Severe pain immediately after waking from right masectomy surgery.

Hi @lilc - sorry you’re having so much pain!!!! My heart goes out to you.

I didn’t go direct to implants. My surgeon did create a “pocket” from cadaver skin that would graft into the front of my breasts… and tissue expanders. Unfortunately I do not know if the pectoral fascia was removed.

I did wake up every day for about three weeks and groggily think what has happened? Because of the pain and discomfort.

My advice would be to contact your surgeon’s office and describe your pain in detail - and ask 1) if this is expected and 2) how long does this recovery usually take.

Without a doubt, the first three weeks are tough, particularly if you have drains. Hopefully you have some pain meds to help.

Also, I would recommend following their instructions precisely in terms of what they said about restricting movement or lifting. I was over active initially and it creates more pain.

Wishing you healing and pain relief.

@colely @rach1009 @boathouse @zolamiller7
Hello ladies, I am new here... joined due to the conversation on post mastectomy pain. I truly did not expect this much! I was told most women feel numb /completely numb and some pain. My chest feels like it has the worst sunburn imaginable. There is a deep aching beneath the implants (my surgeon went direct to implant instead of expanders).

I am trying to figure out if this is because they removed my pectoral fascia. My understanding is about half of surgeons remove it while the other half keep it depending upon location of tumor. My tumor was nowhere near my pectoral fascia and had I known it would be removed, I would have signed any waiver to keep it. My background is health education and I was a former personal trainer. The fascia is rich with nerves, particularly proprioceptive nerves. I understand scar tissue will eventually form, but it will never be as flexible and will lack the nerves the fascia had contained.

My question to those ladies experiencing bad pain (please specify short-term or long-term depending on how far out you are from surgery)... can you please check your surgical report or ask your surgeon if they removed the pectoral fascia. Just within the past 5 years there is a movement for more surgeons to keep the fascia as long as it will not be unsafe to do so with respect to the tumor location. They are realizing it helps with pain and cosmetic outcomes and actually results in the less blood loss and shorter operative time too.

So far, the women I have spoken with who are doing the best post surgery (both short term and long term) had kept their pectoral fascia.

Thank you so much for looking into this!

Hello. You have two major issues causing your pain, fascia removal and implants. You didn't state that you had any lymph nodes removed for testing. That would be a third cause of pain. I can only speak to the fascia removal. This needs to be put in caps: I WAS NOT TOLD ABOUT FASCIA REMOVAL, SO I WAS NOT FULLY INFORMED. THEREFORE, I DID NOT GIVE INFORMED CONSENT! And it is a travesty. Unfortunately since 2020, I had a rare occurrence of a new cancer in my left breast in 2024, and had to have another mastectomy. I asked if my type of cancer tumor and position in my breast would allow me, safely to keep my fascia. The NEW SURGEON said yes. The surgery was night and day different. I have more tissue; the skin isn't glued down- looking in places. I had pin sticking, itching, knife stabbing, water-dripping feelings for 6 months. I had chest muscle spasms for a year off and on. As for your other situation, you need to read about symptoms after implant surgery. I know some women have an auto- immune reaction and can't tolerate them even after healing. You can read about that under the title Breast Implant Illness. I personally know women who had this without a mastectomy first. Ofcourse, first you need to get good information online and then have a long discussion with the plastic surgeon.

Hi @lilc - sorry you’re having so much pain!!!! My heart goes out to you.

I didn’t go direct to implants. My surgeon did create a “pocket” from cadaver skin that would graft into the front of my breasts… and tissue expanders. Unfortunately I do not know if the pectoral fascia was removed.

I did wake up every day for about three weeks and groggily think what has happened? Because of the pain and discomfort.

My advice would be to contact your surgeon’s office and describe your pain in detail - and ask 1) if this is expected and 2) how long does this recovery usually take.

Without a doubt, the first three weeks are tough, particularly if you have drains. Hopefully you have some pain meds to help.

Also, I would recommend following their instructions precisely in terms of what they said about restricting movement or lifting. I was over active initially and it creates more pain.

Wishing you healing and pain relief.

@susan7656 thank you for your reply. I also had the cadaver tissue pockets placed. My pain and tightness is insane. Really far worse in my opinion than what I am hearing from some other women. I know we are all different, but I am seeing a correlation between keeping/removing that fascia. If it only takes a few weeks to feel better, I would be over joyed.

But I know my body pretty well... hoping and praying this is not a long haul type of pain/disability. If there is any way you can check your surgeon's report or ask for me, I would be so grateful! It is helpful to know what I am in for because I had plans for moving and getting back into my career this year, but it looks like that all may need to get put on hold.

Hi @lilc - I did have the pectoral fascia removed. My surgeon’s response is that they routinely remove it for a mastectomy.

My team was at an accredited cancer center, so I have a lot of confidence in them. Also, my surgeon was chief of surgery, so, again, I have a lot of trust in her.

Hang in there. As I mentioned before, my pain was significant in the first 3-6 weeks. Life improved a lot after drains were removed.

If you have concerns, I do encourage you to reach out to your team about pain management.

I am less than 12 weeks past my reconstructive surgery. (6 months post mastectomy) I am in PT. There is tightness, but it is bearing and improving regularly! I hope yours will, too.

It’s a big surgery. Give yourself some grace.

I am thinking of you. Take your pain meds and rest! I watched a lot of mindless Netflix to keep my mind occupied those first few weeks.

@colely thank you so much for this insight. You answered the exact question I needed to know. Since you have had both breasts removed, at different times, right fascia removed and left fascia intact, you are the best person to testify to this.

I have nothing to compare it to except to ask other women and figure out of those who have had the surgery, who has had the better recovery. So far, it looks clear to me, as you said, night and day difference between keeping the fascia and removing it.

Like you, I was never told this was part of the surgery, otherwise I would have signed any waiver to keep my fascia since I already have a host of myofascial issues all over my body! My tumor was nowhere near the posterior towards the chest wall. My tumor was anterior. So the fascia could have safely been kept.

I am desperate to get information to see how long I will be dealing with this pain and disability. So I hope you don't mind me asking the following questions:

1. Can you please tell me how far out you are from both breast surgeries?

2. How are you feeling now? Especially on the right side in which the fascia was removed?

3. Do both sides feel about the same now?

4. How about your muscle spasms, strength, range of motion, etc. on the right?

I am only a couple weeks out of surgery, but experiencing far more pain and tightness than I was ever told I would have. "Iron bra" doesn't cover it. My symptoms include a dramatically tight feeling across my chest impossible to deep inhale. Feeling like the worst sunburn on my chest, deep pectoral pain, strange muscle spasms when just moving my arms, alternating feelings of burning and cold chills in my chest and upper arms.

Kudos to you for figuring out the culprit and being proactive to ask your new surgeon.

My right mastectomy was done in 2020. And my left side done in 2024. I have continuous problems still on my right. I could be helped with O.T. work for the Fourth Time, I am told, but I give up. It feels tight and stuck down. The fascia isn't there, anymore, to slide tissues around, as my O.T. said. But you have implants. That is a very important distinction from me, and can only complicate things even more for you. Maybe you should start a new discussion wanting to hear from women who have your distinct surgical history. I have read that there is the concern of contracture around the implants. That might be possible in your case. What is your plastic surgeon saying about this? Do you just need more time for healing? It definitely was a good 3 months before I felt anywhere near normal.