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Mastectomy Education

FROM SECOND TO NATURE

Second to Nature provides years of experience to our clients and offers this education piece to empower your knowledge of what to expect before, during, and after mastectomy surgery:

What to Expect Before Mastectomy Surgery

Most health providers will provide exact steps of the process of what to expect on the day of your surgery. You will most often be instructed about what to bring, whether you have eating or drinking restrictions, and other health-related concerns to share beforehand. In the hospital on surgery day, you can expect to be wearing a hospital gown and will most often have some waiting time in a preoperative holding area. Some surgical centers and hospitals allow you to have one or two friends or family members with you in your room.

The surgeon or nurse may draw markings on your breast, usually with a felt-tip marker, that show where the incision will be made. You’ll be sitting up while this happens so that the natural crease of your breast can be marked. They may have a list of questions for you to answer or confirm before they begin.

You will be taken into the anesthesia room, where a nurse will insert a needle connected to a long tube—an intravenous infusion (IV) line—into your hand or arm and tape it into place. Soon after this, you will be given relaxing medication through the IV line. Once you are wheeled into the operating room, you will be given general anesthesia.

What Happens During Mastectomy Surgery

A modified radical mastectomy (also known as mastectomy with axillary dissection) procedure can take two to three hours. If there is a reconstruction performed at the same time, the surgery is longer. The surgeon will outline how they expect to go, but mastectomy incisions generally are in the shape of an oval around the nipple, running across the length of the breast. If you are having a skin-sparing mastectomy, the incision will be smaller. This generally includes the nipple, areola, and original biopsy scar.

Once the incision is made, the breast tissue is separated from the overlying skin and from the chest wall muscle underneath. All the breast tissue, which lies between the collarbone and ribs, from the side of the body to the breastbone in the center, is removed. In the case of full, radical mastectomy, some of the chest muscle may be removed as well. If it is part of your surgery plan, an axillary lymph node dissection may also be performed. Immediate reconstruction may be performed at this point, if part of the surgery plan.

Once all removal and replacement work is complete, the surgeon checks the areas for bleeding and inserts surgical drains. These are long tubes that are inserted into your breast area or under the armpit to collect excess fluid that can accumulate in the space where the tumor was. The tubes have plastic bulbs that create suction to help the fluid exit the body. With the drains in place, the surgeon stitches the incision closed. A bandage that wraps closely around your chest covers the entire surgery site.

After Mastectomy Surgery - Hospital Recovery

After surgery, you move to the recovery room where your heart rate, temperature, and blood pressure are monitored. If you experience pain or feel nauseous from the anesthesia, let someone know so you can receive medication. Once you are awake and stable, you return to a hospital room to heal before going home.

Hospital stays after mastectomy average three days. If you have same-day reconstruction, recovery in the hospital may take longer. The doctor or nurse will show you exercises to do starting on the morning after your surgery. These are important to prevent stiffness in your arm, shoulder, and side of the body where you had surgery. Exercise also helps prevent the significant formation of scar tissue.

Some types of exercise should be avoided until the post-surgical drains are removed. Be sure to ask your surgeon or nursing staff if you are unsure about any type of movement or exercise, or if you are especially uncomfortable. You will receive written, often illustrated instructions on doing the appropriate exercises for when you leave the hospital.

What to Expect
from At-Home Recovery After Mastectomy

Before you leave the hospital, the surgeon or nurse will give you information and instructions you need that are important for your recovery at home. These include:
  • TAKING PAIN MEDICATION: The doctor will probably give you a prescription to take with you when you leave the hospital, which you may want to have filled on your way home. You may want to have a friend or family member get it filled for you, so you have it available.
  • CARING FOR THE BANDAGE/DRESSING OVER YOUR INCISION: Your surgeon or nurse will provide information on how to care for the mastectomy bandage. They may ask that you leave things in place until the follow-up visit. If you have any questions, be sure to ask.
  • RECOGNIZING SIGNS OF LYMPHEDEMA: If you have had axillary dissection, you will be given information on taking care of your arm and being alert to signs of lymphedema.
  • WHEN YOU CAN START WEARING A PROSTHESIS OR BRA: The site of mastectomy surgery and reconstruction needs time to heal before you can wear a prosthesis or bra. The doctor will tell you how long you may need to wait.
  • CARING FOR A SURGICAL DRAIN: If you have a drain in your breast area or armpit, the drain may be removed before you leave the hospital. Some patients have the drainage equipment in place until the follow-up visit a week or two after surgery. If you are going home with the drain inserted, be sure to get full instructions on how to empty and care for the drain before you leave the hospital. Know before you go!
  • STITCHES & STAPLES: Many surgeons find it easier to use sutures or stitches that dissolve over time rather than scheduling a separate visit to have them removed. If you have staples or see any residual problems with stitches, let the doctor know so they can remove them during your office visit.
  • RECOGNIZING SIGNS OF INFECTION: The doctor or nurse will describe the signs of infection and when to call their office.
  • EXERCISING YOUR ARM: Expect to receive written/illustrated instructions on the type and amount of exercise you may do during recovery. It is important to exercise every day to avoid stiffness and pain.
Recovery time at home after mastectomy surgery can take a few weeks. It is important to take the time you need to heal and not try to do too many things to stress your body. Some helpful home recovery tips are:
  • GET PLENTY OF REST: You will probably be fatigued from the experience of getting home from the hospital. Allow yourself to get extra rest in the first few weeks after surgery. There are many ways to manage fatigue, and one of the best is to allow others to support your recovery.
  • CONTINUE ARM EXERCISES DAILY: It is important to do the arm exercises as directed by the doctor’s office to help prevent stiffness, keep your arm flexible, and help reduce discomfort.
  • TAKE SPONGE BATHS UNTIL DRAINS/SUTURES ARE REMOVED: Once you have your drains and any staples or sutures removed, you may resume showers or baths. Until then, take sponge baths to stay fresh.
  • TAKE PAIN MEDICATION WHEN NEEDED: As you heal, expect to feel a mixture of pain and numbness around the incision, chest wall, armpit, and arm. If you feel the need, take pain medication according to your doctor’s instructions. There are ways, such as doing light exercises as directed to help reduce discomfort.
  • HAVE HELP AROUND THE HOUSE: Many people plan on having help from family members and friends during recovery. Assistance with “daily” tasks like childcare and meals, and “occasional” tasks like laundry and shopping, can help reduce stress and worries, allowing you to rest and heal well.

Typical Sensations
in the Months After Mastectomy

As you heal, your body continues to adjust to the effects of the surgery. This healing and adjustment can take months, so here are a few things to keep in mind:
  • You may have “phantom” sensations or pain in the months after surgery. This may be due to healing, nerve regrowth, and general discomfort. You may feel weird, ‘crawly’ sensations, itches, sensitivity, and pressure. The aches and pains may go away by themselves, it may persist and you adapt to it, or you may have to take pain medication. Be sure to review any type of ‘phantom’ pain with the doctor so he or she can provide an appropriate prescription if needed.
  • Continuing with arm exercises and other routines as directed by the doctor will help keep you limber and improve your range of motion. These serve to strengthen the surgical area to help prepare it for the eventual placement of prosthesis (if necessary).
  • Fatigue may also be experienced from time to time in the early months after surgery. This is why rest is so important. If you are having trouble with excessive fatigue, consult with your doctor about things you can do.

Frequently Asked Questions

Several types of breast forms are available on the market today. The most popular type is the silicone breast prosthesis. Silicone most accurately replicates the natural texture and movement of the breast. Silicone prostheses are available in full weight, lightweight, and extra lightweight, as well as in a variety of shapes and sizes.

Foam forms are another popular choice. These are soft and available in lightweight and featherweight. They are an excellent choice for sleep or relaxation. One of the newest innovations is the beaded form. The unique construction contours to the chest wall nicely, and allows airflow for a cooler, more comfortable fit. These are also available in lightweight and featherweight.

Other options are also available, including swim forms and custom breast forms.

Second to Nature carries a full line of partial prostheses that can restore a naturally balanced silhouette. Many of these products are self-adhering, and do not require a special bra. Some of our most popular products to use following lumpectomy come from Trulife.
Our partial prostheses work well for women with a breast imbalance. Some, but not all, insurance companies will even cover the cost of a prosthesis for uneven breast development.
You can wear a silicone breast prosthesis in the water. There are also swim forms specially designed to hold up to chlorine or salt water, and preserve your everyday prosthesis. Swim forms are usually covered by insurance. Post-surgical swimsuits with pockets to hold your breast form will keep it securely in place while swimming.

Medicare and most private insurance companies will pay for your bras, camisoles, and prostheses after breast surgery. Second to Nature partners with several insurance providers, including: AARP, Aetna, Anthem, Blue Cross Blue Shield, Humana, United Health Care, VA Premier, and others. We will even check your benefits and file your claim for you. And, since we accept assignment on most products, you may pay little or nothing out of pocket.

We recommend that you come in before your surgery and be fitted with a post-surgical camisole. This soft, comfortable undergarment can be worn in the hospital immediately after surgery and offers pockets to hold a cotton shaper pad and your drainage tubes. Your camisole can be worn until your surgeon approves you to be fitted with a mastectomy bra and prosthesis, usually four to six weeks after surgery.
Many products at Second to Nature are helpful for women undergoing breast reconstruction, including camisoles to wear at the hospital after surgery to provide comfortable support and hold your drainage tube. If your reconstruction is not performed at the same time as your mastectomy, you can use bras and prostheses in the interim. Also, some women find that their natural breast and reconstructed breast differ in size and shape. We offer partial prostheses to restore symmetry. Federal law requires that insurance pay for these items if needed, even after reconstruction.
An appointment is highly recommended. Please bring your insurance cards, a photo ID, and a prescription from your doctor, if you have one. For your first regular bra and prosthesis fitting, please allow 60 minutes for a proper fitting.

If you are a repeat customer who wants the same styles and sizes you received before, please call ahead to make sure we have your items in stock. We can arrange for an appointment to pick them up and complete your insurance paperwork. If you have changed sizes or desire different styles, please schedule a new fitting. If you have had any changes to your insurance information, please bring your new card.

You will need a new prescription from your doctor annually. Many people prefer to have their prescriptions faxed over prior to their appointment. It saves time and reduces the likelihood that the prescription is left at home on the day of the appointment. Fax your prescription to us at (540) 366-2711.

What if I Plan on, or Am Not Happy with, my Reconstruction Surgery?

For post-lumpectomy patients, Second to Nature has several products that may help you feel better:
  • NEW TRULIFE RECOVER: It is a collection of image-care products that offers removable layers of soft 100% natural silicone that provides adjustability for fullness and projection. It is a gentle and comfortable fit during the multiple stages of reconstruction, for post-lumpectomy use and for covering breast tissue that has changed due to radiotherapy.
  • RECOVER SHELL: Three natural silicone layers, ideal for the multiple stages of reconstruction.
  • RECOVER OVERLAY: Two natural silicone layers, ideal for post-lumpectomy and post-reconstruction.
  • RECOVER ENHANCER: Pair of anatomically curved natural silicone enhancers, ideal for post lumpectomy.

How Can I Get Back to my Active Lifestyle After Breast Surgery?

Trulife offers an active lifestyle breast form design called ActiveFlow. It has a nice blend of beads that do not absorb water and fast drying molded spacer fabric that is great for support and structure. It has a flattering, natural profile, whether active or lying down. ActiveFlow is ideal for activities such as:
  • Exercise Class
  • Gardening
  • Swimming/Water Aerobics
  • Yoga
  • Pilates
  • Jogging
  • Biking
Couple this with the Cotton & CoolMax seamless Softcup bra that pulls moisture away from the skin, enhances the drying rate, so that air moves in to keep your body cool and dry. If you find this unsuitable, we have a variety of workout wear by other trusted brands.

Compression Garments for Edema & Lymphedema

WearEase Compression Bras and Shapewear have been a wonderful addition to our aid patients who are recovering from surgery, edema and lymphedema. Constructed of a four-way stretch power mesh, it provides excellent fit and compression. It has a padded front zipper, adjustability for fit and coverage, is antimicrobial, and latex free as the fabric content is 87% Nylon/ 13% Spandex. This special Naturexx fabric build is adept at transfering moisture away from the body, dissipating body heat build-up and providing comfort.
WearEase Shapewear line is lightweight, supportive and moisture resistant. This allows for the garments to be worn long term whether sleeping, traveling or as sportswear. The features include:
  • “Step Into” garments designed for ease of getting into and out of your garment.
  • High cut underarms and back targets swelling
  • Hidden seams and sturdy construction
  • Comfortable body shaping garments
These garments are produced as:
  • Criss-Cross Bra
  • Compression T-Shirt
  • Slimmer
  • Criss-Cross Shaper
  • Compression Cami

More Info – “Step Into” Garments