Mastectomy Recovery: Drains, Sleep, Clothing and the First Few Weeks

Going home

Many people go home the same day or after one or two nights, according to the NHS. If you had reconstruction at the same time, the stay is usually a few days longer. You will feel tired and sore, and the area around the wound and under the arm may feel tight or numb. All of that is expected.

Recovery usually takes several weeks. The NHS says the wounds typically take around six weeks to heal fully, and MedlinePlus says full recovery can take four to eight weeks. Most people are back to many usual activities within a few weeks, but not all of them, and not at the same speed.

Living with drains

Many people go home with one or more thin tubes coming from the wound into a small bulb or bottle. They drain fluid that would otherwise collect under the skin. MedlinePlus explains that you may need to empty them and record how much fluid comes out, and that your surgeon decides when they come out, usually within a week or two.

The drains are the part people find hardest to manage day to day. A few things help (our drain care guide has the step by step):

Somewhere to clip them. A lanyard round the neck in the shower, and a pouch or belt clip during the day, stops the bulbs dragging on the tubes. Some post-surgical camisoles and bras have drain pockets built in, which MedlinePlus suggests asking your nurse about.

A simple log. Keep a notebook by the bathroom for the date, time and amount each time you empty a drain. You will be asked for these numbers.

Pinning, not pulling. Secure the tube so it cannot snag on a door handle or catch when you turn over.

Sleeping

Our guide to sleeping after a mastectomy goes into more detail. Most people find sleeping on their back, slightly propped up, the most comfortable for the first few weeks. Lying on the operated side presses on the wound and the drain sites.

A wedge pillow, or a stack of firm pillows, raises the upper body and makes getting up easier, because you start from half-sitting. A small pillow tucked under the arm on the operated side takes the weight off the armpit and the drain. Some people use a specially shaped mastectomy pillow that sits between the chest and the seatbelt in the car and under the arm in bed. A recliner suits some people well for the first nights, though most manage fine in bed with the right pillows.

What to wear

Soft, loose, front-opening tops are the key. Lifting your arms to pull a top over your head is hard in the first weeks, and buttons or zips at the front let you dress without it.

Your team will tell you when you can wear a bra and what kind. Many people are advised to wear a soft, front-fastening, wire-free post-surgery bra, and if you have had a single mastectomy and want a temporary soft breast form, your breast care nurse can usually provide one. Ask before buying anything tight-fitting or with underwires.

Washing

Your team will tell you when you can shower. MedlinePlus advises not scrubbing tape strips or surgical glue and letting them fall off on their own, and avoiding baths, pools and hot tubs until your surgeon says it is fine. A lanyard to hold the drains, and a handheld shower head so you can direct the water away from the wound, make the first showers much easier.

Moving your arm

It is natural to hold the arm on the operated side close and still. That tends to make it stiffer. MedlinePlus says it is fine to use the arm and that stiffness is common and improves. You will usually be given a sheet of gentle arm and shoulder exercises, and doing them as prescribed is how you get full movement back. Do only the exercises your team or physical therapist gives you, and do not push into sharp pain.

If lymph nodes were removed from your armpit, you may also be given advice about looking after that arm in the longer term. Ask your team what applies to you.

Lifting, driving and returning to work

Lifting. The NHS advises avoiding heavy lifting and strenuous activity for two to three weeks. That includes shopping bags, laundry baskets, vacuuming, and lifting small children.

Driving. The NHS says not to drive until the wounds have healed and you can wear a seatbelt comfortably. MedlinePlus adds that you should not drive while taking strong pain medicine, and only once you can turn the wheel without pain. A small cushion between the seatbelt and your chest helps as a passenger. Our driving after surgery guide covers insurance and the general rules.

Work. This depends on your job, on whether you had lymph nodes removed, and on any further treatment. Ask your surgeon for a realistic timeframe.

Looking after yourself

Tiredness after a mastectomy is real and can last weeks. Accept help with meals, shopping and lifts. Gentle walking each day helps your circulation, mood and energy. Many people find the emotional side catches up with them once the practical side settles down, and that is a normal part of recovery, not a sign that something is wrong. Your breast care nurse can point you to support.

Warning signs

Contact your team, or in the UK call NHS 111, if you have:

• Sudden pain or swelling in the breast area or arm.
• Bleeding from the wound, or a wound that is red, hot, or leaking thick or smelly fluid.
• A high temperature. MedlinePlus gives 101.5°F (38.6°C) or higher as the level to call about.
• Sudden loss of feeling in the arm.
• Pain your medicine does not control, or you cannot eat or drink.

Call 999 or 911 if you have sudden chest pain, severe difficulty breathing, coughing up blood or a very fast heartbeat. These can be signs of a blood clot in the lung. Pain, swelling and warmth in one calf can be a clot in the leg and needs urgent advice.

The short version

Expect to go home within a day or two, possibly with drains, and plan for several weeks before you feel like yourself. Sort out a way to carry the drains, front-opening clothes and a few pillows for sleeping upright before the operation. Use the arm, do the exercises you are given, and avoid heavy lifting for the first few weeks. Follow your surgical team and breast care nurse, and call them about anything that worries you.