Your surgeon will perform mastectomy using general anesthesia. General anesthesia is a combination of intravenous (IV) medications and gases that put you in a deep sleep. You are unaware of the procedure and will not feel any pain. 

You may also have a peripheral nerve block infusion in addition to general anesthesia. A peripheral nerve block infusion is an injection or continuous drip of liquid anesthetic. The anesthetic flows through a tiny tube inserted near your surgical site to control pain during and after surgery.

What to expect the day of your mastectomy

The day of your surgery, you can expect to:

  • Talk with a preoperative nurse. The nurse will perform an exam and ensure that all needed tests are in order. The nurse can also answer questions and will make sure you understand and sign the surgical consent form.
  • Remove all clothing and jewelry and dress in a hospital gown. It is a good idea to leave all jewelry and valuables at home or with a family member. Your care team will give you blankets for modesty and warmth.
  • Talk with the anesthesiologist or nurse anesthetist about your medical history and the type of anesthesia you will receive.
  • A surgical team member will start an IV. 
  • The anesthesiologist or nurse anesthetist will start your anesthesia.
  • A tube may be placed in your windpipe to protect and control breathing during general anesthesia. You will not feel or remember this or the surgery as they happen.
  • The surgical team will monitor your vital signs and other critical body functions. This occurs throughout the procedure and your recovery until you are alert, breathing effectively, and your vital signs are stable.

What are the risks and potential complications of mastectomy?

As with all surgeries, a mastectomy involves risks and possible complications. Complications may become serious and life threatening in some cases. Complications can develop during surgery or recovery.

General risks of surgery 

The general risks of surgery include: 

  • Anesthesia reaction, such as an allergic reaction and problems with breathing 
  • Bleeding, which can lead to shock
  • Blood clot, in particular a deep vein thrombosis that develops in the leg or pelvis. A blood clot can travel to your lungs, heart or brain and cause a pulmonary embolism, heart attack, or stroke.
  • Infection and septicemia, which is the spread of a local infection to the blood

Potential complications of mastectomy

Complications of a mastectomy include:

  • Damage to nearby organs, such as the lymph nodes and lungs
  • Fluid buildup under the incision scar, which could be a hematoma (blood) or a seroma (clear fluid) 
  • Hardening of the incision scar 
  • Lymphedema, swelling of the arm on the side of the removed lymph nodes 
  • Numbness, tenderness, or sensitivity of the surgery site due to cut nerves 
  • Weakness of the arm muscles due to nerve damage
  • Opening of the external incision
  • Shoulder pain or soreness on the side of the removed breast (occurring mostly with radical mastectomy)

Reducing your risk of complications

You can reduce the risk of certain complications by following your treatment plan and:

  • Following activity, dietary and lifestyle restrictions and recommendations before surgery and during recovery. This includes physical therapy, occupational therapy and other rehabilitation treatments.
  • Informing your doctor if you are nursing or there is any possibility of pregnancy
  • Notifying your doctor immediately of any concerns, such as bleeding, fever, increase in pain, or wound redness, swelling or drainage 
  • Taking your medications exactly as directed 
  • Telling all members of your care team if you have any allergies

How do I prepare for my mastectomy?

You are an important member of your own healthcare team. The steps you take before surgery can improve your comfort and outcome.

You can prepare for a mastectomy by:

  • Answering all questions about your medical history and medications. This includes prescriptions, over-the-counter drugs, herbal treatments, and vitamins. It is a good idea to carry a current list of your medical conditions, medications, and allergies at all times.
  • Getting preoperative testing as directed. Testing will vary depending on your age, health, and specific procedure. Preoperative testing may include a mammogram, breast biopsy, chest X-ray, EKG (electrocardiogram), blood tests, and other tests as needed.
  • Losing excess weight before the surgery through a healthy diet and exercise plan
  • Not eating or drinking before surgery as directed. Your surgery may be cancelled if you eat or drink too close to the start of surgery because you can choke on stomach contents during anesthesia.
  • Stopping smoking as soon as possible. Even quitting for just a few days can be beneficial and help the healing process.
  • Taking or stopping medications exactly as directed. This may include not taking aspirin, ibuprofen (Advil, Motrin), and blood thinners.