Double Incision Mastectomy Care Instructions

At this stage, you may feel a pop or something giving way under your chest. This is just the internal stitches we used in your operation starting to break down and give out.

It’s not dangerous but the feeling can be unexpected.

There are two types of scar massage we would like you to do. You don’t have to both every day, but you can. At the very least, do one of them. You don’t have to keep track of which one you’ve done more.

Circular massage:

The goal of this type of massage is to keep the scar from sticking to your chest muscles. Put your hand or fingers on the scar and move the skin around so that you know that section of the scar can move freely over your chest muscles. Do this for the entire length of your scar. It should take you between one to five minutes to do. You should do this with dry fingers/hands.

Linear massage:

The goal of this type of massage is to encourage your scars to stay flat. It also helps to keep your scar from getting hypersensitive. Use some form of lubrication on your fingers. Usually, a bland hand or body lotion works great.

Some people will do this in the shower with soap. Initially, you will only touch your scar lightly because it may cause an “icky” feeling when you try to push deeper. Over time, that feeling will get less and less. Your goal is to massage ALONG the direction of your scar (not across it) at a pressure that makes you feel just a little bit “icky”.

Try to find a rib under your skin to push against so that you have a firm massage platform. Move your finger along the entire length of your scar, back and forth for about a minute on each side. The lubrication keeps you from rubbing your skin raw.

At this stage, you should start to increase your shoulder range of motion. Don’t try to do it all right away. But your goal should be to have full range of motion in your shoulders similar to what you had before the operation by the end of month 2 after your surgery. If you’re NOT on track for this, please let us know so we can coach you through this.

Between months 1 and 2, we recommend having a lifting restriction of 15 pounds. This doesn’t mean you have to be fully sedentary though! You can still do a LOT of other physical activity, including going to the gym (if that’s something you used to do, or want to start doing). Leg workouts, particularly with machines can be a great opportunity. Mostly, you want to avoid exercises where your scars are stretching out.

After month three, you are fully cleared for all activities. If you have specific questions about exercises, please ask Dr. Chung for substitutions or adaptations.

Sometimes, your body will eject or “spit” your sutures from your skin. This usually looks like a pimple over your incision line that eventually bursts and leaves a small hole behind.

You may see some thread or fishing line sticking out. If you do, trim the part with a clean pair of scissors like you would trim hair at the level of your skin.

While this area is open, keep it covered with a bit of vaseline or polysporin and a bandaid. Let us know if the hole gets bigger.

At this stage you shouldn’t need any more dressings, unless you develop stitch spitting.

You should also stop wearing the binder. If you want a bit of compression because you still feel swollen, then use a compression shirt like the Underarmour compression line, or the Nike Combat line.

You may also develop electrical shock or zinging sensations in your chest, which is a sign that your nerves are regenerating.

Signs of a fluid collection include gradual swelling of one area of your chest over the course of a day or two, and the feeling that fluid is sloshing around under your skin. If you tap the fluid collection, you’ll notice a ripple effect. This is not an emergency, but please let us know about it by email or phone as we might need to see you sooner to drain it.

If you have any problems after surgery, please call the office during the day. Contact information is included in your post-op instruction documents.