Ten Frequently Asked Questions After Breast Reconstruction Surgery
Many questions and concerns may run through your mind before undergoing breast reconstruction surgery. How long will the process take? What will my reconstructed breasts look like? Will I be in pain after that? Experts say, no matter how prepared you are for surgery, you’ll still have questions for your doctor in the coming days, and you should be sure to ask them before you leave the hospital.
“Your surgeon should review everything with you beforehand. But patients are often nervous and internalized a lot at the time. Many of the recommendations also differ from patient to patient and from surgeon to surgeon, and are also highly dependent on the type of procedure performed on the patient” . – Aaron Pelletier, MD – Plastic and Reconstructive Surgeon at The Hospital of Chicago
To help patients prepare for life after breast reconstruction, Dr. Pelletier and Dr. Daniel Liu, plastic and reconstructive surgeons at our Hospital of Chicago, answer common questions about what to expect and what to do after surgery.
Q: Will I be able to wear a regular bra later?
A: Wearing a surgical bra after the procedure will likely depend on the surgeon’s preference and the type of surgery that was performed. Some patients will benefit from wearing compression bras throughout the day for the first four to six weeks, but many are advised not to wear compression bras, says Dr. Liu. Underwire bras that do not provide much support for the first six weeks after surgery are generally not recommended.
Q: Can I shower after surgery? What about exercise?
A: Generally, patients are advised to start showering 48 hours after surgery and to use warm, soapy water. Don’t worry if water gets into cracks or drains. When it comes to exercise, ask your surgeon when you can start exercising again, as advice can vary depending on the type of surgery you had.
Q: Is massage recommended?
A: Massage can help improve the appearance of scars or break down deep scars in the soft tissues and chest wall that are causing pain or problems with range of motion. But in other cases, such as the use of implants and shape expanders, massage is not recommended immediately after surgery. “Patients should talk to their surgeon about this and follow his advice,” says Dr. Pelletier.
Q: Are there ways to help the scars disappear?
A: It may take a year or two for the tissues to fully heal and the scars to disappear, but the scars usually do not disappear completely. Although many products, such as vitamin E oil and topical silicone gel pads, are often touted as tools to help scars fade or disappear, none of them have been scientifically proven.
Q: How long will the drains remain in place?
A: Drains are small tubes that are placed in the incision and over time help remove excess fluid during the healing process. Drains are commonly used in all types of reconstruction procedures, but many factors go into determining how many drains are used and when they are removed. Most of the time, your surgeon will share these details with you before the procedure.
Q: How long does it take for the swelling to go away and for a new breast to reach its final size and shape?
A: Everyone is different and a large part of the recovery process depends on the type of procedure being performed. However, it generally takes three to six months for the swelling to subside and the breasts to take their final shape, but it may take longer, especially for patients who have received radiotherapy for breast cancer. Radiation permanently damages tissue at a microscopic level, making it difficult for tissue to heal.
Also keep in mind that the final shape of the breast is often affected by the severity and elasticity of the tissue.
Q: How long do implants take?
A: Next generation implants are likely to last the patient’s life. “I usually tell my patients that in 10 to 15 years, they may need another operation to have their implants checked or changed,” says Dr. Liu. But no surgeon should guarantee the duration of transplants. Patients may choose to change implants later in their lives for a number of reasons, most of which have nothing to do with problems with the implant itself.
But if a problem does arise, it is often called a capsular contracture, which is when a scar forms around the implant and presses on it, causing the breasts to feel firm. This condition is often treated with surgery to remove the scar and possibly replace the implant.
Q: Will I have to undergo another procedure?
A: Breast reconstruction often involves more than one procedure, because it usually takes two or more surgeries to complete the reconstruction with time to heal in between. Sometimes the process includes a review. Other times, follow-up surgery may be necessary to achieve symmetry, while other procedures may be done to rebuild the areola or place a tattoo on the nipple. “Everyone is different in terms of what they need and want, and this is something every patient should discuss with their surgeon,” says Dr. Liu.
Q: Will I still need mammograms and breast self-exams?
A: Experts say that women who undergo breast reconstruction after a mastectomy do not need routine mammograms. But if a physical examination finds anything to worry about, a diagnostic mammogram, ultrasound, or MRI may be done. Every breast reconstruction patient should have a weekly self-examination and the surgeon should have annual checkups, says Dr. Liu.
For women who have silicone-filled implants, the FDA recommends that they have an MRI of their breasts three years after receiving their implants, and every two years after that, to look for signs of rupture.
Q: When will the numbness go away and the sensation return to my chest?
A: Some feelings may return after several years, but patients should not wait for breast reconstruction to regain a feeling of fullness. Some of the numbness is likely to persist even years later.
Breast reconstruction surgery often causes many physical and emotional changes. It may take some time for you to accept that your new breast is your breast, especially if it does not look like your old breast. It may be helpful to talk to other women who have gone through the same experience. Talking to your doctor about what to expect can also give you a sense of control over the path ahead. And be sure to contact your doctor if you notice worrisome symptoms after surgery.
“Although it can be a stressful time, listen to your doctor before you leave the hospital,” says Dr. Pelletier. “Before you are discharged from the hospital, you need to understand how to care for your surgical sites and how you should take care of your breasts based on the surgery you had.”