Physical preparation and recovery after breast reconstruction

Breast reconstruction is an operation to recreate a breast after a mastectomy. The aim of the surgery is to make a new breast shape, often called a breast mound. Choosing to have a breast reconstruction is a significant decision because it not only involves the physical impacts of major surgery, but also presents many physical, social, emotional challenges.

Being in the best physical shape possible prior to surgery can help enhance your recovery. Physical preparation enables you to build strength in the muscles that will be needed during your recovery from surgery, while a progression of exercises after surgery helps to improve flexibility and assist in muscle strength that may have been affected.  

This article addresses physical preparation for and recovery from breast reconstruction surgery and offers a dedicated exercise program for people having a breast reconstruction.

Guidance from your treating team

The information and exercise program provided on this page are general in nature. They are not prescriptive and are not intended to replace medical or clinical advice from the health professionals on your treatment and care team.

At all times throughout your cancer journey, please speak with your treating team before you start a new exercise program or even individual exercises. Your treating and care team may include your oncologist, surgeon and nurses as well as an exercise physiologist, occupational therapist or physiotherapist. They can help design a set of exercises personalised for your recover from the specific type of surgery you’ve had.

Preparing for breast reconstruction

Research shows that most people are not aware that exercise before and after a major surgery such as breast reconstruction has a significant impact on recovery.

In 2018, Breast Cancer Network Australia (BCNA) and Breast Research Australia, University of Wollongong, in conjunction with clinicians and people who have undergone breast reconstruction, developed a range of resources to assist physical recovery after breast reconstruction surgery.

The program, entitled Physical Preparation & Recovery After Breast Reconstruction, includes exercises for pre- and post-surgery developed by a physiotherapist, are demonstrated in real time and may be performed in your home, with the prior knowledge of and guidance from your treating team.

It is important to remember that there are different types of breast reconstruction surgeries, so it is best to work with your treating team to understand what exercises will be best suited to you.

It generally takes at least six weeks to achieve significant changes in muscle strength and flexibility. This period will take longer if you’ve had radiotherapy. If your surgery is sooner, experts advise to focus on preparing yourself emotionally and on making temporary adjustments to your home environment that will assist your recovery. These are explained in the preparing your home environment video.

Don't worry if you do not have time to do exercises before your surgery. Your treating team will give you exercises to do after your surgery to ensure your physical recovery.

Pre-surgery videos

We present here videos containing exercises that are intended for before your breast reconstruction surgery. 

Shoulders/upper trunk

This video presents a series of exercises to help prepare your shoulders and upper trunk for breast reconstruction surgery. It is intended for people having any type of breast reconstruction surgery.

Strengthening exercises can assist the surgery and help you recover faster:

• upper back
• pectoral (“pec”) muscles
• latissimus dorsi (“lat dorsi”) muscles (e.g. “lats”)
• rhomboid muscles.

You may also find these stretching exercises helpful in your preparation for surgery:

• pectoral major muscles (“pecs major”)
• pectoral minor muscles (“pecs minor”)
• latissimus dorsi (“lat dorsi”) muscles (e.g. “lats”)
• serratus muscle.

Trunk/torso

This video presents exercises that are designed to help strengthen your trunk (pelvis, hips, lower back and abdominal areas) before a tissue-based breast reconstruction surgery, which involves tissue like skin, fat and sometimes muscle from your trunk area being used to recreate your breast.

Read more about types of breast reconstruction, including tissue-based (or autologous) breast reconstruction.

These exercises can help you prepare for and recover from your breast reconstruction surgery:

• gluteal muscles (“glutes”) 
• abdominal muscles (“abs”)
• hip stretch
• squats.

Preparing your home environment

This video details how to become mobile as soon as possible after breast reconstruction surgery to assist recovery. It is intended for people having any type of breast reconstruction surgery and includes practical advice on preparing your home, best positions for sleeping and guidance on showering and dressing and other topics like:

• sleeping positions
• lying to sitting
• getting dressed
• getting toddlers dressed
• in the bathroom
• checking your wounds
• when to contact your treating teams
• in the kitchen
• in the laundry
• sitting to standing
• stairs
• planning ahead
• asking for help.

Post-surgery videos

Shoulders

These post-surgery exercises are designed for people who have had any type of breast reconstruction surgery. Both your breast reconstruction surgery and your drains can affect the muscle strength and flexibility of the muscles that move your shoulder, shoulder blade and upper trunk. It is important to perform these exercises to start moving again. It is a good idea to practice these exercises before your surgery.

This video covers the following exercises:

• shoulder rotations
• assisted shoulder raises
• one-armed backward rows.

Circulation

This video demonstrates a series of exercise designed to improve circulation and is intended for people who have had any type of breast reconstruction surgery. Healing after surgery requires good circulation of both blood and lymphatic fluid throughout your body, especially in your chest and arm. In the first weeks after surgery, when people are commonly not moving “normally”, these exercises will ensure you have sufficient circulation and lymphatic drainage to maximise healing and minimise any risk of lymphoedema. It is a good idea to practise these exercises before your surgery.

The following exercises are included in this video:

• deep breathing
• toe points/flexes (“calf pumping”)
• head side tilts
• head turns
• head nods
• shoulder shrugs
• modified breast strokes
• arm curls
• repeat breathing and calf pumping
• arm self-massage.

Podcast: Planning and recovery 

Associate Professor Deirdre McGhee and Jodi Steel, a Consumer Representative who has lived experience with reconstructive surgery, discuss how the right exercises and asking the right questions can make a big difference to your recovery.

Listen to the podcast: Episode 14: How to plan for and recover from breast reconstruction surgery.

Webcast: Preparing for the best possible recovery

Associate Professor Deirdre McGhee is joined by plastic surgeon Dr Dean Trotter, breast care nurse Monique Baldacchino and lymphoedema specialist Louise Koelmeyer to discuss the benefits of physical preparation and recovery from reconstructive surgery and look at ways to help remove barriers.

Extra resources to help

• Find a breast surgeon on BreastsurgANZ’s online tool.
• Visit the Reclaim Your Curves website, which provides some helpful tips on managing your experience.
• Access Cancer Council resources to help you with emotional and practical issues of living with cancer, including impacts of exercise.
• Learn more about YWCA Australia’s free Encore breast cancer exercise program.
• Learn about the EX-MED Cancer Program.