Recovery when you stay flat after mastectomy

After surgery with aesthetic flat closure, you will stay in hospital for a few days. Recovery when you stay flat is generally easier than after breast reconstruction. 

What to expect in hospital

Wound care

Immediately after surgery you will: 

• have a dressing over the wound
• often have a drain tube in place for a few days. 

The drain is there to take away any fluid ('seroma’) that builds up under the skin near the wound. Sometimes the fluid continues to build up, meaning that the drains will stay in for longer. Your breast surgeon or nurse usually tells you they'll remove the drain when the fluid reduces to a certain number of millilitres each day. 

Pain relief and comfort

You’ll have medication to relieve pain. Pain levels can be different from person to person.

Movement and exercise

The physio will usually start with exercises to move your arms and shoulders. It's important to prevent lymphoedema and get back any strength you have lost.

Your surgeon may also tell you how and when you can safely increase activity. 

Exercises before and after breast reconstruction has exercise videos developed by a physiotherapist.

Advice from your treating team

Before you leave hospital, your treating team will give you instructions about:

• dressings or wound care including information about stitches
• what exercises you can and can’t do
• your next appointment.

The first few weeks at home

Wounds, stitches and scars

The surgical area area can take up to 3 months to settle. You may have some issues with how the breast area looks or feels, such as:

• pockets of fat or tissue where the scar ends under the arm (often referred to as ‘dog ears’)
• bulging at the end of the wound or scar (‘suture’) line.

Talk to your breast or plastic surgeon if you are not happy with anything after you have healed. They may be able to do minor surgery (a ‘revision’) to improve the appearance.

Tightness or tingling

Some people feel tightness, tingling and numbness or shooting pain across their chest from the surgery. The feeling is sometimes referred to as ‘iron bra’ syndrome. It can last for months or even years after surgery.

Iron bra happens when nerves are damaged and scar tissue forms.

It is important to raise any concerns with your treating team. They can refer you to a physiotherapist for massage and exercises. These can be very helpful to:

• improve how much you can move (‘range of motion’)
• loosen the tightness
• reduce discomfort from scar tissue.

For many people, the tightness reduces over time. Others adjust to some feeling of tightness across their chest.

Posture and strength

Staying flat after a double (‘bilateral’) mastectomy means your body is symmetrical so you should not have any structural ('posture') problems.

After a single mastectomy, you will need some time to get used to the weight change on your chest. This can affect your posture but a physiotherapist can give you advice and exercises to:

• keep or improve your strength
• correct any issues with your posture. 

Emotional wellbeing

You may experience a range of emotions after surgery. Support is available if you need it.

• Talk to your breast care nurse or doctors about how you are feeling.
• Connect with others who have had breast reconstruction surgery in our Online Network.
• Contact our Helpline on 1800 500 258.
• See a clinical psychologist.

Other things you can do when staying flat  

Wear a breast prosthesis 

An external breast prosthesis, which you wear in your bra. This can be made from:

• fabric to copy the shape of your breast or breasts
• silicone to try and match the shape and weight of your breast or breasts.

Choose clothes that give you confidence

After surgery, the most important thing is to wear clothes you feel good in. Choose comfortable clothes in the colours, patterns and styles you like.

Some people need time to get used to their new appearance when they stay flat. Our members have shared tips to help while you are becoming comfortable with your new shape.

• fabrics with large busy, patterns – try florals and paisleys rather than small designs
• dark colours can make it less obvious there is no shadow underneath the flat part of your chest 
• look for tops in styles such as halter neck, off-shoulder or with ruffles and ties.  
• wear shirts with breast pockets
• choose styles that emphasise other parts of your body 
• wear a jacket or jumper over a fitted t-shirt
• cover your chest with a scarf or shawl.