Double Mastectomy: Types, Surgery, Recovery and Risks
Updated: 7 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: November 2026 · How we review
Quick Answer: What is a double mastectomy?
A double (bilateral) mastectomy is surgery that removes all breast tissue from both breasts. It is done to treat breast cancer in both breasts or to prevent cancer in people at very high risk. Without reconstruction it takes a few hours, and most people go home the same day. [1]
What the research says
Preventive removal of both breasts lowers breast cancer risk in high-risk women. A Cochrane review of 61 studies covering 15,077 women found that removing both healthy breasts reduced both new breast cancers and breast cancer deaths, especially in BRCA1 and BRCA2 carriers. Unplanned repeat surgery ranged from 4% without reconstruction to 64% with reconstruction. (Carbine et al., Cochrane Database of Systematic Reviews, 2018) [2]
Removing the healthy breast cuts the risk of a second cancer, but survival gains are unclear. In a meta-analysis of 14 studies, women with a strong family or genetic risk who had the healthy breast removed had a 96% lower risk of cancer in that breast (RR 0.04), about 24 fewer cases per 100 women, but no improvement in overall survival. (Fayanju et al., Annals of Surgery, 2014) [3]
Key takeaways
A double mastectomy removes the breast tissue where cancer could grow and spread, from both breasts. [1]
It can treat cancer in both breasts or prevent cancer when the risk is very high. [1]
Skin or nipples can sometimes be kept so the breasts can be rebuilt (reconstructed). [1]
Surgery takes a few hours, or six to 10 hours with reconstruction at the same time. [1]
Wounds need at least four weeks to heal, or up to eight weeks with reconstruction. [1]
Who needs a double mastectomy?
A surgeon may recommend a double mastectomy when it may be lifesaving, based on your cancer risk or the stage of your cancer. The main reasons are: [1]
Cancer in both breasts. Surgery removes the tissue where cancer could grow and spread.
Very high risk of breast cancer in both breasts. Preventive surgery may be offered, for example to some people with BRCA gene changes. [2]
Cancer in one breast. Some people choose to have the healthy breast removed at the same time as a preventive step.
Surgery is not the only option and is not the best choice for everyone. It is almost always the best choice when cancer is present and has not spread. [1] Learn about other options in our guides to breast cancer surgery and PARP inhibitors for BRCA-related cancers.
What are the types of double mastectomy?
Double mastectomies are grouped by why they are done and by what tissue is removed or kept. [1]
The six main types of double mastectomy.
Type | What it means |
Prophylactic bilateral mastectomy | Preventive surgery for people at high risk of cancer in both breasts |
Contralateral prophylactic mastectomy | Cancer is in one breast, and the healthy breast is removed at the same time |
Both breasts are removed with no reconstruction planned | |
Both breasts plus several underarm lymph nodes are removed and tested for cancer | |
Most of the breast skin is kept for reconstruction | |
The skin, nipples and areolas are kept for reconstruction |
Sources: [1]
How do you prepare for a double mastectomy?
Preparing for a double mastectomy starts with agreeing on a treatment plan with your provider and deciding whether surgery fits that plan. [1]
Before surgery, your provider will: [1]
Explain what will be removed and whether your skin or nipples can be saved
Help you decide whether to have reconstruction now, later or not at all
Explain how to prepare and what to expect at home, where you may need changes or help with daily tasks
What happens during a double mastectomy?
A double mastectomy is done under general anesthesia, so you are asleep, with a breathing tube in place. A substance is injected into the breasts to find the lymph nodes. It may be a blue dye, a mild radioactive tracer or both. [1]
The breast tissue is removed from each breast, saving skin and/or nipples when possible and wanted. This takes one to three hours.
Lymph nodes are checked. At least one lymph node is removed from each underarm and tested for cancer. Sometimes all the underarm lymph nodes are removed.
Reconstruction is done if you chose to have it now. This takes three to eight hours and may use implants, your own tissue or both.
The incisions are closed, surgical drains are left in place and the chest is bandaged.
Sources: [1]
How the time adds up during a double mastectomy.
Double mastectomy at a glance
Item | Typical detail |
Anesthesia | General (you are asleep) |
Breast tissue removal | 1 to 3 hours |
Reconstruction (optional) | 3 to 8 hours more |
Total time | A few hours without reconstruction; 6 to 10 hours with it |
Hospital stay | Usually same day; sometimes one or a few nights |
Drains | A few days to a few weeks |
Wound healing | At least 4 weeks; up to 8 weeks with reconstruction |
Sources: [1]
How long does recovery from a double mastectomy take?
Most people go home the same day, while some stay one or a few nights for monitoring. Wounds need at least four weeks to heal, or up to eight weeks with reconstruction. [1]
Typical recovery milestones after a double mastectomy.
Drains: Surgical drains stay in for a few days to a few weeks to remove extra fluid. Special mastectomy bras can hold them in place. [1]
Care at home: Your team will explain how to manage pain, care for your wounds and drains, spot signs of infection or lymphedema, and do arm and shoulder exercises. [1]
Follow-up: You will usually have a visit in a couple of weeks to go over the pathology report and your treatment plan, which may include treatments such as radiation therapy. [1]
While you recover, avoid driving, reaching and heavy lifting. Expect some stiffness and tightness, which daily exercises help. Tiredness can last for weeks or months, and chest feeling changes as the nerves recover. Some people stay numb in the chest for years. [1]
What are the benefits and risks of a double mastectomy?
The main benefit is a lower risk of cancer growing or coming back, which can be lifesaving. Operating on both breasts carries more risk of complications than surgery on one breast, but the risks from cancer are usually far greater. [1]
Risk | What it means |
Infection | Bacteria get into the surgical wound |
Bleeding | Blood loss during or after surgery |
Nerve damage | Numbness or changed feeling in the chest |
Lymphedema | Long-term swelling from lymph fluid buildup after lymph node surgery; treatable, especially if caught early |
Post-mastectomy pain syndrome | Ongoing nerve pain with tingling, prickling, burning, itching or shooting pain; medicines can help |
Sources: [1]
For people who have cancer in only one breast, removing the healthy breast lowers the chance of cancer in that breast, but studies have not clearly shown that it helps people live longer. [2] [3] Talk through your own risk with your care team.
When should you call your doctor after a double mastectomy?
Contact your provider if you notice any of these signs: [1]
Redness or swelling around your incisions
Unusual swelling in your arms or legs
Pain that does not improve or gets worse
Stiffness that does not improve with movement
Conclusion
A double mastectomy removes breast tissue from both breasts to treat cancer or to prevent it in people at very high risk. Many people go home the same day, and wounds usually heal within four to eight weeks. [1]
Deciding whether to have surgery, and whether to have reconstruction, is a personal choice. Ask your surgeon about your own cancer risk, the type of mastectomy that suits you and your options for rebuilding the breasts.
Keep learning: Explore our breast cancer guide to understand symptoms and treatment, or read about breast cancer in young women.
FAQ
What is a double mastectomy?
A double (bilateral) mastectomy is surgery that removes all breast tissue from both breasts to treat breast cancer or to lower a very high risk of getting it.
Who needs a double mastectomy?
It may be advised when there is cancer in both breasts, or for people at very high risk of breast cancer in both breasts, such as some carriers of BRCA gene changes.
What are the types of double mastectomy?
Types include prophylactic bilateral, contralateral prophylactic, simple (total), modified radical, skin-sparing and nipple-sparing double mastectomy.
How long does double mastectomy surgery take?
Removing the breast tissue takes one to three hours. With reconstruction at the same time, the whole surgery takes about six to 10 hours.
Can I have breast reconstruction at the same time?
Yes. Reconstruction can be done during the same surgery, later or not at all. It adds three to eight hours and may use implants, your own tissue or both.
Will I stay in the hospital after a double mastectomy?
Most people go home the same day. Some stay one or a few nights so the team can monitor them.
How long do drains stay in after a double mastectomy?
Surgical drains usually stay in for a few days to a few weeks to remove extra fluid from the chest.
How long is recovery after a double mastectomy?
Wounds need at least four weeks to heal, or up to eight weeks with reconstruction. Tiredness and chest numbness can last longer.
What are the risks of a double mastectomy?
Risks include infection, bleeding and nerve damage. Long-term problems can include lymphedema (arm swelling) and post-mastectomy pain syndrome.
When should I call my doctor after a double mastectomy?
Call your provider for redness or swelling around the incisions, unusual swelling in your arms or legs, pain that gets worse, or stiffness that does not improve with movement.
How do I prepare for a double mastectomy?
Preparation starts with agreeing on a treatment plan with your provider. Before surgery, your provider explains what will be removed and whether skin or nipples can be saved, helps you decide whether to have reconstruction now, later or not at all, and explains what to expect at home, where you may need help with daily tasks [1].
Does a double mastectomy hurt, and what anesthesia is used?
A double mastectomy is done under general anesthesia, so you are asleep with a breathing tube in place and feel nothing during surgery. Afterward, your care team explains how to manage pain at home; stiffness and tightness are common, and chest numbness can last while the nerves recover [1].
Related Reading
Prophylactic Mastectomy: Who It's For, Types and Recovery explains prophylactic mastectomy.
DIEP Flap Surgery: Breast Reconstruction, Recovery and Results explains DIEP flap breast reconstruction.
References
Cleveland Clinic. Double (Bilateral) Mastectomy: What It Is, Surgery & Recovery. Last updated June 9, 2025. https://my.clevelandclinic.org/health/procedures/double-mastectomy
Carbine NE, Lostumbo L, Wallace J, et al. Risk-reducing mastectomy for the prevention of primary breast cancer. Cochrane Database Syst Rev. 2018;4(4):CD002748. PMID: 29620792. https://doi.org/10.1002/14651858.CD002748.pub4
Fayanju OM, Stoll CRT, Fowler S, et al. Contralateral prophylactic mastectomy after unilateral breast cancer: a systematic review and meta-analysis. Ann Surg. 2014;260(6):1000-1010. PMID: 24950272. https://doi.org/10.1097/SLA.0000000000000769
Medical disclaimer
This article is for general education only and does not replace advice from a qualified healthcare professional. Talk to your doctor about your own situation before making decisions about your health. If you think you have a medical emergency, call your local emergency number right away.
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