Patient information · Recovery and aftercare
After your breast surgery — recovery, scar care, exercises, and what to expect
Recovering after breast surgery — wound and drain care, pain relief, exercises, lymphoedema risk, and when to call the practice. Guidance from Dr Fiona Tsang-Wright (GMC 4549831), Consultant Oncoplastic and Reconstructive Breast Surgeon, for patients cared for privately in London and Buckinghamshire and on the NHS at the Bucks Breast Unit, Buckinghamshire Healthcare NHS Trust.
Quick answers
What is this page?
The practice guide to recovery and aftercare after breast surgery.
Who is it for?
Patients of Dr Fiona Tsang-Wright (GMC 4549831) in London, Buckinghamshire, and the Bucks Breast Unit (NHS).
Early weeks or later?
Weeks 0–12 stay on this page. Surveillance and late effects are on Survivorship.
Short FAQs?
See Questions you may have for booking, fees, and recovery in brief.
The practice’s principle is simple: if anything is worrying you and you can’t tell whether it is normal, contact us — Sarah or Nadiya on the phone or [email protected]. The threshold to ask is low.
This page is the practice guide to recovery and aftercare after breast surgery.
The first 24 hours
You will go home from hospital either the same day or the following morning, depending on the operation:
Lumpectomy / wide local excision
Usually same-day discharge.
Lumpectomy with sentinel node biopsy
Same-day or one-night stay.
Mastectomy without reconstruction
One-night stay typically.
Mastectomy with implant reconstruction
One or two nights.
Mastectomy with autologous reconstruction (DIEP, latissimus dorsi, others)
Three to five nights, sometimes longer.
By the time you leave hospital you will have been mobilised, eaten, used the toilet, and had pain control reviewed. A discharge summary, painkillers, and an appointment for the first wound check will be in your pack.
The first 24 hours at home are mainly about resting, taking your painkillers on schedule rather than waiting for pain to build, and keeping comfortable. You should:
Take painkillers regularly
For the first few days — don’t wait until pain is severe. Most patients use a combination of paracetamol four times a day, with anti-inflammatories (ibuprofen) if there is no medical reason to avoid them, and a stronger painkiller (codeine or tramadol) for the first 2 to 5 days as needed.
Sleep semi-upright
Propped up on two or three pillows for the first week or so. Lying flat is uncomfortable when there are chest sutures.
Drink and eat normally
Constipation from anaesthetic and codeine is common — drink plenty of water and use a gentle laxative if needed for the first few days.
Move regularly
Gentle short walks every few hours, even just around the house. Bed rest delays recovery and increases the risk of clots in the legs.
Clot prevention: Most patients are discharged with anti-embolism stockings and, depending on your operation, a course of small heparin injections (LMWH) that you or a carer give once a day. These reduce the risk of a clot in the leg veins. The duration is set by your surgical team – usually until you are fully mobile for shorter operations, and up to 28 days for major reconstruction. Follow the schedule on your discharge sheet, and call us if you miss a dose or run out.
Wound care, drains, and dressings
Most breast surgery wounds are closed with dissolvable internal sutures plus surgical glue or paper strips on the surface. Some operations have one or more suction drains soft plastic tubes coming out of the wound area, attached to a bottle that collects fluid (lymph, blood) for the first few days.
Dressings
stay in place over the wound for the first 5 to 7 days. They are designed to be showered through. Most can simply be left alone until the first wound-check appointment.
Drains
kept until the daily output drops to a defined threshold (typically 30 ml per 24 hours for two consecutive days). The breast care nurse or the practice’s clinic team will remove drains at a planned appointment — it is a quick procedure, often done in clinic.
Showering
you can shower from the day after surgery (let warm water run over the dressing — don’t scrub it). Bathing or swimming should wait until the wound is fully sealed (usually 2 to 3 weeks; the breast care nurse will confirm).
Signs your wound needs attention
Increasing redness
spreading from the wound edge.
Increasing pain
rather than improving day-by-day.
Hot to touch
, particularly with a fever or feeling generally unwell.
Pus or unusual discharge
from the wound.
A sudden swelling
under the wound or around the chest wall.
These can indicate infection or a collection of fluid (a seroma or haematoma). Call us — early antibiotics or aspiration of a fluid collection is a routine fix; waiting tends to make it worse.
Bras, compression, and what to wear
A post-surgical bra (sometimes called a mastectomy bra or compression bra) is provided after most breast operations. The bra is front-fastening (no overhead movement needed), wider strapped, and made of stretchy supportive fabric. It is worn 24 hours a day for the first 2 to 6 weeks, depending on the operation:
Lumpectomy / wide local excision
2 weeks day and night.
Mastectomy with reconstruction
4 to 6 weeks day and night, then a sports-bra style for several months while the reconstruction settles.
DIEP / autologous flap reconstruction
Usually 6 weeks or longer in the post-surgical bra, plus a separate abdominal binder for several weeks for the donor site.
The point of the bra is to support the chest wall while it heals, reduce swelling, and stop you from inadvertently stretching or pulling the wound. It is not glamorous but it is one of the more important pieces of recovery equipment.
After the initial period, most patients move to a wirefree sports bra style for the next several months. Underwired bras should be avoided until the practice or breast care nurse advises — typically 3 months for lumpectomy, longer for mastectomy or reconstruction.
If your bra is uncomfortable, doesn’t fit, or you need a different size as swelling settles, get it changed — there is no virtue in suffering. The breast care service or the practice can arrange a re-fit.
Pain — what is normal, and for how long
Pain after breast surgery follows a fairly predictable curve:
- 1
Days 0 to 3
Moderate pain, well-controlled with regular painkillers. Most patients can sleep through, walk around the house, and eat normally.
- 2
Days 3 to 10
Pain decreases steadily. Most patients reduce or stop the stronger painkillers around days 4 to 7 and continue with paracetamol and anti-inflammatories alone.
- 3
Weeks 2 to 6
Discomfort rather than pain. Tightness, pulling sensations, and occasional sharp twinges are common, particularly with movements that stretch the chest wall or upper arm.
- 4
Months 1 to 3
Most patients are off all painkillers by 4 to 6 weeks. Occasional twinges around the scar persist for several months and gradually fade.
- 5
Beyond 3 months
Most patients have settled. Some patients experience a more persistent post-surgery pain syndrome in the chest wall or armpit, particularly after axillary surgery. This is treatable; see “Persistent pain” below.
Pain that is worsening rather than improving, or that comes with any of the wound-attention signs above, is a reason to call us early. Don’t wait for the next appointment.
Persistent pain
A small proportion of patients have ongoing pain in the chest wall, armpit, or down the inner upper arm beyond 3 to 6 months. This is usually due to small nerves cut or stretched during surgery (particularly axillary surgery) and is treatable — options include neuropathic pain medication (gabapentin, amitriptyline), physiotherapy, and sometimes specific nerve-block procedures. If you are still in significant pain at 3 months, raise it at follow-up rather than assuming it will simply fade — it sometimes does, but treating it earlier helps.
Lymphoedema risk and how to reduce it
If you have had axillary surgery (sentinel lymph node biopsy or axillary clearance), there is a risk of lymphoedema long-term swelling of the arm on the operated side. The risk is higher after axillary clearance (around 20 to 25%) than after sentinel node biopsy alone (around 3 to 5%), and is increased by radiotherapy to the axilla.
Use the affected arm normally
Don’t favour it. Modern guidance is not to baby the arm but to keep it active and strong.
Take care with skin breaks on the affected side
Cuts, insect bites, sunburn, or infections can trigger lymphoedema in a susceptible arm. Wear gloves for gardening, treat any skin infection promptly, and ask for an antibiotic early if a wound on that side becomes red.
Avoid blood pressure cuffs and blood draws on the affected side
Where possible — use the other arm. (This is precautionary; the evidence is mixed, but most centres still recommend it.)
Air travel
The previous advice to wear compression sleeves on flights is no longer routine; if you have any swelling tendency, raise it with the breast care nurse before booking long-haul flights.
Notice early signs
A feeling of heaviness, mild swelling, tightness in rings or watches on that side. Catching lymphoedema early gives the best chance of controlling it. Tell the breast care service the moment you notice anything.
You can reduce the risk:
A lymphoedema specialist nurse is available through the practice and through NHS breast services. Treatment is most effective when started early.
Exercises after breast surgery and after mastectomy
Movement matters. Without specific exercise, the shoulder and chest wall can stiffen rapidly after breast surgery, leading to frozen shoulder and persistent restricted movement. Most patients are given a sheet of post-operative exercises in hospital, usually based on the breastcancernow.org programme.
- 1
Days 1 to 7
Gentle movement only. Hand and finger exercises, elbow movement, very gentle shoulder shrugs and rolls. Don’t lift the arm above shoulder height. Don’t lift anything heavy.
- 2
Weeks 2 to 4
Gradual reintroduction of full shoulder range. Wall-walking exercises (fingers walking up a wall, slowly increasing the height each day), elbow circles, gentle stretches. Stop at the point of resistance — don’t push through pain.
- 3
Weeks 4 to 8
Most patients regain full shoulder range. Continue daily stretching to maintain it.
- 4
Months 2 to 3
Return to normal upper-body activity, including light gym work, swimming, racquet sports if these were part of life before.
- 5
Months 3 to 6
Heavy lifting, contact sports, and strenuous upper-body work.
The general progression is:
The specific timeline depends on your operation — a wide local excision allows faster return than a mastectomy with reconstruction. The practice’s breast care nurse will give you the specific exercise programme for your operation; the above is a general framework.
If you are not regaining shoulder range by 4 to 6 weeks, ask for a referral to a breast cancer physiotherapist. Specialist physio is highly effective and is often available on the NHS or through private health insurance.
Scar care
Scars from breast surgery typically follow a predictable evolution:
- 1
Weeks 0 to 4
Pink, slightly raised, sometimes itchy. The scar is at its most fragile.
- 2
Months 1 to 3
Scars fade and flatten gradually. Some are thicker than others depending on individual healing.
- 3
Months 3 to 12
Most scars become pale and flat. The mature scar is what you will live with long-term.
Things that help:
- Don’t let the scar dry out once the wound is fully sealed (usually 2 to 3 weeks), apply a simple moisturiser daily. Vitamin E cream, plain emollient, or a dedicated scar gel are all reasonable.
- Massage the scar once it is fully healed (typically from 3 to 4 weeks). Use the pads of two fingers and apply gentle circular pressure along the length of the scar for a few minutes once or twice a day. This helps soften the scar tissue, prevents adhesions, and improves the long-term appearance.
- Silicone gel or silicone sheets clinical evidence shows silicone reduces scar thickness and redness in patients prone to thicker scars. Available over the counter; apply daily for at least 3 months. Worth doing if your scars are showing signs of becoming raised at 4 to 6 weeks.
- Sun protection fresh scars (the first 12 months) burn easily and pigment more readily. Use a high-factor SPF on the scar whenever it might be exposed.
If a scar is becoming thick, raised, red, itchy, or painful at 6 to 12 weeks rather than settling, it may be developing into a hypertrophic or keloid scar. This is treatable — silicone, intralesional steroid injections, or specialist scar review. Mention it at your follow-up.
When can I drive, travel, work, and exercise?
| Activity | Lumpectomy | Mastectomy ± implant | Mastectomy + autologous flap |
|---|---|---|---|
| Driving | 1 to 2 weeks | 3 to 4 weeks | 4 to 6 weeks |
| Light office work | 1 to 2 weeks | 2 to 4 weeks | 4 to 6 weeks |
| Manual / lifting work | 4 to 6 weeks | 6 to 8 weeks | 8 to 12 weeks |
| Swimming | 3 to 4 weeks (after wound seals) | 4 to 6 weeks | 6 to 8 weeks |
| Light gym | 4 weeks | 6 weeks | 8 weeks |
| Heavy lifting / contact sport | 6 to 8 weeks | 8 to 12 weeks | 3 months+ |
| Long-haul flying | 2 weeks | 4 weeks | 6 weeks |
Driving
the legal requirement is that you can perform an emergency stop without hesitation and have full control of the vehicle – practise the controls in a stationary car first. You do not need to notify DVLA for routine recovery from breast surgery (DVLA only needs telling if a condition affecting driving will last more than 3 months). Your insurer is the binding party – most policies want you to have been told by your surgeon that you are fit to drive, so ask at your wound-check appointment and check the wording of your policy. A folded soft scarf or a seat-belt cushion under the chest strap is often more comfortable for the first few weeks.
Flying
there is a small additional risk of clots in the leg veins after major surgery; long-haul flights should wait the times above, and shorter flights can usually be sooner. If you have to fly sooner, discuss with the practice — anti-clot stockings and an anti-clot injection on the day of travel are sometimes offered.
These are general guides. Your specific operation, how it is healing, and your personal recovery rate all matter — when in doubt, ask.
Reconstruction-specific recovery notes
If you have had reconstruction at the time of mastectomy:
Implant reconstruction (one-stage or two-stage with expander)
- Recovery follows the mastectomy timeline above, with the additional consideration that the implant or expander needs time to settle
- With a tissue expander, periodic clinic visits over weeks add saline to gradually stretch the skin; the visits are 5 to 10 minutes each
- The final implant exchange operation (in two-stage reconstruction) is typically 3 to 6 months after the first operation and has a much faster recovery (1 to 2 weeks)
DIEP flap and other autologous reconstructions
- There are two surgical sites: the chest and the donor site (most commonly the lower abdomen for DIEP)
- The abdominal site has its own recovery — an abdominal binder is worn for 4 to 6 weeks, you sleep semi-upright with the legs slightly bent for the first 1 to 2 weeks, and you avoid stretching the abdomen for 6 to 8 weeks
- Full recovery from the donor site adds time on top of the chest recovery — most patients are back to normal life at 8 to 12 weeks
Nipple reconstruction
- Usually done as a smaller second-stage operation 3 to 6 months after the main reconstruction, when the breast has settled to its final shape
- Recovery is short (a week or so) and is a clinic-based or day-case operation
Tattooing of nipple-areolar complex
- Usually 2 to 3 months after nipple reconstruction
- Done by a specialist nurse or medical tattooist; takes around an hour
The full reconstruction journey can take 12 to 18 months from the first operation to the final tattooing. This is normal.
Mental health, body image, and emotional recovery
Recovery from breast surgery is not just physical. The first 2 to 3 months are when most patients describe the emotional impact — relief at being through the operation, anxiety about the future, sometimes a sense of grief about the changes to the body, and the practical realities of looking at the chest in the mirror for the first time after surgery.
This is normal and expected. It is also worth having support beyond the practice — the breast care nurse service, the dedicated counsellors at organisations like Breast Cancer Now and Macmillan, and peer support groups all play a role. The survivorship page outlines the routes to specific support.
If you are struggling — sleep is significantly disturbed, you are tearful most of the time, intrusive thoughts about cancer recurrence are taking over the day — tell the breast care nurse or your GP. Anxiety and low mood after a cancer diagnosis are common and treatable, and getting help early shortens the recovery.
Weeks 0–12 stay on this page. Surveillance, late effects, and life after treatment are on Survivorship.
When to call us
Call the practice (Sarah or Nadiya on the phone, or [email protected]), or the breast care nurse on the number you have been given, if any of these happen:
- Wound — Increasing redness, pain, swelling, pus, or any sign of infection.
- Sudden swelling — Of the chest wall or under the wound.
- Severe pain — That is not controlled by your prescribed painkillers.
- Fever — Above 38°C, or feeling generally unwell with shivers.
- Calf pain or swelling — Or chest pain or shortness of breath — possible signs of a clot in the leg or lung. Call urgently or attend A&E.
- A reconstruction that suddenly looks darker, paler, or feels colder — Than the other side — this can be a sign of compromised blood supply and should be checked promptly. Call urgently.
- Anything that is worrying you — And you can’t tell whether it is normal — call. The threshold is low; we would rather check something that turns out to be fine than miss something that wasn’t.
For genuine emergencies (severe shortness of breath, chest pain, sudden unilateral leg swelling, anything that needs immediate medical attention), call 999 or attend the nearest emergency department directly.
Follow-up appointments
Your follow-up schedule will be on your discharge information. In broad terms:
- 1
First wound check
Typically 7 to 14 days after surgery. May be in person at the practice clinic or with the breast care nurse, depending on the operation.
- 2
Histology results appointment
Usually 2 to 3 weeks after surgery, to discuss the final pathology of the tissue removed and the next steps in treatment.
- 3
Six-week review
To check the wound has fully healed, swelling has settled, and you are back on track. Discuss any persistent issues here.
- 4
Three-month and six-month reviews
Depend on the operation and the broader cancer treatment plan.
- 5
Annual surveillance
For breast cancer patients, annual mammograms (or MRI for high-risk patients) plus a clinic review for at least 5 years, often longer.
These can sometimes be combined or adapted to your circumstances — flag scheduling issues early so we can adjust.
Weeks 0–12 stay on this page. Surveillance, late effects, and life after treatment are on Survivorship.