Preparing for Breast Reconstruction Surgery

As you get ready for breast reconstruction surgery, ask your surgeon what to expect. Your surgeon can help you be as prepared as possible. You want to have realistic expectations of how your body will look and feel after surgery, and understand the benefits and risks of the type of reconstruction you are having.

Ask questions and follow your surgeon’s instructions carefully. 

Gathering your list of questions

Some questions that may help you know what to expect include:

• What should I do to get ready for surgery?
• If I smoke, when is the best time to stop before surgery?
• How much discomfort or pain will I feel after surgery?
• How long will I be in the hospital?
• Will I need blood transfusions?
• How long will it take me to recover?
• What will I need to do at home to care for my incisions (surgical scars)?
• Will I have a drain (tube that lets fluid out of the wound) when I go home?
• How much help will I need at home to take care of my drain and wound?
• Will I be taught exercises to do after surgery? When can I start them?
• How much activity can I do at home?
• What do I do if my arm swells?
• When will I be able to go back to normal activities such as driving and working?

Breast reconstruction can make you feel better about how you look and renew your self-confidence, but keep in mind that the reconstructed breast will not be a perfect match or substitute for your natural breast. If tissue from your tummy, back, thigh, or buttocks will be used, those areas will also look different after surgery. Talk with your surgeon about surgical scars and changes in shape or contour. Ask where they will be, and how they will look and feel after they heal.

Your surgeon or other involved doctors/staff should explain the details of your surgery, including:

• The drugs (anesthesia) that will be used to make you sleep and not feel pain during the surgery
• Where the surgery will be done
• How long the surgery will take
• Possible complications of surgery (long-term and short-term)
• What to expect after surgery
• The plan for follow-up
• Costs associated with the surgery

Understanding your surgery costs

Health insurance policies often cover most or all of the cost of reconstruction after a mastectomy, but this might not always be the case if you have reconstruction after breast-conserving surgery (lumpectomy or partial mastectomy). Check your policy to make sure you are covered, and find out what portion of the bill you’ll be expected to pay. Also, see if there are any limits on what types of reconstruction are covered.

Before surgery, make sure your insurance company will not deny breast reconstruction costs (for mastectomy or lumpectomy). Your surgeon may be able to help you with this if your insurance plan wants to deny coverage, so be sure to ask if you need help. It may take some time and effort. In the past, health plans have denied coverage for certain reconstruction procedures despite federal laws that require coverage in most cases. They often reverse such decisions on appeal.

Getting ready for surgery

Your breast surgeon and your plastic surgeon should give you clear instructions on how to prepare for surgery. These will probably include:

• Help with quitting smoking, if you smoke
• Instructions to take or avoid certain vitamins, medicines, and dietary or herbal supplements for a period of time before your surgery
• Instructions on eating and drinking before surgery

Plan to have someone take you home after your surgery or your stay in the hospital. You may also need them to stay and help you out for a few days or longer.

Where your surgery will be done

Breast reconstruction often means having more than one operation. The first creates the breast mound. This may be done at the same time as the mastectomy or later on. It’s usually done in a hospital.

Follow-up procedures such as filling expanders or creating the nipple and areola are most often done in an outpatient facility. But this decision depends on how much surgery is needed and what your surgeon prefers, so you’ll need to ask about this.

What anesthesia will be used

The first stage of reconstruction is almost always done using general anesthesia. This means you’ll be given drugs to make you sleep and not feel pain during the surgery.

Follow-up procedures may only need local anesthesia. This means that only the area the doctor is working on will be numbed. A sedative drug may also be used to make you feel relaxed but awake. You might feel some discomfort.

Possible risks of breast reconstruction surgery

Any type of surgery has risks , and breast reconstruction may pose certain unique problems for some women. Your surgeon will go over the possible risks of reconstruction surgery with you. Be sure to ask questions if there’s anything you’re not sure about. For more on the possible risks after surgery, see What to Expect After Breast Reconstruction Surgery.