Everyone is in a hurry to heal after surgery, but at what point is your body actually “healed?” Many people consider their wounds healed within 12 weeks. After this period, there is less concern for infection or re-opening of the wound, so you’re out of the woods. However, the healing process continues, and it’s a discussion many doctors don’t have with their patients.
Think back to when you were a kid…
As a child, you may have experienced cuts or scrapes that resulted in pink scars. Over time, these scars may have transformed into uneven white spots. As an adult, if you go back to look at where you had a skinned knee or elbow, the scar will be nearly invisible.
Many studies focus on simple cuts like these, but breast surgery is a complex process that occurs internally where things are less visible.
Patients often ask when the healing process will end, but the body doesn’t work that way. Our body constantly changes and remodels our connective tissues, especially tough tissues that have experienced trauma.
What happens when tissue is injured?
When injured, tissue usually seals bleeding vessels and sticks together in the first two to 48 hours. It then knits together, and collagen builds over the next two days to six weeks.
Collagen tightens as healing fibers called myofibroblasts pull together, making the tissue hard and lumpy within six weeks to six months. It may be two years before this tissue fully softens. Over the next few years, the body will constantly dissolve and rebuild the structural elements at the healing site.
Breast-Conserving Surgery
After surgery, especially lumpectomy or oncoplastic surgery, your breast tissue may become firm and uneven at about two to six months after the procedure, regardless of your breast size. It should soften and can take as long as two years to fully remodel depending on the type of breast cancer.
Breast Biopsies
If you’ve had a biopsy, you may feel a lump for one to two weeks afterwards. This is completely normal and part of the healing process (nothing is growing inside of you!).
Mastectomy
After mastectomy surgery, you may feel smaller M&M-like nodules along the surface of your reconstruction for six weeks to three months. These should melt away with time.
Fat Grafting
After fat grafting, the area is typically swollen (which goes down in two to three weeks). In time, you will feel hard lumps at about six weeks to six months after the procedure. These lumps can take 1-2 years to melt away. Some of them can become permanent areas of hard fat necrosis. These usually get smaller and harder with time and then stabilize.
Possible side effects during healing:
· Itching
· Shooting/zinger-type pains as nerves wake up
· Suture splitting
· Seromas
“When do we need to worry about a lump?”
The chances of having recurrence after lumpectomy or mastectomy within the first one to two years are incredibly low. In a study using MRI imaging tests to check for recurrent breast cancer, no patients had a recurrence in the first three years. If there is any remaining illness, it usually takes time for it to return and become noticeable or detectable.
Keeping that in mind, once everything stabilizes over the first one to two years, you should not expect to feel a new hard lump. Scar tissue doesn’t typically just build and pop-up years after surgery once it has otherwise healed.
Typical scar tissue is hard and thick initially and then becomes softer or smaller and less noticeable. So, if you feel a new, hard, painless lump, especially near your original area of disease or on the same side as the breast that had cancer years after your initial surgery, once everything has essentially healed, consider it a red flag. That would be something that would need investigation with imaging and/or tissue sampling for different treatment options.
Trust the Breast Experts
Remaining patient during the healing process is important. You will get better, but how quickly that will happen is different for every individual and will depend on the part of the body and amount of traumatized tissue.
If you are concerned at any moment during your healing process, our team of breast health experts are here to answer your questions. Call Bedford Breast Center at (310) 278-8590 or contact us using the online form to schedule an appointment.
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