Understand · Surgery
The short answer on what happens during a mastectomy
A mastectomy is surgery to remove the breast. It usually takes one to two hours under general anesthesia, and most people go home the same day or the next. You'll probably go home with one or more drains, a lot of numbness, and some limits on lifting and reaching. Most people feel close to themselves again in three to eight weeks.
What to know about what happens during a mastectomy
- There's more than one kind. Some keep the skin, some keep the nipple, some also remove lymph nodes from the armpit.
- It isn't always the "stronger" choice. For many early breast cancers, a lumpectomy plus radiation works as well as a mastectomy.
- Drains are normal. They're thin tubes that carry fluid away, and they usually come out within one to three weeks.
- Numbness is expected. The chest, and sometimes the upper arm, can feel numb or strange for a long time.
- Some symptoms mean call now. A fever, a hot red wound or a swollen arm are worth a phone call the same day.
What are the different kinds of mastectomy?
The word covers several different operations. Which one you have depends on the cancer, your body, your genetics, whether you want reconstruction and what you want.
Simple (or total) mastectomy. The surgeon removes the breast tissue, the nipple and areola, and some skin, through one oval-shaped cut. The chest muscle stays.
Skin-sparing mastectomy. Most of the breast skin is kept, and the surgeon works through a smaller opening around the nipple. It's usually done when reconstruction happens in the same surgery, so the skin can cover the new breast.
Nipple-sparing mastectomy. The skin and the nipple are both kept, often with the cut hidden in the fold under the breast. It isn't right for every cancer, especially ones close to the nipple.
Modified radical mastectomy. A total mastectomy plus removal of lymph nodes from the armpit. Removing nodes is what raises the risk of arm swelling later, called lymphedema.
Radical mastectomy. This older surgery also removed the chest muscles. It's now rare.
How do you choose between a mastectomy and a lumpectomy?
A lumpectomy removes the tumor and a margin of healthy tissue and keeps the breast. Large, long-running trials found that, for many women with early breast cancer, a lumpectomy followed by radiation leads to the same overall survival as a mastectomy.
So a mastectomy is a choice, and sometimes a recommendation. Common reasons include a tumor that's large compared with the breast, cancer in more than one area of the breast, not being able to have radiation, an inherited gene change that raises risk, and simply preferring it. All of these are worth talking through with your surgeon, and many women get a second opinion.
What happens on the day of a mastectomy?
You'll be asleep under general anesthesia. Many teams also give a nerve block, an injection that numbs the chest for hours afterward, and antibiotics before the surgery starts.
The surgeon makes the cut, lifts the breast tissue off the chest muscle along with the thin layer covering the muscle, and sends it to the lab. Before closing, they usually place one or more drains. The stitches are often under the skin and dissolve on their own. According to MD Anderson, the operation itself usually takes one to two hours. Reconstruction in the same surgery adds time.
When do you go home after a mastectomy?
Many people go home the same day or after one night. If you have reconstruction using tissue from your belly (a DIEP flap), the stay is usually closer to four or five days.
You may go home in a surgical bra or a compression wrap, and your team may ask you to keep the arm on that side fairly still for the first day or two. After that, they'll usually want you moving it gently and walking around the house.
Why do you have drains after a mastectomy?
A drain is a thin tube that comes out through a small opening in your skin and ends in a soft plastic bulb. It pulls away fluid that would otherwise collect under the skin. You'll be shown how to empty it and write down how much comes out each day.
Drains come out once the amount gets low. Teams use slightly different numbers, often somewhere around 20 to 30 milliliters a day. That usually happens within one to three weeks. Taking one out is quick and usually done in the office.
A lanyard or a camisole with pockets keeps the bulbs from pulling. Our surgery checklist has the small things people say helped.
What are the first few weeks after a mastectomy like?
Numbness is normal. The skin of the chest may feel numb, tingly or tight. If lymph nodes were removed, the inside and back of the upper arm may too. Some feeling may come back slowly over months, and some may not.
Move, but carefully. Do the arm and shoulder exercises you've been shown, and only those. Hold off on heavy lifting and reaching overhead until your team says it's fine.
Driving waits until you're off prescription pain medicine and can turn the wheel comfortably.
Showers are usually fine once your team clears you. Baths, pools and hot tubs wait until the incisions have healed and you're told it's OK.
Recovery takes time. Most people need three to eight weeks to feel close to normal, longer after reconstruction. Feeling wiped out, or low, along the way is common.
What complications can happen after a mastectomy?
Most mastectomies heal without trouble. These are the problems teams watch for.
Fluid build-up (seroma). The most common one. It feels like a soft swelling under the skin. It usually goes away on its own, and sometimes it's drained with a needle in the office.
Infection. StatPearls puts it at about 5 to 8 in 100 people. Most are treated with antibiotic pills.
Bleeding. Up to about 5 in 100. About 2 in 100 need to go back to the operating room, usually in the first day.
Skin or nipple damage. Sometimes part of the skin doesn't get enough blood and dies back. It's more likely after skin-sparing or nipple-sparing surgery with implants.
Lasting pain. Pain that continues past about two months is real, it has a name, and there are treatments for it. Mention it.
Lymphedema. Swelling in the arm, which can show up months or years later. The risk comes mostly from lymph node surgery and radiation, not from removing the breast.
When to call your care team after a mastectomy
- A temperature of 101.5°F (38.6°C) or higher
- Swelling in your arm, or new swelling in the chest
- A wound that's bleeding, red, warm, or leaking thick or cloudy fluid
- Pain your medicine isn't helping
- Trouble breathing, or a cough that won't go away
- Trouble eating or drinking
Get the after-hours number before you leave the hospital. If it feels like an emergency, call 911.
Questions to bring to your surgeon before a mastectomy
- Which kind of mastectomy are you recommending, and why that one?
- Would a lumpectomy with radiation be an option for me?
- Will you remove any lymph nodes? What does that mean for lymphedema?
- Can I meet with a plastic surgeon about reconstruction, or about going flat, before we decide?
- How long will I be in the hospital, and how many drains should I expect?
- When can I shower, drive, lift my kids or go back to work?
- Which arm exercises should I do, and should I see a physical therapist?
- Who do I call at night or on the weekend?
From the Toolkit
- The Surgery Recovery Checklist Interactive checklist
- Questions for your surgeon Printable
- Everything for surgery in The Toolkit Toolkit
Sources: Puckett Y, Menon G, Goethals A, Rose JA. Mastectomy. StatPearls, National Library of Medicine, updated January 2026. MedlinePlus, Mastectomy – discharge. MD Anderson Cancer Center, mastectomy recovery. This article is general information, written in Babette's own words, and is not a substitute for advice from your care team. Illustrations by Babette.
