After Surgery

Before surgery, you have probably spent almost all of your time focusing on preparing for surgery—understanding your condition and your surgery—so that you now may have questions about what you should expect after your operation.

What to Expect

Fortunately, most breast procedures today do not require even an overnight hospital stay.  You should be able to go home safely and comfortably. 

The first night after surgery is usually the most uncomfortable, and you should expect to need several of the prescribed pain pills. (The doctor should have discussed with you just before your surgery which pain medications would likely be best for you.)   Healing begins immediately, however, so that there should be progressively less pain as each day passes. 

Any surgery, however, requires some postoperative pain medication, so we will have arranged before the procedure to make sure that you will have a prescription for pain pills.  You may already have pain medication that you are using for another condition, and this is fine to use, so long as it does not include aspirin (called “acetylsalicylic acid” on the label.)

Other medications that you may require for other medical conditions such as high blood pressure, diabetes, or a heart condition you should take as prescribed right after the surgery.  However, blood thinners such as Coumadin, Aspirin or Heparin, should not be started for 1 or 2 days after the procedure unless you are instructed otherwise.

What You Can Do

Almost everyone can resume routine daily activities immediately after surgery.  These include walking indoors and outdoors, going up and down stairs, riding in a car, and all activities of personal hygiene. 

Many patients will deliberately restrict movements of their arm on the side of the surgery—especially if they have had mastectomy—fearing that they will damage something.  In fact, the reverse if often true, and restricting movements will actually slow healing.  You should feel confident that the incision will not “break open” with any routine activities.

In general, you should return to normal activities "slow and easy" and stop any activity that causes pain in the incision. 

Also, if you stopped smoking before the operation, keep up the good work and resist the temptation to start smoking again!  Smoking interferes with wound healing besides causing lung cancer and heart disease.

Drains and Wound Care

Your incision requires no special care:  The sutures are all beneath the skin, and the incision is covered with a sterile plastic dressing (Dermabond) which is water repellant.  It will dissolve on its own over the next 5-10 days.

If you have had a mastectomy, then you will have a small “drain”—a hollow plastic tube that will remove excess fluid from beneath the skin.  Before you go home, you will receive instructions on how to empty the drain and record the amount of drainage. 

You may shower within 12 to 24 hours of surgery, and take a bath within the next 2 to 3 days.

What You Should Not Do

Certain activities are dangerous any time and you should avoid them after the operation.

 • Do NOT drive if you have incisional pain, or if you are still taking the pain relievers prescribed after surgery.  Not only can this be painful for you, but could also cause you could to lose control of the vehicle and cause an accident.  This applies equally to operation of any machinery.

 • Do NOT continue any activity that causes pain.  This may increase the risk of wound complications.

 • Do NOT use alcohol with the pain relievers prescribed after surgery.  Narcotic analgesics and alcohol do NOT mix!       

 • Do NOT sign any important legal documents if you are still using the prescribed pain relievers.

When to be Concerned

Surgery and anesthesia, in general, are both usually very safe, but complications can occur with any procedure or new medication.  Some of these can be very serious—even an allergic reaction to a simple medication like penicillin can be life threatening—so that if you experience any problems with chest pain, shortness of breath, or severe abdominal pain you should go to the emergency room immediately. 

Breast surgery, in particular, usually has very few complications, but here are some things to watch for as you recover:

• Fever above 101 degrees, especially if this starts several days after the operation.  A slight fever can occur the first day or two after the operation, and is quite normal.

• An area that is red, hot, swollen and tender in or around the incision.  Some black and blue is quite common with many breast procedures, but an area that is fire-engine red that is increasingly painful may be a sign of infection. 

• Progressive swelling at the surgical site.  If this happens the evening of the surgery (especially if it forms an area the size of an apple or orange), it may represent an area of localized bleeding. 

If any of these occur, you should call the office immediately so we can make sure that you do not require additional treatment.