What to Expect After Surgery?


Most women with breast cancer would have breast surgery (mastectomy or lumpectomy) as part of their cancer treatment plan. Breast surgery is a major operation and like any other major operation you need to take extra care of yourself, physically and mentally, during your recovery. 

When You Wake Up

    You will have anaesthesia administered to put you to sleep and make you unconscious during surgery. The anaesthesia given varies according to the type of surgery you are having. For a lumpectomy, most patients can get by with a light sedation given through an intravenous (IV) line in the arm and local anaesthetic to numb the breast. [1]As for a mastectomy, general anaesthesia is required. 


    As you slowly come out of the effect of the anaesthesia, you may feel somewhat groggy. The grogginess will go away about one to one-and-a-half hours after the surgery. You may also experience soreness, swelling and bruising in the area of the surgery. These effects will naturally go away as you heal and recover. Some people experience nausea and vomiting which are common side-effects of anaesthesia. Quick-relief medications also known as rescue medications can be provided post-op to alleviate these side-effects. 


    Tubes & Drains

      After your surgery you may find that some tubes have been inserted into your body. You may have: 

      • An intravenous (IV) drip to give you blood transfusions or fluids until you are well enough to eat and drink again. 
      • Wound drains designed to stop blood and fluid from collection around the surgery area. The drain is usually a plastic tube from under the skin to outside your body with a bulb attached to it. 
      • A tube into your bladder to collect urine.

      If you have wound drains, they will stay in until the drains stop draining fluid which may be anything from 2 to 5 days. [2] It is also possible that you may still have the drains in after being discharged from the hospital. Your attending nurse will provide instructions on how to empty the drains when they are full and how to take care of them at home. You can shower one day after the drains are removed, or if you have a plastic dressing. 


      Incision Care

        Your surgeon would have placed a pad type of dressing over the incision or a clear sticky dressing. Some surgeons use waterproof dressing that stays in place until your first post-surgery outpatient appointment. Check with your surgeon what type of dressing it is so that you can care for it accordingly. Do not remove the dressing on your own. Your surgeon will remove the dressing in 7 to 10 days after the surgery. [3] If the dressing falls off, do not attempt to replace it yourself. Seek assistance from your surgeon or nurse.


        Suture Removal

          The sutures or stiches on your wound will be removed by your surgeon in one to two weeks [4], unless stitches that dissolve on their own were used. In which case, it will slowly dissolve over two weeks after your breast surgery.


          Bathing

            You won’t be able to have a shower or bath (full immersion of body in water) when the dressing and sutures are still in. Keep yourself clean and refreshed with a sponge bath instead. You may not be able to wash your hair for a while after surgery. Braid your hair to keep it out of the way. Use dry shampoo to absorb any excess oil on your scalp to help you feel more comfortable. Some people may even opt to have their hair cut short prior to surgery for easier hair management.


            Pain Management

              It is perfectly normal to feel pain after breast surgery. The extent of the pain or amount of discomfort after surgery varies from person to person. The goal of pain management is to assess the level of your own pain or discomfort and to take medication as needed. Healing and recovery improve with good pain management. 


              Your doctor can easily prescribe you with the appropriate analgesic drugs or pain killers. You will have better results in managing your pain if you take pain medication earlier before the pain becomes too severe. Inform your cancer team of any drug allergies; reactions or medical problems that you have that may prevent you from taking pain medication.


              Recognise Signs of Infection

                Coming out of surgery, you can be exposed to the risk of infection. Learn how to recognise some of the most common signs of infection: 


                Fever - It isn’t uncommon for patients to have a mild fever after surgery. Monitor your temperature periodically to ensure that it doesn’t go beyond 38 Degrees Celsius. A high fever may be an indication that your body is fighting infection.


                Increased Pain – It is normal to experience pain, soreness and tenderness in or around the surgery area. However, if there is a sudden increase in pain or severe pain, it could be a sign of infection.


                Wound infections – If the wound area has redness, swelling and tenderness or emitting pus or other fluids or a bad odour, these are signs of an infection. You should seek medical assistant immediately. Surgical infections can be very dangerous because it can lead to sepsis (infection in the blood), poor and prolonged wound healing, as well as heart and respiratory problems. [5] 


                Seek medical assistance immediately if you’re experiencing any signs of infection.  


                Scarring

                  Scars are a natural part of the body’s healing process, but they can be a source of irritation and some may find them unsightly. As different people heal differently, the extent of the scarring also varies from person to person. Taking care of the wound scar or scars will also help the prevention of keloids (hypertrophic scar that continues to grow, increasing in height and spreading over normal tissue even after it has healed). [6]Some surgeons suggest silicone gel sheeting can help prevent keloids. [7]


                  Keloids are further exacerbated by inflammation. Therefore, reducing inflammation is a key step in preventing the development of uncomfortable keloid scars. [8] Maintaining a healthy diet that delivers all the necessary nutrients to support your healing and increasing your intake of protein, which is essential for tissue development, are necessary in preventing keloids. 


                  Depending on the type of breast surgery you are having, there are methods in which your surgeon may employ to minimise or hide where the scar would be. For example, a surgeon can ensure that the scar lies as flat as possible against the chest, making it feel relatively smoother, otherwise some women are left with rolls of skin on the chest that can create a bulging appearance. [9] Over the years of breast surgery, the approach that surgeons take to surgical incision has changed significantly resulting in a variety of surgery options available to women. Discuss with your surgeon on the approach he/she intends to use and what the outcome may be. [10]


                  Breast Appearance

                    Whether you are having a mastectomy or a lumpectomy, both types of breast surgery will result in significant changes to the appearance of your breast and chest area. In the case of a mastectomy, all breast tissue will be removed. If you did not opt for reconstructive surgery immediately after the mastectomy, your chest will appear flat and with usually a horizontal scar across where your breast were. 


                    As for a lumpectomy, your breast after surgery may appear asymmetrical and misshapen. The Can-Care Post-Op Kit which consists of a Post-Op Bra and Post-Op Molded Breast Form are specially designed for immediate use after surgery to provide a temporary shape replacement without compromising the healing of the wound. A small squeeze ball for hand exercises to reduce stiffness in your arm and shoulder is also included in the Can-Care Post-Op Kit


                    For some women, surgery doesn’t affect how they feel about themselves, but others may find the changes more difficult to accept. Some women may feel lop-sided or incomplete. Some women may want to try to restore the natural appearance of their breasts through reconstructive surgery. Others may instead opt for breast prosthesis, an artificial breast form that fits in your bra cup, as an effective long-term choice to reconstructive surgery. Can-Care offers a wide range of breast prosthesis for various forms and shape.


                    Sleep and Activity

                      Sleeping may be difficult after breast surgery due to your restricted movement and inability to lie comfortably in certain positions. Many women find sleeping on multiple pillows placed on their upper back helpful. Keeping your torso elevated helps relieve pressure on the surgery area, reducing swelling and pain. 


                      After breast surgery, your doctor may advise on doing some light arm exercises to keep the mobility in your arm and lower the risk of lymphedema (swelling of the arm due to fluid retention). Can-Care has specially engineered compression arm sleeves which exert a consistent pressure on the blood vessels and lymph network, making it easier for your body to remove the extra lymph fluid which causes the swelling. Avoid strenuous activity, heavy lifting and vigorous exercise which may aggravate your arm and impair your healing process. 


                      With breast surgery come a multitude of new experiences and challenges. Some of these experiences and challenges may not be medical related. Can-Care offers a comprehensive range of breast care products, professional counselling services and support programs to strengthen your journey of recovery after surgery. Let Can-Care be your personal post-care partner in your journey to a comfortable recovery by providing for your non-medical needs.


                      Citations:  

                      1) Anaesthesia for Breast Cancer Surgeryhttps://www.yalemedicine.org/conditions/anesthesia-for-breast-cancer-surgery/ 

                      2) What happens after surgeryhttps://about-cancer.cancerresearchuk.org/about-cancer/breast-cancer/treatment/surgery/after-surgery/what-happens-after-surgery 

                      3) Anaesthesia for Breast Cancer Surgeryhttps://www.yalemedicine.org/conditions/anesthesia-for-breast-cancer-surgery/ 

                      4) Mastectomy: Instructions After Surgeryhttps://www.ucsfhealth.org/education/mastectomy_instructions_after_surgery/ 

                      5) Mastectomy: Instructions After Surgery https://www.ucsfhealth.org/education/mastectomy_instructions_after_surgery/ 

                      6) How to Know When to Call The Doctor After Mastectomy Surgeryhttps://www.wikihow.com/Know-when-to-Call-the-Doctor-After-Mastectomy-Surgery 

                      7) Caring For Scars After Breast Cancer Surgeryhttps://www.breastcancercare.org.uk/about-us/news-personal-stories/caring-scars-after-breast-cancer-surgery 

                      8) Recovery: What to Expect While Healing After Breast Reduction Surgeryhttp://www.breastreduction4you.com/recovery.htm 

                      9) What Happens If Your Scars Start to Keloidhttps://www.ftmtopsurgery.ca/blog/keloid/happens-scar-starts-keloid/ 

                      10) What to Know About Mastectomy Scarshttps://www.medicalnewstoday.com/articles/320379.php



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