Count on 1 day of feeling “off” for every hour you’re under general anesthesia. You’ll experience enough pain to take painkillers for at least a day or so; and you’ll certainly be sore for awhile after that. You’ll also be fatigued for awhile; surgery is a real challenge to your system.
You’ll also be dealing with drainage tubes. These flexible tubes, with a collection bulb at the end, drain excess fluid from your wound; you’ll measure and empty this fluid from the bulbs regularly. When the drainage slows to a certain point (that’s why you’re measuring), a nurse will remove the tubes; expect a short, sharp pain, like a shot or bee sting. You may have the tubes in for only a couple of days, or they may be with you for a couple of weeks or more. While they’re in, you can’t shower; so be prepared to have someone help you bathe, either in the tub, or with a sponge and basin.
How quickly you heal will be a reflection of both the length and complexity of your surgery, and how healthy you are in general. Smokers take longer to heal, due to a compromised vascular system. In fact, smokers usually don’t have the option of reconstruction, as there’s such an increased chance of it failing. And a simple mastectomy heals more quickly than one with an accompanying reconstruction.
You should probably plan to take a minimum of 1 week off work for a simple mastectomy; and at least 2 weeks, probably more like 3 weeks, for a mastectomy with reconstruction. If you have a physically challenging job, you’ll need to take longer, in order to let everything heal thoroughly before you put it to the test by lifting, carrying, etc.
Your doctor will give you exercises to do at home, and will tell you when to start doing them. Don’t shirk this responsibility; exercise after surgery, even when painful, will help prevent arm and shoulder problems later on.
As with any surgery, be sensible. Don’t overdo. No lifting or carrying with your affected arm till your surgeon says it’s OK. If you have any signs of infection (fever, swelling, redness), let the surgeon or nurse know. And if your arm and/or trunk swells, you may be experiencing lymphedema; this is another thing to report.
Q. What will it look like afterwards, once everything is healed?
A. Again, depends what surgery you have. A simple mastectomy will leave you with a flat place on your chest bisected by a horizontal scar. A reconstruction will look anywhere from nearly natural to not-so-good, depending on the skill of your surgeon and the size of your breasts; smaller breasts are easier to reconstruct than larger ones. But remember, hardly anyone (maybe only you) will see your reconstruction au naturel; most reconstructions look just fine covered, as they usually are, by a bra and shirt.
Most women go on to have further treatment—radiation, or chemo, or both—after their mastectomy. You’ll soon get past worrying about your surgery, since you’ll have other things to worry about! Good luck, and remember: you’re doing everything you can to prevent cancer form coming back, so it’s all worth it.