Surgical Procedures: Simple Mastectomy

Also called: Mastectomy, skin-sparing simple mastectomy with same day breast reconstruction

What is a Simple Mastectomy?

A simple mastectomy is a surgery done to remove your whole breast. This includes the nipple, skin, areola, and breast tissue. Lymph nodes are not removed.

Will I stay overnight?

Most people stay overnight. Your stay will be longer if you have breast reconstruction.

What is recovery like?

Your provider will talk to you about your recovery. Often, you will be up and moving the day after surgery. You will need to make some changes to your activity level in the first week or so. A surgical drain(s), placed at the time of surgery, is used to remove fluid that builds up in the area after this procedure. It is placed under the arm on the side you had surgery. The drain stays in for about 7-10 days. It is removed in the provider’s office, a quick and often painless procedure. You will be given instructions on how to take care of the drain at home.

After surgery, you may:

• Have pain and/or feel sensitive along the chest or reconstructed breast.
• Have numbness along the chest or reconstructed breast. This numbness puts you at risk for a serious burn. Do not use heating pads or hot packs on this area. If you have concerns, please talk about this with your healthcare team.
• After the drain is removed, a seroma could develop. A seroma is a pocket of fluid under the arm or chest wall. It can be uncomfortable but is not serious. Most go away on their own over time. In some cases, they need to be drained in the office with a needle.

Can I prevent infections?

Getting an infection after this procedure is not common. You can help prevent an infection by:

• Taking a shower the night before surgery and washing your body with soap and water.
• On the second day after surgery, making sure to shower or at least clean the incision with soap and water. Pat dry. Do not rub the incision. Do this every day, or at least every other day, to keep the incision site clean.
• Not putting the incision under water (soaking in a tub or swimming).
• Always washing your hands before and after touching the incision or changing the dressing.

What will I need at home?

• Gauze pads (4x4) to cover the drain, abdominal pads (also called surgi-pads) to place across your chest or reconstructed breast for padding/comfort, and 1-inch paper tape. These can all be found at your supermarket or pharmacy.
• A specimen cup to measure fluid from the drain. This should be given to you by your healthcare team before going home. Write down in a notebook how much fluid there is in the cup each time you empty it.
• Clean, supportive pillow(s) to put under your arm while sitting or to help with your position at night.
• You may have constipation after surgery. Over-the-counter medications, adding fiber to your diet, exercise (as simple as walking), and fluids may ease constipation. Ask your health-care team about over-the-counter medications that may work for you.

How do I care for the incision?

If you have a bandage after surgery, remove when your provider’s instructions say to do so (often within 48 hours). Once the bandage is removed, you may shower, but do not scrub the incision. To dry, carefully pat the incision with a clean towel. Do not use lotions, powders, or deodorant on or near the incision during the first 1-2 weeks until it is fully closed.

Most surgeons use dissolvable sutures (stitches) inside your body, which will go away on their own. On the outside, your surgeon may use surgical glue, paper tape called "steri-strips," or nothing at all. Both glue and steri-strips can get wet in the shower.

How can I care for myself?

You may need a family member or friend to help you with your daily tasks until you are feeling better. It may take some time before your team tells you that it is ok to go back to your normal activity.

Be sure to take your prescribed medications as directed to prevent pain, infection and/or constipation. Call your team with any new or worsening symptoms.

There are ways to manage constipation after your surgery. You can change your diet, drink more fluids, and take over-the-counter medications. Talk with your care team before taking any medications for constipation.

Taking deep breaths and resting can help manage pain, keep your lungs healthy after anesthesia, and promote good drainage of lymphatic fluid. Try to do deep breathing and relaxation exercises a few times a day in the first week, or when you notice you are extra tense.

• Example of a relaxation exercise: While sitting, close your eyes and take 5-10 slow deep breaths. Relax your muscles. Slowly roll your head and shoulders.

This article contains general information. Please be sure to talk to your care team about your specific plan and recovery.