I had a double mastectomy with prepectoral expanders placed - this means that they are over the muscle. I believe this is somewhat less painful than under the muscle reconstruction because you do not need to cut the muscle. I had one lymph node removed.
When I woke up from surgery, I was sore, but I did not feel any sharp pains. I thought the pain medication from the surgery would wear off and I would be in a lot of pain, but that didn't exactly happen.
Because of the mastectomy, I did not have any nerve endings in the front of my breasts. Because of that, the cuts / stitches on my breasts never hurt. Occasionally I would feel slight discomfort deeper in my breasts where the tissue was removed, but it wasn't sharp pain.
The parts that were most uncomfortable for me were the drain sites (I had three drains total - two on one side and one on the other). These felt a little bit pinchy and annoying, but not deeply painful. Also, especially at first, the lymph node removal site was sore. I was lucky to only have one lymph node removed. I found that ice made it feel better - I left the hospital with an ice pack and used one for a few days after intermittently.
However, I was able to recover from the double mastectomy with only over-the-counter pain medications (mostly Tylenol and some ibuprofen). I took these for a couple of weeks, and in the end just at night. I wasn't interested in taking any heavier pain medication because I didn't feel like the pain was all consuming - It was localized and just annoying. Mostly, the fear of pain (like, will the seatbelt press on my breasts and make them hurt?) was worse than any actual pain.
How does this compare with an exchange surgery? Well, I just had my exchange surgery and it was even less painful. In fact, I never felt any pain in my breast area. This is what made me think about how the drain site and the lymph node were the source of most of my pain the first time. For the exchange surgery, I also just took some Tylenol and ibuprofen. (I also had my ovaries and fallopian tubes removed at the same time and that was the slightly more uncomfortable area, so I don't know if I would have even needed much for the breasts).
if you're about to have surgery, I hope it's helpful to read this! I know everyone is different and some people do experience a lot of pain after surgery, especially if they are having under the muscle reconstruction. But it's always good to read about the best case scenario, and I was so surprised how little pain was involved in the surgery. In fact, I found recovery from childbirth to be much more challenging!
