From Prehabilitation, well into Survivorship
Click on the quick links below to access videos and education resources for each phase of your recovery
Preparing for Hospital
Phase 1 (Weeks 1-2)
Phase 2 (Weeks 3-6)
Phase 3 (Weeks 6-12)
Phase 4 (Month 3-6)
Phase 5 (Month 6-18)
Prehabilitation
Some women don’t have weeks or months to prepare before surgery — and that’s okay. While prehabilitation can be beneficial, it is not a prerequisite for a good recovery. Many women recover well without formal exercise beforehand.
If you have time to get fit prior to surgery, it is important to focus on:
Strength: abdominal, chest and upper back strength and posture. Leg strength will also help post operatively.
Flexibility: Shoulders, chest, thoracic, abdominal/lumbar area.
Aerobic: the higher your VO2, the fewer operative/post operative complications you will have.
Preparing for Surgery
Full shoulder range of motion
Strong, upright posture and confident movement
Whole-body strength, including safe, progressive abdominal and trunk rehabilitation
Had treatment prior to surgery?
You most likely have gone through chemotherapy and or radiation prior to this surgery, therefore you also need to recover from that first and build up fitness to prepare for DIEP
Preparing for Hospital/Surgery
Mental Preparation
Understand and recognise the Emotional/mental fatigue of recovery.
Possible aesthetic changes (e.g., belly button removal).
Be realistic recovery timelines, and understand that things may not go to plan.
Psychological & Emotional Needs
Emotional impact and loneliness often underestimated.
Need for peer connection, empathy, mental support.
Join our support group, a Facebook page,
Recommend psychologist sessions early.
"Mental rehab" just as important as physical rehab.
What women wish they knew before they had surgery
Recovery Timelines Vary: Full functional recovery can range from 6 months to 18 months or more. Be patient with your body. Some individuals may not feel they have regained full function even after this period.
It can take more than 18 months to get back to 'normal'.
Hospital Stay: Expect to be in hospital for approximately 5-7 days.
Fatigue: Extreme fatigue is very common post-operatively and can last for many weeks. Rest when you feel you need to.
The chance that you might need to return to surgery within the first 24hours. (The plastic surgeon should prepare patients for this, but not all do). This is not uncommon!
That you might get fluid build up/ lymphoedema following surgery. You need to know what to look for, how to treat it, and who to see about it.
Things to prepare in your home before you go to hospital
Breast pillow for in the car - seat belt pillow.
Chair for shower.
Have food etc on bench top, not in high cupboard.
Note book for documenting medication.
Ready-made meals for Freezer
Ask close friends or family to set up a Meal Train or 'Lotsa Helping Hands'
A Tri Pillow is also useful. (again, kmart)
An under bed, mobile table, (like hospital) is particularly useful in the first few months
Wedge from Clarke rubber for your bed at home.
Things to ask you surgeons that some of our clients forgot, but wish they asked sooner
Recommendation/requirements for the binder and scar management/protection.
Tubigrip.
SRC pants.
Prevena pump: what it is, how it works.
Hospital Packing List
Clothes:
Large soft knickers in a massive size, (Kmart have great ones), large enough to comfortably cover the scar and bandaging.
PJs that button up
Light dressing gown
Front Zip crop top/bra - Kmart
Button up dress for leaving the hospital day
Slide on Slippers
Compression garment – what the surgeon recommends
SRC compression Shorts?
Toiletries/personal items
Lip Balm
Flushable wet wipes to freshen up
A head band if you don't like your hair falling in your face. (Or plait your hair)
Dry Shampoo
Eye Mask
Ear plugs
Toothbrush, toothpaste
Random useful items
Long charging cord
Back scratcher
Small carry bag to carry your drains, good especially if you have 3.
Water bottle with Straw
Throat soothing lozenges as throat can feel dry and sore after the anaesthetic tube.
Neck pillow – to make sleeping upright more comfortable
Phase 1 (Weeks 1-2)
Goals of Phase 1
Full shoulder range of motion
Strong, upright posture and confident movement
Whole-body strength, including safe, progressive abdominal and trunk rehabilitation
What to expect
Pain
Fatigue: Extreme fatigue is very common post-operatively and can last for many weeks. Rest when you feel you need to.
Very tight feeling in abdomen
You will be unable to lie flat for some time.
Lying flat timeline:
Range: some people are able to lay flat 1-2 weeks to 14-15 weeks
Most around 6 weeks without pillow wedge
Wedge support highly recommended for comfort
Unable to lie on your side for a few days (check timeline with surgeon)
Tips/Education
Laying Flat: This varies significantly, from a few weeks to over 3 months post-surgery. Using a wedge pillow can provide comfort and support posture.
Laying on Side: This may take a couple of months. Fear of causing damage is common. Use pillows for support. Check with your surgeon, but it is generally considered safe once discharged from hospital.
Sleep included wedges and pillows
It will be uncomfortable and not possible to lay flat for between 6-15 weeks.
Clark Rubber sells wedges that will prop you up.
Fatigue Management
Nutrition to optimise recovery
Lymphedema prevention and management.
May experience cramping in the abdominal area.
Compression Garments
Most will wear abdominal compression for at least 6 weeks, but this varies. Some use it on an as-needs basis for up to 12 months, particularly at the end of the day when the core feels tired.
Garments like belly bands, Tubigrip, or SRC pants can provide support and comfort.
Possible complications
Limited shoulder range of motion.
Abdominal weakness and cramping (Braxton Hicks feeling)
Ongoing numbness.
Cording (Axillary Web Syndrome).
Common Post-Operative Limitations
Infection
Haematoma
Lymphedema.
Cording
No blood supply and need to reconnect
Post-surgery recovery
Fatigue: underestimated, prolonged.
Compression Garments:
Most will wear abdominal compression for at least 6 weeks, but this varies. Some use it on an as-needs basis for up to 12 months, particularly at the end of the day when the core feels tired.
Garments like belly bands, Tubigrip, or SRC pants can provide support and comfort.
Kmart front zip up bra
Scar Management: Seek advice on scar massage techniques. A myotherapist or physiotherapist can provide guidance on abdominal scar release.
How to get out of bed safely
Phase 2 (Weeks 3-6)
In this phase, you should:
Start to feel somewhat normal again.
Pace your day and your week. You will have limited energy and may still be uncomfortable.
Returning to Daily Activities: You may be able to do 95% of your normal daily activities around 12 weeks post-op, but only for short durations (e.g., 10-15 minutes at a time) before needing to rest.
What to expect:
Start to feel somewhat normal again.
Energy levels improving, but still unpredictable
Ongoing abdominal tightness and pulling sensations
Swelling fluctuating throughout the day (especially by evening)
Shoulder mobility improving but may still feel stiff overhead
Scar sensitivity or hypersensitivity around breast and abdomen
Gentle return to light household tasks
Walking tolerance increasing, but still requiring regular rest breaks
Emotional ups and downs are common during this phase
Phase 3 (Weeks 6-12)
In this phase, you should:
Feel approximately 80–95% back to normal by 12 weeks — though energy may still fluctuate
Be increasing independence with daily activities
Begin structured, progressive strengthening
Improve shoulder range and postural control
Build foundational core strength (without heavy strain)
Possibly return to driving - at surgeons discretion
What to expect:
Abdominal tightness and weakness still present with higher effort tasks
Core fatigue by the end of the day
Mild swelling with increased activity
Improved walking tolerance and light exercise capacity
Scar tissue firming as part of normal healing
Some residual numbness or altered sensation
Greater confidence in movement, but still needing pacing
Phase 4 (Month 3-6)
In this phase, you should:
Return to most normal daily activities without restriction
Progress strength training with gradual load increases
Resume more challenging core and whole-body exercises
Improve endurance and activity tolerance
Feel more physically confident and capable
What to expect:
Occasional abdominal pulling during stretching or heavier tasks
Continued scar remodeling (softening and flattening over time)
Energy levels more consistent
Rare swelling, usually after long days or travel
Rebuilding higher-level strength takes time and patience
Movement feeling more natural and less protective
Phase 5 (Month 6-18)
In this phase, you should expect:
Regain full strength and range of movement
Continue with gradual progression of strength to minimise lymphedema
Continued gains in strength and endurance
Ongoing scar maturation (can continue up to 12–18 months)
Return to higher-level strength training and impact exercise (if appropriate)
Minimal swelling, though may occur with overexertion
Improved core connection and abdominal control
Feeling physically capable and confident
Some altered sensation or numbness may remain long-term
