Many women who have had a breast removed because of cancer now have reconstructive surgery. As more and more reconstructive operations have been carried out, techniques and implants have improved. Nowadays the complications are much less than they used to be. However, there are still some risks connected with any type of surgery and a few connected particularly with breast reconstruction. It is best to be prepared for these possible problems to help you cope with them if they occur.

Problems associated with any type of surgery, and which may occur after breast reconstruction, include: bleeding, problems associated with having a general anaesthetic, collection of fluid under the wound (seroma), pain and discomfort, and excessive scar tissue (keloid scarring).

After any type of operation you are likely to have some pain and discomfort. Women vary greatly in how much pain they have after breast reconstruction. Many women will need painkillers for a few weeks or so after surgery. Make sure you ask for pain-relieving drugs if you need them. Research suggests that women with good pain relief recover more quickly after surgery.

You may find it uncomfortable to move the arm on the side where surgery has been carried out. This is particularly likely if you have reconstruction at the same time as surgery for breast cancer and have had some lymph glands removed from your armpit. It is important that you continue using your arm and carry out the exercises suggested by your physiotherapist.

This is a complication of any type of surgery. If it occurs, antibiotics can usually get rid of the infection. In a very few cases, infection may continue despite antibiotics. If an implant has been used, it may have to be removed in order to treat the infection successfully. In this situation, doctors generally advise waiting for a few months before having another implant inserted, or they may recommend that you have a different type of reconstruction.

Check your wound (incision line) regularly once you are back at home after surgery. Tell your breast care nurse or doctor immediately if you have any of the following:

• Increased redness or change in colour over the breast, around the scar area, or both
• Discharge (fluid being released) from the wound
• A fever, with your temperature going above 38C (100.5F).

After breast reconstruction surgery, you will have drainage tubes into the wound to drain away any fluid that may collect. These are long, thin, plastic tubes attached to vacuum drainage bottles. They are usually removed several days after your operation. However, after the removal of the drains, a collection of fluid (a seroma), or blood (a haematoma), sometimes develops under the wound. The body may absorb these if the amount of fluid or blood is small, but if they are large they may need to be removed by a surgeon or nurse, using a small needle and syringe.

As the wound heals it may itch. This may be very uncomfortable, but it is important not to scratch the healing skin. The itching will reduce as the wound heals.

After immediate breast reconstruction (carried out at the same time as breast cancer surgery) you may feel tingling sensations down your arm on the side of the new breast. You may also have some numbness in the upper and inner arm. This is an effect of the surgery on the nerves in that area. It may gradually fade over time but is often permanent.

If your reconstruction involved taking tissue from your abdomen, you will find bending and stretching uncomfortable for a few weeks after surgery. Supporting your wound with your hands when you bend should help.