A Young Woman’s Guide To Breast Surgery


Getting back to normal again

After you’ve had breast surgery, you will probably want to take things easy for a while. You should rest as much as you need to but you should also make sure you get some mild exercise in the form of gentle walking. This is important to help the body rid itself from the anaesthetic and get you on the road to recovery.

If you have had a lumpectomy, wide local excision or mastectomy you will be advised by the hospital to refrain from lifting or driving for several weeks. The hospital should also let you know when it is safe to return to work again. If there is anything at all that you’re not certain about or if you think you might have an infection, you should contact the hospital immediately for advice.

Wearing a bra again
Your breasts will probably be tender for a while after breast surgery so you may find that underwired bras are uncomfortable. A non-wired support bra can often help you feel more comfortable as it offers some support to the wound or you may prefer to wear a simple crop top. Some types of reconstruction require you to wear a support bra 24 hours a day for a period of time – again the hospital will advise you if this is the case.

If you had a mastectomy without a reconstruction, you may like to purchase a special mastectomy bra, which has little pockets to hold your prosthesis. Your breast care nurse should have a variety of catalogues to browse through or you can use one of the many on-line stores.

  • If you have had a mastectomy and buy specialist products like a mastectomy bra or prosthesis for your own use, you don't have to pay VAT under something called group 14 of the zero rate schedule for the VAT tax act 1983. Many mastectomy bra stockists are aware of this clause and will get you to sign a VAT exemption form when you buy from them. You will be able to find out more about this concession through your breast care nurse.

Implant expansions
If you have had a mastectomy with a reconstruction that involves implants, you may need the implants expanding until the reach the desired size. Very small-busted women often find they can escape this stage if the surgeon uses fixed volume implants, ie implants that are already expanded. For everyone else, expandable implants may be used. These are like balloons that sit under the skin or muscle that are gradually injected with saline through a small port or nozzle located at the side of the breast. The port is hidden under the skin but may be felt in some slimmer women or those who have very fine skin.

Implants are usually expanded about four weeks after the mastectomy, just to allow time for the body to heal. You may already have been lightly expanded during surgery. Generally expansions occur every few weeks until the desired size is reached and then the implant is overfilled to allow for natural breast droop. Some implants, called Becker implants, can be left in so the overfill is drained off and the port can be removed under general anaesthetic if it’s bothering you. If you don’t have Becker implants, you can have the expandable implant exchanged for a silicone one. This is called an exchange surgery and usually takes place several months after the mastectomy provided you have not needed radiotherapy. Radiotherapy can cause implants to harden but your consultant will be able to discuss this further with you.

Exchange surgery is carried out under a general anaesthetic and you’ll normally be discharged the next day. The original mastectomy incision is used and the expandable implant swapped over for a silicone one – either round or teardrop in shape. A long-term study has clarified that silicone implants are safe and do not cause auto-immune disease as was once thought. The benefits of silicone implants are that they are less prone to rupturing than saline, less heavy and they tend to feel softer. However it may take several weeks after exchange surgery for the differences to be felt.

Implants are measured in ml or cc. If you have opted for an implant only reconstruction, you’ll find your new implant is slightly larger than your original breast (unless you’ve had a reduction at the same time). This takes into consideration that the implant sits behind the chest muscle rather than in front of it. Implants rarely jiggle like natural breasts and it can be difficult to get a middle cleavage with them so any visions you might have of looking like a Page 3 model aren’t entirely accurate!

 

Injections and blood tests
If you’ve had a mastectomy, it’s important to let a nurse or phlebotomist know if you need a blood test or an injection so they can use your “good” arm. In the case of a double mastectomy, a vein can be used on your leg instead. This reduces your risk of a condition called lymphoedema and infection.

Birth control and fertility
If you have had a benign breast lump, it should be perfectly safe for you to continue taking the contraceptive pill after your operation, just remember that you won’t be protected against pregnancy for at least a week after the break. Your fertility levels should also remain unaffected.

Certain types of breast cancer can be hormonally triggered and if that’s the case with yours, you shouldn’t use hormone-based methods of contraception. If you need to have chemotherapy, your fertility levels may be affected and you should discuss the implications of this with your consultant.



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