Breast Surgery Post-operative Care

The pathway for each surgical procedure has many steps that involve all members of your care team—including you. Some of our pathways build on an approach called Enhanced Recovery After Surgery (ERAS). These are evidence-based guidelines designed to optimize hydration, nutrition and pain control, leading to a faster, safer and more comfortable recovery from surgery.

We also go beyond ERAS to make sure that you are benefitting from the best-known practices throughout your entire surgical journey – including after you leave the hospital. Our pathways decrease complications, including surgical site infections, heart rhythm problems, blood clots and more. Patients and caregivers alike are seeing the benefits of this team-based approach that revolves around you and your recovery.

Learn more about Enhanced Recovery After Surgery (ERAS).

After surgery, you will go to a PACU (recovery room) where you will receive comprehensive care from an experienced clinical staff that will closely monitor you as you recover from anesthesia. The length of time spent in the PACU depends on the type of surgery performed and your specific condition. The clinical staff may do the following:

• Monitor vital signs such as pulse, breathing and blood pressure
• Take your temperature
• Monitor for signs of complications
• Check your incisions and surgical drains
• Check intravenous infusions
• Monitor your urine output
• Maintain your comfort with body positioning and pain medication

Our clinical staff will instruct you in performing breathing and moving exercises to aid the speed of post-anesthesia recovery, such as:

• Deep breaths - As lying flat for an extended period of time can cause secretions to accumulate in the lungs, taking deep breaths utilizing the entire diaphragm and abdomen can prevent pneumonia.
• Turning - Changing positions in your recovery bed stimulates circulation, encourages deeper breathing and relieves pressure areas.
• Coughing - This helps to remove chest secretions.
• Foot and leg exercises - Moving your feet and legs stimulates circulation.

Many factors contribute toward the amount of discomfort following surgery. Typical discomforts following breast surgery may include:

• Mild sore throat (due to the tube placed in the windpipe for breathing during surgery)
• Nausea and vomiting from general anesthesia
• Pain, swelling and soreness around the incision site
• Thirst
• Constipation and gas (flatulence)
• Sleeplessness and restlessness

Your healthcare team will work with you to minimize any discomfort you may have following surgery.

Although rare, complications can occur following breast surgery. The most common complications after breast surgery are:

• Bleeding from the site of surgery. This may require your doctor to take you back to the operating room.
• Wound infections occur when bacteria enter the site of surgery. Infections can delay healing.
• Deep vein thrombosis (DVT) is a blood clot in a large vein typically in the leg. Symptoms include pain, swelling and redness in the affected area. If you have these symptoms, call your health care provider.
• Pulmonary embolism is caused when a clot (DVT) separates from the vein, and travels to the lungs. This is a medical emergency and symptoms include trouble breathing, chest pain, fast heartbeat, coughing up blood, sweating and fainting.
• Lung (pulmonary) complications can arise within 48 hours of surgery due to lack of deep breathing and coughing exercises. Symptoms may include wheezing, fever, cough and chest pain (among others).
• Temporary urinary retention, or the inability to empty the bladder, may occur after surgery due to the anesthetic. Urinary retention is usually treated by inserting a catheter to drain the bladder until the patient regains bladder control or by using medicines to stimulate the bladder.
• Reaction to anesthesia, although rare, allergies to anesthetics do exist. Symptoms can range from mild to severe.

A certain amount of pain is typical following surgery. With today’s new and improved pain medications, there is no reason for anyone to tolerate severe pain. If pain does not subside with pain medication, however, there may be a more serious problem.

By effectively treating pain, you will heal faster and be able to go home and resume normal activities sooner. Discuss pain control options that have worked well or not worked for you in the past with your doctor before surgery. Following surgery, your doctors and nurses will want to know how your pain medicine is working and whether or not you are still experiencing pain. If necessary, your doctor will change the medicine and/or dosage.

The amount of postoperative discomfort you experience depends on various factors, particularly the type of surgical procedure and your threshold for pain. Discuss your pain management options with your doctor, including the various types of pain medications and their side effects.

What are the different types of pain relief medications commonly used after surgery?

Some pain relief medications used after surgery may include:

• Nonsteroidal anti-inflammatory drugs (NSAIDs), such as aspirin, naproxen (for example, Aleve) and ibuprofen (for example, Advil and Motrin), are most often used for mild or moderate pain. NSAIDs carry no risk of addiction, and depending on the amount of pain, they may eliminate the need for stronger medications. However, NSAIDs may cause nausea, vomiting or kidney problems.
• Acetaminophen (for example, Tylenol) is a type of pain reliever that is unlikely to cause stomach irritation that may be associated with others and may be less likely to interact with other medications you are taking. Some opioid combination oral pain medications contain acetaminophen, and it is important to know the quantity of acetaminophen in these combination medications. Acetaminophen can cause liver damage if taken in excess or by patients with certain medical conditions.
• Opioids, including morphine and oxycodone, are most often used for acute pain immediately following surgery. These medications can be safely used for short periods. If these medications are taken for longer periods, there is an increased chance that a person may become addicted. Opioids may cause nausea, constipation, vomiting, dizziness, itching or other skin rashes. Learn more about opioids.

Breathing and relaxation exercises can also help in controlling pain. Consult your doctor for more information.

Learn more about pain management in our health library.

Typically, your incision will be closed either by surgical glue (Dermabond) or Steri-Strips. To clean your incision, you can gently wash the area and pat dry. You should leave Steri-Strips or Dermabond on until they wear off on their own. Occasionally non-absorbable sutures are used, and in these cases your physician will explain how you should care for your incision prior to surgery.

Your nurse will review how to care for your drains after you leave the hospital.

Learn more about drain care following breast surgery.

The Brigham and Women's Hospital breast cancer surgeons offer the following patient information sheets:

• Drain Fact Sheet and Guide
• Opioid Pain Reliever Fact Sheet
• Day Surgery Post-Operative Checklist
• Post-operative Mastectomy Checklist
• Post-operative Breast Surgery FAQs

Read more in our health library:

• Post-operative care
• Post-operative management
• Pain management

Visit the Kessler Health Education Libraryin the Bretholtz Center for Patients and Families to access computers and knowledgeable staff.

Access a complete directory of patient and family services.