What to expect when you have a mastectomy

While the exact process of having a mastectomy can vary based on the type of procedure you're having and your surgeons(s) personal recommendations, the overall process the day of the surgery tends to be fairly consistent. Here's what you can expect if you're about to undergo a mastectomy. 

Before the surgery 

In the weeks before your surgery you will likely have a preoperative appointment with your doctor. During this time, you may have a mammogram, blood tests, and other testing as deemed necessary by your medical staff to make sure you're safely prepared for the upcoming procedure. 

Throughout this process, you will also speak with the medical staff about how to prepare for the day of your surgery. Some things your doctor will typically tell you are: 

  • What time to arrive for your procedure.
  • Any specific directions to prepare for your surgery like whether or not you can eat for so many hours leading up to your appointment.
  • What to bring with you. Some regular recommendations are a comfortable shirt, dress or recovery robe that can either button up the front or be stepped into to wear home after the surgery. You won't be able to lift your arms for a few weeks so it's recommended to stock up on these garments to be worn throughout the duration of your recovery. 
  •  To arrange a ride home after the surgery and to have someone who can check on your regulary throughout the first few days of your recovery. 

On the day of your surgery, you'll arrive at the hospital and start the pre-op process. This usually involves a few steps: 

  1. Your surgeon will draw some markings on your chest with a felt tip marker to help inform where the incisions will be made. 
  2. You will then be given an IV so that medication can be administered during and after the procedure. This is needle is typically placed in a vein in your hand or arm. Helpful tip: if you know that pain medication tends to make you nauseated, let your medical staff know before they administer any medication and they can give you a patch that goes behind your ear to help reduce nausea!
  3. Once the IV is inserted you will be given medication to relax and calm you down as you're moved to the operating room. 
  4. Once in the operating room you will receive general anesthesia to put you completely out. Under general anesthesia you won't be aware of anything that occurs during the procedure. 
  5. Your medical staff will likely insert a catheter once you're asleep as well. A catheter is used to manager your urinary functions when you're asleep and unable to use the restroom.

During the surgery

Most bilateral mastectomy procedures take 2-3 hours. If you have opted to have immediate reconstruction the process will take a little longer to account for these additional actions. 

During the surgery, incisions will be made to allow for all of the breast tissue from the overlying skin and chest wall muscle underneath to be removed. All of the tissue from the collarbone down to the ribs, and from the side of the body to the breastbone in the center will be removed. 

After all of the breast tissue is removed, any reconstructive measures that have been previously discussed with your doctor, if any, will be performed. 

Your surgeon will then insert medical drains on either side of your body to remove fluid from the surgical sites. Most patients will have two drains that operate using suction on either side of the body.

Your surgeon will then close the surgical sites with a combination or sutures, medical glue, and bandages. 

After the surgery 

After your surgery you'll be moved to a recovery room for the remainder of the night. Most patients are discharged within 24 hours, but some stays can take up to 3 days.

While in the recovery room, the staff will monitor your heart rate, temperature and other vitals while managing your pain by administering pain medication through your IV. 

The morning after your procedure, once your anesthesia has worn off, you can expect a few things: 

  • Your catheter will be removed. This doesn't hurt, but is rather just an odd sensation.
  • You'll be shown how to empty, clean, and monitor your medical drains.
  • You'll be prescribed a mixture of pain medication and muscle relaxers to help manage discomfort while you recover. You may also be advised to take a stool softener while on pain medication to help keep your digestion regular. 
  • The staff may show you some simple arm exercises you can do to help alleviate muscle discomfort and maintain flexibility. 
  • You may be told how to care for your incisions, but typically your medical team will ask you to not remove the bandages or recovery bra until your followup appointment where you will then be taught how to care for the wounds.

We understand that undergoing such a procedure can be like navigating a whole new world. That's why it's important to remember that your surgeon(s) and medical staff are your number one resources! Never hesitate to ask questions you have about the procedure or the results- no matter how silly you think your question may be!

We hope this article has helped to alleviate some questions you may have leading up to the day of your procedure, but don't hesitate to contact your doctor with any follow up questions you may have!

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