anaesthetic, which shouldn’t make you feel drowsy although you may have some discomfort in your breasts for several days, and possibly weeks afterwards. You shouldn’t have any limitations with lifting and should be able to go back to work a few days later.

Lumpectomies, wide local excisions and mastectomies are all carried out under a general anaesthetic and have a slightly longer recovery time. When you wake up from the anaesthetic, you will usually have an oxygen mask on your face, a blood pressure sleeve around your arm and a small plastic cuff on your finger to monitor your pulse rate. This is a standard procedure and you should not be alarmed by it. It enables the nurses in the recovery room to ensure everything is going smoothly. Once they are happy that you are conscious, you will be wheeled back into the ward and left to rest.

You may have a small drain running from your breast into a container – this is usually the case with larger incision sites and helps reduce the amount of swelling and fluid in the breast post-operatively. The drainage tube is usually secured in place with a small stitch or dressings at the base of the breast so not in the wound itself. For lumpectomies or WLEs, drains are normally left in for a day if they’re used at all. For mastectomies, two or more drains per operated breast are normally used and they can be left in from three days up to about a week, sometimes longer. You can move about the ward as normal while the drains are in, just make sure you carry the container as you go! They can be a little uncomfortable when they are removed but it’s over very quickly.

For longer operations, like mastectomies, you may be injected with a blood thinner. This is preventative and helps reduce the risk of a blood clot. You may also wake up with a catheter bag – this is a tube which is inserted into the bladder and collects urine in a bag, which is then emptied. It is held in place with an inflatable balloon, which is deflated when the device is ready to be removed. This means you don’t have to get up to go to the toilet. Catheters can be a bit uncomfortable but they shouldn’t be painful.

You will probably still have a canula in the back of your hand. This is the small plastic tube through which the general anaesthetic was injected. Canulas are normally kept in place for the duration of your hospital stay just in case further injections need to be given. No needle is left in the canula and it is held in place with a sticky dressing.

Most surgeons prefer to use dissolvable stitches for breast operations – this means they gradually dissolve over time and it’s important not to get them wet for the first few weeks. A small number use a kind of glue to keep the wound sealed. Either way you will probably have clear tape over the wound to keep it clean and possibly further dressing over the top of that. Some surgeons like to use clear dressings to they can check the wound while others use a thicker fabric dressing. Dressings are normally kept on for about a week or two after the operation and should be kept as dry as possible.

Back on the ward, you will have access to a “Nurse Call” button, which you can press if you feel unwell. Some people find the anaesthetic or pain killers can make them feel or be sick. If this is the case, you should let a nurse know and she can give you anti-sickness medicine. You should also let the nurse know if you are in any pain so that she can administer more painkillers.

Post-operative pain does depend on an individual’s pain threshold – some people will need a high dose of painkillers while others won’t need any. The worst pain is usually felt in the first three days after the operation.

With mastectomies and reconstruction, you may be visited by a breast care nurse and a physiotherapist who will advise you on exercises to rebuild your muscles. It is important to keep your arms moving as much as possible after breast surgery to avoid muscle stiffness although you shouldn’t overdo it! You shouldn’t lift anything heavy or drive for 4 weeks after a lumpectomy and 6-8 weeks after a wide local excision or mastectomy. If you do, you risk straining the wound site and it can cause complications.

You will usually be asked to see the consultant two to five weeks after the operation to discuss progress and any concerns you might have.

Washing after the op
Some dressings shouldn’t be got wet while others are splashproof – the hospital will be able to tell you which you have. Splashproof dressings are fine to use in the shower but you should avoid soaking in the bath with them. You may find it easier to wash your upper body with a face cloth or sponge until your dressings are removed. Wet dressings can increase the risk of infection and remember: prevention is always better than a cure!

You may also want to avoid using deodorant until your wound site has healed, particularly if it is close to your armpit. The alcohol in some sprays can really sting if it drips down. You can buy roll-on deodorants or crystal blocks which are safer to use post-operatively. Likewise, an electric shaver is an excellent investment if you’re having a mastectomy.

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