Getting Through a Mastectomy, Step by Step

Written by Rachel Reiff Ellis
Medically Reviewed by Traci C. Johnson, MD on September 11, 2025
8 min read

Whether you’re having a mastectomy to remove cancer from your body or prevent it in the first place, you likely have many questions about the process. Your doctor can tell you about your specific surgery, but it also helps to hear advice and encouragement from someone who’s been through it.

A few years ago, Melissa Grant, 45, was diagnosed with a genetic mutation that increased her risk of breast cancer. After a year of screenings — which were disruptive and stressful — she was ready to make a different choice for her body.

“I just felt like I was a ticking time bomb,” says Grant, whose mother was diagnosed with breast cancer years ago. “It was rough worrying each time what they might find. I didn’t want to keep doing that.”

So, she decided to have a prophylactic (preventive) mastectomy.

More than 100,000 people in the U.S. have mastectomies each year. That can mean removing one breast or both. You may keep or remove your nipples, and you may opt for reconstructive surgery right away, later, or not at all. 

“The exact type of surgery you have depends on your diagnosis, risk factors, and personal choices,” says Meghan Williams, PA, who works at Surgical Specialists of Atlanta. 

These practical tips can help you ready your mind and spirit before your mastectomy.

Your doctor will go over the instructions you need to follow to prepare for your specific surgery itself, such as:

  • Which medicines or supplements you need to stop taking and when to stop them 
  • When to stop eating and drinking before surgery (typically midnight the night before)
  • What time to get to the hospital

They’ll also ask who will drive you home from surgery once you’re discharged from the hospital.

In the weeks leading up to your surgery, you can take many practical steps at home to make recovery easier. Grant suggests enlisting the help of your community to support your post-surgery home life.

“I had friends set up a meal train, and that was amazing, especially with kids,” she says. “Another friend collected donations so we could pay for house cleaning. I couldn’t lift things for weeks, so even small chores felt impossible. Having meals, cleaning help, and childcare support meant I could just focus on healing.”

Other ways to prepare include:

  • Move items you use a lot (especially in your kitchen or bathroom) to waist height so you can avoid reaching and lifting.
  • Set up a recovery area in your house with supplies like water, snacks, a TV remote, a blanket, pillows, and chargers within reach.
  • Stock up on comfy clothes with button or zipper fronts so you don’t have to lift your arms to get them on and off.

One important way to get ready — if you have the time and ability — is to exercise. Physical preparation can make your recovery easier. Grant says she approached it like training for an athletic event.

Williams agrees that even small steps can help. “We encourage patients to stay active, do gentle strength and mobility exercises, and eat well leading up to surgery,” Williams says. “It makes a difference in healing.”

Packing for the hospital 

Although you’ll have specific instructions on what to wear (or not wear) for your surgery, afterward, you’ll want to have some comforts from home as you recover in the hospital. Be sure to bring:

  • Toiletries (toothbrush, hairbrush, glasses/contacts) 
  • Slippers and extra socks
  • Tablet or smartphone
  • Bathrobe
  • Extra pillows
  • Earplugs if you’re sensitive to noise when you sleep

Grant says if she could go back in time, she would have brought better pillows to use in her hospital bed.

“The most pain I had afterward was from my back and shoulders being cramped, not from the surgery itself,” she says.

Although each hospital has its own check-in process, they all typically follow a pattern, says Williams. 

You go through the registration check-in process, then head to the pre-op area where you meet the nurse, she says.

After that, you’ll likely:

  • Change into a gown.
  • Get vital signs.
  • Meet the anesthesiologist.
  • See your surgeon again.

Some medical teams offer medications to help you relax once your paperwork is done, says Williams. 

How long your surgery takes depends on several factors, including:

  • Type of mastectomy
  • Whether reconstruction is included
  • Breast size
  • Whether your nipples are being kept

Grant remembers being nervous about the potential length of surgery and what that would mean for her body. 

“They told me it would be an 8-12 hour surgery, and I kept thinking, ‘I’m going to be under anesthesia for what amounts to an entire workday,’” she says. “That just completely wigged me out. But it was a much better experience than I thought it would be.”

Williams says some people go home the same day of their surgery, especially if they don’t have reconstruction. Others may stay a night or two for monitoring. Once you’re home, you’ll take on the tasks of resting and following post-op instructions for the best chance at healing.

Dealing with drains

A surgical drain is a temporary tube your surgeon puts in your chest to help collect excess fluid. You may have drains for one to two weeks, during which time you’ll need to empty them and care for the area and keep it clean. Williams says that for many people, drains are one of the hardest parts of recovery.

“Drains can feel overwhelming, but really, it’s just a suction bulb. You empty the bulb a few times a day and keep track of the fluid,” she says. Having a notebook or notes on your phone is handy for recording your output to tell your doctor.

Grant admits that drains were one of her least favorite parts of the recovery process.

“The drains are a real pain in the neck,” says Grant. “You wouldn't think it's a big deal, but there’s something about having an object hanging around your neck all the time. After a while, you just can't stand it.”

Her advice: Wear pajamas with an inside pocket — or a mesh belt when you’re in the shower — that can hold the drain so that you don’t feel the weight of it around your neck.

Home recovery is different for everyone, but there are some common milestones:

First week

Expect to be managing drains, dealing with fatigue, and taking pain medication as needed. Grant says she was even more tired than she thought she’d be.

Two weeks

By this point, your drains are typically gone, and you can do gentle movement as your doctor recommends. Gentle stretching and movement are key, says Williams.

“We don’t want women to baby their arms too much,” says Williams. “Gentle range-of-motion exercises help prevent stiffness.”

Four to six weeks

By this time, most people can return to light work and normal activity. Grant says she found physical therapy (PT) to be vital to her recovery and wishes it was a standard of care for everyone who has a mastectomy.

“My core felt so different after surgery,” she says. “PT helped me figure out how to move again.”

Two to three months

Strength and energy gradually return, and you may start to have “normal” days. Grant, who teaches piano, says she expected to be out of work for two months, but went back sooner.

“I was starting to go stir crazy,” she says. “But I have the privilege of working from home and in small bits, so I could schedule two students and then not work the rest of the day, which made my recovery and getting back to work a lot easier.”

Emotional Recovery

While physical healing is measurable, emotional recovery may be more unpredictable. For many people, losing breasts means losing part of their identity. But everyone’s experience is different.

“Some women feel very attached to their breasts, and for them, it’s harder emotionally,” says Williams. “Others just want the cancer gone or the risk lowered, and they’re more focused on the medical side. We talk through both.”

Reconstruction has its own obstacles. Your clothes may fit the same, and your silhouette may remain, but other losses that affect your relationships and self-image remain.

“Even though I was fortunate to keep my skin and nipples, I lost sensation,” says Grant. “A year and a half later, I still don’t have feeling in my nipple. It’s really bizarre, and it does impact intimacy. You have to be honest with your partner about that.”

Will I wake up in pain?

Most people don’t at first, because of anesthesia and long-acting local medications. Usually, you can manage pain with over-the-counter medicine.

How long will I have drains?

Typically, for one to two weeks, depending on how much fluid is collecting.

When can I go back to work?

It varies. You may be able to return after two to four weeks, especially if your job isn’t physical. But if your job involves being on your feet or if you had reconstruction surgery, it may take longer — several more weeks — before you're ready to return. 

Will I lose all feeling in my chest?

It’s common to lose feeling after a mastectomy, especially in the nipple and chest area. Sometimes, it improves over time, but many people have permanent changes.

Do I need physical therapy?

It’s not always required, but many women find it very helpful for regaining movement and strength.

How long until I feel normal?

Everyone’s journey is different. Physically, you may recover in a few months. Emotionally, it may take longer to adjust to the changes.