Breast reconstruction is rarely completed in one operation, so do ask your surgeons how many operations you’re likely to need. If it’s necessary to have more surgery to complete your reconstruction, it can be difficult to get used to the idea of going back into hospital if you’re not expecting it.
Following surgery, you’ll see that your breast shape has been altered. This may take you some time to get used to. You may find it helpful to look at the scars while still in hospital and then to get used to gently touching the changed area, by carefully massaging cream into the healed scars. Some women also find it helpful to show others their new breast as soon as possible, but these are very personal choices.
When you first look at your breast after reconstruction, it will probably look swollen and bruised. Any operation takes time to settle down and heal. If you’re having tissue expansion after your surgery, don’t forget that when you first look at your reconstructed breast it may be smaller or larger when you compare it with your normal breast, and it’s likely to be a different shape.
Because of the tissue expansion, when I first looked at my new breast, my chest looked massive and I couldn’t escape it. I wanted to forget about it but it seemed so much there. You have to keep
positive because it doesn’t look good to begin with. It helps to think back to the photographs of the end results and know that
you will get there.
Regardless of what type of surgery you have, you’ll probably get tired easily to begin with. It’s important to take things easily and you’ll need to avoid strenuous exercise for several weeks after surgery. As you recover and the wounds heal, you’ll gradually be able to resume normal activity.
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When I first woke up from my latissimus dorsi breast reconstruction, I felt that it was behind me and I was on the road
to recovery. I could do everything when I went home but it took quite a while to get my strength back. I wouldn’t say that it is an easy operation because it was six months before I could sleep on my side. That was a minor thing, though. I had nearly six weeks
off work.
During the recovery period everyone is affected differently. There may well be a time when you experience a range of varied emotions and you may need to be gentle with yourself, particularly when you feel tired. You might well have good and bad days during this time but the number of good days will increase as you recover.
Here’s an account from a 34-year-old woman who had a latissimus dorsi breast reconstruction. Her two small children were a priority in her recovery:
It was decided that I would have a latissimus dorsi breast reconstruction with a tissue expander at the same time as the
mastectomy. I did get upset in the first few days afterwards because I couldn’t see the light at the end of the tunnel. You have
to be prepared for the incapacity afterwards. I felt that it was important to get moving as quickly as possible. I couldn’t do a huge amount when I first went home and did have help getting the children to school. I drove again after about
a month and that gave me much more freedom. After that, the recovery was quite quick. About six weeks after the operation, everybody came to us for Christmas and I did quite a lot of the cooking. It was only my back which hurt. I still couldn’t do things like putting a duvet into the cover but the movement came back
in time.
Some bonuses came from accepting help from family members during the immediate recovery period:
The children were eight, seven and nearly three at the time. We are a very close family and my mum and dad came and stayed to
help look after the family for the first two weeks. My dad
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retrained the children while I was in hospital. He said that I did far too much for them, which was true. He said that they were old enough to tie their laces and taught the youngest one to climb
into her car seat because I couldn’t lift her for a while. The children wanted to help because they knew I had been poorly.
For this woman at 67 years old, a mastectomy and immediate auto - logous latissimus dorsi breast reconstruction was chosen:
Once the operation was over, I didn’t feel too bad. I walked around the next day and went home after a week. I could do most things at home but tired easily. I couldn’t reach high things
for the first three weeks. I drove again after six weeks. I don’t think that the strength in my arm was affected.
Recovery after a TRAM flap reconstruction can be slower than with other operations:
I couldn’t do a lot when I first went home. My husband did the cooking and looked after me. One of the main things that strikes you is how tired you get. You very quickly find out that you can’t do what you thought you could. It is easy to become impatient. I found that I got used to it and settled into making the most of
being at home.
I drove again after two months. That wasn’t purely because of the physical side. I felt that because I had been out of it for so long, I
wasn’t sure that I was up to speed mentally.
I went back to work after ten months and had a staggered return. I have been back at work full-time for a year and I do get tired sometimes but I think that I would have done anyway. I have quite a demanding job. There are no practical things that I still find difficult.
Recovery from any operation can of course be slowed down by compli - cations after surgery. Have a look at pp. 137–145 to find out more about these complications.
All these accounts show that recovery from breast reconstruction can vary enormously, and it’s a very individual thing depending on the
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type of operation you’ve had and your personal circumstances. Talk as much as possible to the team looking after you and make sure they know about your lifestyle and commitments. Ask them plenty of questions and they’ll be able to give you a very good idea about what to expect in the early days after your operation, and in the weeks that lie ahead once you’ve gone home. Your doctors and nurses are there to help and support you through this time, and to make the experience as easy as possible for you and those close to you.
G Movement and exercise will help you to recover more quickly from your surgery.
G Your team will explain the kind of exercises you’ll need to take to avoid stiffness and to get back to normal.
G Your speed of recovery will depend on your own fitness and the type of surgery you’ve had.
G Incorporating your exercises into your daily routine after you’ve recovered will help to prevent stiffness and maintain full movement.
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ith all that is happening to you at the moment and all thedecisions you’re having to make, physiotherapy may not be at the front of your mind. However, rehabilitation following your surgery is very important, as this woman describes so well:
I was given exercises by the physiotherapist in hospital to do at home. I did not realise how important that was. My back became
stiff while I was having radiotherapy and I had some more physiotherapy. I wish that I had had more physiotherapy help
earlier.
The aim of the exercises and advice given to you after your operation is to regain normal movement in all areas affected by your operation, and get back to being independent as soon as possible. This is important in restoring some sense of control over what is happening to you. In the early stages in hospital, the whole experience can feel