Recovery after implant breast reconstruction: stage by stage

Two NHS trust leaflets inform this page, and they differ in places, as units have their own protocols. Whether you have a one-stage implant or a two-stage expander, whether mesh is used and whether radiotherapy is planned all change the timetable, so your plastic surgery team's written plan takes priority.

The picture is one of slow, staged progress. The first weeks are about the wound, the drain and protecting the implant pocket. The middle weeks bring back driving and work, and the months after bring swelling resolution, assessment of symmetry and possible further procedures. The operation is described in the guide to implant reconstruction.

You will have drains from the operation. Plymouth says you may go home with one, taught how to look after it, and reviewed at the dressing appointment about one week later. In hospital, the Cambridge leaflet says drains stay in initially and are removed as the output falls.

Swelling is expected and settles gradually. The reconstructed breast will feel heavier and colder than your natural breast, according to Plymouth, with reduced skin sensation that may improve slightly but is unlikely to return to normal. Cambridge says reconstructed breasts are usually numb to a degree.

Watch the wound for redness, heat, increasing pain or discharge, and for sudden swelling or a tight, bruised breast, which can mean bleeding or fluid around the implant and needs prompt assessment.

Plymouth advises avoiding driving for up to four weeks and taking at least four to six weeks off work. Driving legally depends on being able to control the car, including an emergency stop, and GOV.UK advises asking your doctor if you are unsure and telling the DVLA if you cannot drive three months after an operation. Your insurer's conditions matter too.

A supportive bra, without underwiring in the Cambridge leaflet, is worn day and night for at least six weeks at Plymouth, and for three months in Cambridge. Cambridge notes that most patients have four to eight weeks before normal activities, and full recovery can stretch to six months or more for larger operations.

• Keep arm movement below 90 degrees at first, as Plymouth advises.

• Ask before returning to lifting children or heavy shopping.

• Plan help at home for the first few weeks.

Plymouth says no strenuous activity for six weeks or more. Walking is encouraged from early on, which also lowers the risk of clots. Upper-body exercise, running and swimming should wait for your team's approval, and the leaflets give no firm dates beyond the six-week point, so ask at your hospital review.

Plymouth describes review of the wound at one week, a hospital review at three to four weeks and oncoplastic clinic visits for up to a year. If you have an expander, fills are done at clinic visits. Cambridge says the reconstruction takes three to six months to settle before adjustments are considered, and describes nipple reconstruction with a graft or a prosthetic nipple, followed by tattooing to match colour, after three to six months.

If radiotherapy is planned, Plymouth warns that complications can delay it, and says capsular contracture is more likely after radiotherapy. Your team will coordinate the timing.

Contact your breast care nurse or plastic surgery team the same day for fever, a hot, red or increasingly painful breast, a wound that opens, or a sudden change in the size or shape of the breast. Use NHS 111 out of hours, and call 999 for chest pain, sudden breathlessness or collapse, which can signal a clot on the lung.