Sternotomy: Procedure, Recovery Timeline, Wires and Warning Signs
Updated: 6 days ago
Written and medically reviewed by Dr. Baraa Alnahhal, MD · Last reviewed: October 2026 · How we review
Quick Answer: What is a sternotomy?
A sternotomy is a surgical cut through the breastbone (sternum) that lets a surgeon reach the heart and nearby blood vessels, most often for bypass surgery. The bone is split, held open, then closed with 8 to 12 steel wires. It takes about 8 weeks to heal, with lifting limited to 10 pounds and no driving for about a month. [1]
What the research says
Strength training after a sternotomy appears safe. A review of 18 trials with 3,462 people found resistance training was safe and feasible after median sternotomy, with heart-lung fitness gains similar to aerobic training alone. The authors also noted that standard lifting limits don't match the weights used in many daily tasks. (Pengelly et al., Heart Lung Circ, 2019) [2]
Smaller incisions may mean shorter hospital stays. Across 75 studies of aortic valve replacement, minimally invasive approaches (mostly ministernotomy and minithoracotomy) had lower odds of death within 30 days (odds ratio 0.65) and shorter hospital and ICU stays than full sternotomy, although operations took longer. (Servito et al., Innovations, 2025) [3]
A chest support vest may cut wound problems, but proof isn't final. In 4 randomized trials with 3,820 heart surgery patients, wearing a thorax support vest was linked to fewer deep sternal wound infections (odds ratio 0.24 in the fixed-effect model). The authors said the evidence isn't yet strong enough for firm recommendations. (Caldonazo et al., Interdiscip Cardiovasc Thorac Surg, 2024) [4]
Key takeaways
A sternotomy is the access route, not the treatment — it moves the breastbone out of the way so the real heart operation can happen.
A mini sternotomy uses a 2–3 inch cut, about half the length of a full one.
The breastbone is closed with 8–12 steel wires that usually stay in for life.
Healing takes about 8 weeks: limit lifting to 10 lb, lift with both arms close to your body, and wait about a month before driving.
Call your doctor if your breastbone hurts, moves, cracks, pops or leaks fluid.
What is a sternotomy?
A sternotomy is a surgical cut through your sternum (breastbone), the flat, narrow bone running down the center of your chest. Together with your ribs, the sternum forms a protective cage around your heart and lungs. In adults, it's about 6 inches (15 cm) long. [1]
That protection becomes an obstacle when the heart needs repair. A sternotomy solves this by cutting the sternum lengthwise, spreading the two halves apart, and giving the surgeon a direct, wide view of the heart.
After the heart operation is finished, the two halves are brought back together and wired shut so the bone can knit back into one piece. It's the most common way surgeons reach the heart, with more than 700,000 done each year in the United States. [1]
Is a sternotomy open heart surgery?
A sternotomy is what makes open heart surgery possible. Once the breastbone is opened, the surgeon opens the pericardium — the heart's protective sac — and can then see and work directly on the heart. So if you're having a sternotomy, you're almost always having open heart surgery.
Is a sternotomy major surgery?
Yes, a sternotomy is considered major surgery. The bone needs about two months to heal, and the procedure is usually paired with open heart surgery. [1]
What is the difference between a full and a mini sternotomy?
A full sternotomy opens the entire breastbone, while a mini sternotomy (upper hemisternotomy) opens only the upper part through a 2–3 inch cut, about half the length. The mini sternotomy is the most common alternative to the full-length cut. [1]
Feature | Full (median) sternotomy | Mini sternotomy (upper hemisternotomy) |
Incision length | Full length of the sternum (about 6 in in adults) | 2–3 inches — about half the length |
Where the cut runs | From between the collarbones to the bottom of the sternum | From the top of the sternum down to about the 4th rib |
Bone opened | Entire sternum split top to bottom | Only the upper part |
Main advantage | Widest, clearest access to the heart | Smaller incision |
Typical use | Bypass surgery and most heart operations | Selected operations where full access isn't needed |
[1]
Your surgeon chooses the approach based on the operation you need and your own situation. If you're curious why one was chosen over the other, it's a fair question to ask before surgery.
Why is a sternotomy done?
A sternotomy is done to temporarily move the breastbone out of the way so the surgeon can reach the structures underneath it. It doesn't fix or remove anything by itself. Those structures include:
The heart (for bypass surgery, valve problems such as a bicuspid aortic valve, and other repairs)
The aorta and aortic arch
The pulmonary arteries and nearby structures such as the pulmonary valve
It's the approach cardiac surgeons use most often for coronary artery bypass surgery. [1]
How do you prepare for a sternotomy?
Preparation for a sternotomy focuses on lowering your infection risk. Your care team will typically:
Ask you to shower or bathe before you come to the hospital
Trim chest hair if needed
Give you antibiotics
Clean the skin on your chest — and sometimes beyond it, depending on the operation
[1]
How is a sternotomy done?
A sternotomy is done by cutting the skin over the breastbone, splitting the sternum down the middle with a sternal saw, and holding the halves apart while the heart operation takes place. Afterward, the bone is wired shut and the skin is closed. The procedure follows a clear sequence:
Step | What happens |
1. Skin incision | A cut is made from between the collarbones (top of the sternum) down to where the sternum ends. |
2. Bone division | A sternal saw cuts through the middle of the sternum from top to bottom. |
3. Spreading | A retractor gently holds the two halves apart. |
4. Thymus (children only) | Part or all of the thymus gland may be removed to improve visibility. |
5. Opening the heart sac | The pericardium — the protective sac around the heart — is opened. |
6. Heart operation | The surgeon performs the planned heart (or nearby) surgery. |
7. Wiring the bone | The sternum is closed with 8–12 steel wires. If the bone is too hard for a needle, small holes are drilled for the wires. |
8. Closing | The chest tissues and skin are closed. |
9. Wound care | Antibiotic ointment is applied to the incision. |
[1]
What are sternotomy wires?
Sternotomy wires are stainless steel wires that hold the two halves of your breastbone together while the bone heals. In most people, they stay in permanently. [1]
Doctors usually remove them only if you:
Have ongoing (chronic) pain or discomfort after surgery
Develop an infection in that area
Need another surgery
Can the wires break? Yes — a wire can break if it was tightened too much. This is one reason to report any clicking, popping or movement in your chest. [1]
What happens right after a sternotomy?
Right after a sternotomy, fluid drains from your chest through tubes, pain is controlled with medicine, and some people wear breast support to protect the incision. In the first days, expect:
Chest drainage. Fluid drains from your chest through tubes for a short time.
Pain control. Most people manage well with acetaminophen (paracetamol) and other medicines your team prescribes (NSAIDs such as ibuprofen are generally avoided after heart bypass surgery). Some need stronger medicine for a while.
Breast support (if needed). If you have more than a small amount of breast tissue, you'll be asked to wear a supportive bra 24 hours a day to take weight off the incision. Keep this up for 1 to 2 weeks after leaving the hospital.
[1]
How long does sternotomy recovery take?
Sternotomy recovery takes about 8 weeks, the time your breastbone needs to heal. During that time, you'll follow "sternal precautions" — simple rules that protect the bone while it knits together. [1]
If you join cardiac rehabilitation after surgery, your team will also limit how much you move your upper body while the bone heals — though research on exercise after sternotomy suggests supervised strength training is safe. [2]
Timeframe | What to expect |
Hospital stay | Chest drains remove fluid; pain is controlled with medicine |
First 1–2 weeks at home | Wear breast support around the clock if needed |
Weeks 1–8 | Lift no more than 10 lb; use both arms; keep arms close to your body |
About 4 weeks | Most people can drive again |
About 8 weeks | Breastbone healing is typically complete |
[1]
What are the lifting rules after a sternotomy?
Don't lift more than 10 pounds (about 4.5 kg). For scale, a gallon of milk weighs about 8 pounds.
Use both arms whenever you lift something.
Keep your arms close to your body while lifting.
You'll also follow any specific instructions for the heart operation itself — those may add extra limits. [1]
When can you drive after a sternotomy?
Most people can drive again about a month after surgery. Until then, ride in the front passenger seat and always wear your seat belt. Even if the belt and airbag feel uncomfortable on your chest, they protect you far better in a crash than skipping them. [1]
What are the benefits and risks of a sternotomy?
The main benefit of a sternotomy is excellent access to the heart, while its risks include infection, bleeding, an abnormal heart rhythm and swelling. Complications are uncommon. [1]
Benefits | Risks |
Gives the surgeon excellent access to the heart | Infection |
Well tolerated by most people | Bleeding |
Quick and straightforward for surgeons to perform | |
Complications are uncommon |
[1]
Complications don't happen often, but knowing the warning signs helps you act early. Learn more about how infections can affect the heart.
When should you call your doctor after a sternotomy?
Call your doctor after a sternotomy if your breastbone hurts, moves, cracks, pops or leaks fluid from the incision. Keep all your follow-up appointments, and between visits contact your healthcare provider if your breastbone:
Hurts (new or worsening pain)
Moves or feels unstable
Cracks
Pops or clicks
Leaks fluid from the incision
Reporting these signs early lets your care team check the bone and wound promptly. [1]
Conclusion
A sternotomy sounds intimidating, but it's one of the most frequently performed and well-understood steps in heart surgery. It gives your surgeon the clear view needed to repair your heart, and the breastbone is wired back together to heal over about 8 weeks.
Your part in recovery is simple but important: protect the bone with the lifting and driving rules, take pain medicine as directed, and report any pain, movement, popping or drainage right away. Bring this guide to your pre-surgery visit and use it as a checklist for your questions.
Want more clear, doctor-reviewed heart health guides? Explore the Rinnit.com health library and bookmark this page to share with your family and care team.
FAQ
What is a sternotomy?
A sternotomy is a surgical cut through the breastbone (sternum) that lets a surgeon reach the heart and nearby blood vessels. The bone is split, held open during surgery, then wired back together.
How long does it take to recover from a sternotomy?
The breastbone takes about 8 weeks to heal. During that time you should limit lifting and follow your surgeon's activity rules.
How much can I lift after a sternotomy?
No more than 10 pounds (about 4.5 kg) while the bone heals. Lift with both arms and keep them close to your body.
When can I drive after a sternotomy?
Most people can drive again about a month after surgery. Until then, ride in the front passenger seat with your seat belt on.
Are sternotomy wires removed?
Usually not. They're removed only if they cause ongoing pain, become infected, or another surgery is needed.
Can sternotomy wires break?
Yes, a wire can break if it was over-tightened. Tell your doctor if you feel popping, clicking or movement in your chest.
What is a mini sternotomy?
A mini sternotomy (upper hemisternotomy) uses a 2–3 inch incision — about half the length of a full sternotomy — that runs from the top of the breastbone to about the fourth rib.
Is a sternotomy painful?
Most people control pain with acetaminophen and other medicines their team prescribes; NSAIDs are generally avoided after bypass surgery. Some need stronger medicine for a short time.
Why do I need to wear a bra after a sternotomy?
If you have more than a small amount of breast tissue, a supportive bra worn 24 hours a day takes weight off the incision. Wear it for 1–2 weeks after leaving the hospital.
What are the warning signs after a sternotomy?
Call your doctor if your breastbone hurts, moves, cracks, pops or leaks fluid from the incision.
Related Reading
Coronary Artery Bypass Graft (CABG) Surgery: Procedure and Recovery explains how bypass surgery reroutes blood around blocked heart arteries.
Open-Heart Surgery: Procedure, Preparation, and Recovery covers how to prepare for and recover from open heart surgery.
The Sternum (Breastbone): Anatomy, Function, and Common Conditions describes the breastbone's structure, function and common problems.
Minimally Invasive Heart Surgery: Types, Benefits, Risks, and Recovery explains heart operations done through smaller cuts without splitting the breastbone.
References
Cleveland Clinic. Sternotomy: Procedure Details & Recovery. Cleveland Clinic. Last updated August 9, 2022. https://my.clevelandclinic.org/health/treatments/24016-sternotomy
Pengelly J, Pengelly M, Lin KY, et al. Resistance Training Following Median Sternotomy: A Systematic Review and Meta-Analysis. Heart Lung Circ. 2019;28(10):1549-1559. PMID 31208899. https://doi.org/10.1016/j.hlc.2019.05.097
Servito M, Ramsay H, Mann S, et al. Surgical Outcomes After Minimally Invasive Versus Full Sternotomy Aortic Valve Replacement: Meta-Analysis of 75 Comparative Studies. Innovations (Phila). 2025;20(3):257-264. PMID 40359073. https://doi.org/10.1177/15569845251335969
Caldonazo T, Dell'Aquila M, Cancelli G, et al. Thorax support vest to prevent sternal wound infections in cardiac surgery patients—a systematic review and meta-analysis. Interdiscip Cardiovasc Thorac Surg. 2024;38(4):ivae055. PMID 38530971. https://doi.org/10.1093/icvts/ivae055
Medical disclaimer
This article is for general education only and is not a substitute for professional medical advice, diagnosis or treatment. Always talk with your surgeon or a qualified healthcare provider about your own situation before making decisions about surgery.
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