This information will help you learn about how to care for yourself after your breast surgery.

What to expect after your surgery

You will be in hospital for 1-2 days. After your surgery you will have a dressing in place and 1- 2 drains in place. The drain collects fluid that normally develops under the skin after surgery. This is usually removed before you go home, in some circumstances, you may go home with the drain still in. You may be on antibiotics for the period of time your drain is in place.

Some discomfort is normal after surgery, you may also experience a stinging sensation along the incision line and your drain site may be itchy. You may also experience some tenderness along your lower rib cage. These sensations will gradually decrease after the procedure. You may take analgesia as prescribed by Dr Gault when you need it, do not hesitate to ask for it so that you will be as comfortable as possible.

Other common sensations you may experience after surgery:

• Numbness under the arm and over the chest
• Warmth in the arm

These sensations are caused by the nerves being cut or removed during surgery. They will gradually get better as the months go by, but some degree of numbness may be permanent.

Following Discharge

On the day of discharge have somebody drive you home, organise to have someone to help you at home for 1-2 days. Get plenty of rest, eat a balanced diet, increase fluid intake and begin gentle exercise such as walking. Take pain medication as prescribed and regularly. Do not take aspirin or any blood thinning medication unless approved.

• Avoid drinking alcohol when taking pain medications.
• Stop smoking, smoking not only delays healing but also increases the risk of complications.

Incision

Full healing of the incision takes about 6 – 8 weeks.  As deodorant can cause infection do not wear it until you wound is healed. Be careful not to get it on your incision or drain site. Do not use deodorant if there is a break in the skin.

Your dressing is to remain on until Dr Gaul removes it.  A ‘hyperfix’ a white mesh like dressing will be applied to the suture line to replace the original dressing in some cases. This dressing acts to support the internal suturing as you heal. You are able to shower with this dressing on, be sure to pat it dry after your shower.

The dressing will start to peel off on its own, at this time you are able to fully remove it (leave on for 2-3 weeks if possible).

Activities

Do not do lift anything more that 5kg for the first 2 weeks, and perform only light activities, avoid housework such as sweeping, vacuuming etc. After 2 weeks you can resume some of these activities with caution. Regular exercise such as walking is good for you, avoid high impact aerobics, jogging, lifting weights and swimming until Dr Gault approves of these activities. Avoid all exercises that build up your chest muscles.

Do not drive for approximately 2 weeks following surgery.

As a guide you can drive when:

• You are no longer taking pain medication
• You are able to turn your head and shoulders comfortably to reverse or observe your surroundings to drive safely
• You are able to tolerate stopping the car suddenly, with seat belt across your chest.
• You are able to use a clutch and brake, and change gears comfortably

Post-operative exercise

Decreased shoulder mobility post breast surgery has been well documented, in order to prevent and manage shoulder mobility it is necessary to incorporate an arm exercise regime in post operative care.  Our breast care nurse will provide you with information about a post-operative exercise regime to be commenced in hospital. These exercises should be continued until you see a physiotherapist for further instruction and management.

Physiotherapy

For patients undergoing a mastectomy, breast reconstruction and or axillary surgery, physiotherapy is an important part of post-operative care. Approximately 1-2 weeks following surgery, you will need to see a physiotherapist who will instruct you on exercises that will help to keep the shoulder mobilised and for prevention/management of lymphoedema.

Post-operative problems

Wound Infection

Call Dr Gault’s reception staff if you notice any redness, swelling or excess in pain, or if you have a temperature above 38 degrees. Inspect your incision lines each time you have a shower.

Bruising and Swelling

Swelling and bruising is common post breast surgery. It can vary from being mild, moderate or severe. This will disappear with time. If however, the swelling becomes severe or pronounced please call Dr Gault’s reception staff for further instruction.

Seroma

A Seroma is a build up of fluid under the wound which often will need to be drained by your surgeon or breast care nurse. This affects about 20% of patients following breast surgery. If you notice excessive swelling forming under your arm or across or on your chest please call Dr Gault’s reception staff.

Lymphoedema

When you undergo breast surgery you will have a number of lymph nodes removed. The lymphatic system helps to fight disease in your body and is all connected to the blood system. The lymph nodes under the arm can be the first site where the breast cancer cells can spread to. When these are removed there is a small chance you could get ‘lymphoedema’ a swelling of the arm. This will always be something that you will need to be aware of.

You will be given additional information on lymphoedema by your breast care nurse and physiotherapist.

Post-operative Garments

Mastectomy

You are able to wear your post operative bra and prosthesis as soon as you are comfortable to do so. The bra is designed to be worn as early as required after surgery. It is wider under the arms than most bras to provide both support and comfort. The soft prosthesis is designed to be used until you are ready to use a more permanent prosthesis.

Breast reconstruction

You will be fitted with a soft post operative bra which can be worn home from hospital. Following your first tissue expander filling you will be fitted with a compression bra which is to be worn during the day for the duration of the expansion process and following the final implant exchange operation.  The timing and type of bra you will be required to wear will be directed by Dr Gault and his breast care nurse.

When to Call

• If you have a sudden increase in swelling or bruising.
• If you notice swelling and redness persisting after a few days.
• If you have increased redness along the incision.
• If you have severe or increased pain not relieved by medication.
• If you have any side effects to medications; such as, rash, nausea, vomiting etc.
• If your temperature is 38 degrees or higher
• If you have any yellowish or greenish drainage from the incisions or drain.
• If you notice an offensive odour.
• If you have bleeding from the incisions

If you have any concerns at all, please call our friendly staff on 07 5539 3999.