Medical Oncologist
CION Cancer Clinics
Breathing and chest movement after reconstruction | CION Cancer Clinics
After chest wall surgery, breathing is shallow and effortful in the first days, mostly because deep breaths hurt and the repaired side moves less. It gets steadily easier over the following weeks as pain settles and the repair firms up. Most people get back close to their earlier breathing, and those with weak lungs beforehand notice more. This page explains what to expect week by week, the exercises that matter, and what cannot wait. CION Cancer Clinics’ surgical oncologists in Hyderabad can talk this through with you.
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Medically reviewed by Dr. Muralidhar MuddusettyConsultant Surgical Oncologist · MBBS (AIIMS), MS (Surgery, AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh) · last reviewed September 2026, next review due September 2027
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On this page
- How will breathing feel after chest wall surgery?
- How breathing changes from the first day to full recovery
- What makes breathing harder in the early weeks
- The breathing exercises, and why they matter
- Four things families tell us, and what is actually true
- Who recovers more slowly, and what this page cannot tell you
- Common questions about breathing after chest wall surgery
The short answer
How will breathing feel after chest wall surgery?
Shallow and effortful at first, then steadily easier. In the first days most people take small breaths because deep ones hurt, and the side of the chest that was operated on moves less than the other. Over the following weeks, as pain settles and the repair firms up, breathing returns to something close to what it was.
Why it feels different
Breathing in is a movement. The ribs lift and swing outwards, and the muscles between them pull. When ribs have been removed and the gap bridged with mesh or a plate, that patch of chest no longer moves in the same way. The lung underneath still fills, but the chest wall over it is stiffer, and the muscles around it are sore and cautious.
What it usually does not mean
Feeling short of breath on the stairs in the first weeks is expected and does not mean the lung has been damaged. Lung function tests taken months later usually show a modest drop compared with before, and many people notice nothing in daily life. The exceptions are people whose lungs were weak before the operation.
Breathing that suddenly gets worse, rather than slowly better, is a different matter. The red-flag box below says what to do.What to expect
How breathing changes from the first day to full recovery
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The first day or two
You may wake with a chest drain in place and a pain pump or an epidural running. Breathing is shallow. Nurses and physiotherapists will ask you to take deep breaths and cough, and it will feel too soon. It is not.
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The rest of the first week
The drain comes out once the fluid slows. Walking the corridor several times a day starts here. Each walk opens the lung a little more. Pain is managed with tablets by the time you go home.
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The first month at home
Breathing is easier at rest but you tire on stairs and slopes. The chest feels tight, especially in the morning. Keep doing the breathing exercises and walking a little further each day.
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Around three months
Most people are back to their usual routine. The operated side may still feel stiff, and the skin below the scar numb. Heavy lifting is usually allowed again by now if the surgeon agrees.
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Six months and beyond
Scar tissue has firmed up around the repair. What you feel now is roughly what you will feel long term. A follow-up lung function test may be arranged to compare with the one taken before surgery.
Not sure whether this applies to you?
Ask an oncologistThe causes
What makes breathing harder in the early weeks
Usually several of these at once, and each improves on its own timetable.
Pain
The biggest cause by far. When a deep breath hurts, you stop before the lung is full. Taking pain relief on time, before the exercises rather than after, is the single most useful thing you can do.
A stiffer chest wall
Mesh and plates do not swing outwards the way ribs do. The lung underneath fills, but you have to work slightly harder to expand that side. This settles as you get used to it.
Weak or cut muscles
The muscles between the ribs, and any muscle moved as a flap, were part of your breathing. Other muscles take over, but they need weeks to strengthen.
Fluid or air around the lung
A little fluid or air in the space around the lung is common after the drain comes out and the body absorbs it. A larger collection can press on the lung and is one reason an X-ray is done before you go home.
Every day
The breathing exercises, and why they matter
Deep breaths in sets
Sit upright. Breathe in slowly through the nose until the chest is full, hold for a moment, then let it out. A few breaths, several times an hour while awake. This opens the small air pockets at the base of the lung that close when you breathe shallowly.
The blowing device
You may be given a plastic device with a ball or piston that rises as you breathe in. It shows you how deep each breath is. Use it as the physiotherapist shows you, and keep it by the bed at home.
Coughing with support
Hold a folded towel or pillow firmly against the wound and cough. The pressure stops the chest from jarring. Clearing phlegm this way is what keeps a chest infection away.
Walking
The best exercise there is for the lungs after surgery. Start with the corridor, then the street, then further. Breathlessness while walking is expected. Chest pain or dizziness is not, and means you stop and tell someone.
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Breathing that cannot wait
Breathlessness that comes on suddenly or is getting worse hour by hour, a part of the chest that sinks inwards when you breathe in, lips or fingertips turning blue, sharp chest pain with each breath, or a fever with a wet cough. Go the same day to the hospital where you had the operation or the nearest emergency department, and say you have had chest wall surgery. Do not wait for the morning.
Commonly believed
Four things families tell us, and what is actually true
"Deep breathing will tear the stitches or move the mesh."
The repair is stitched to bone and built to take the movement of breathing from the first day. Shallow breathing is what causes harm, because the base of the lung closes down and infection follows.
"She should rest in bed until the wound heals."
Lying still is the surest route to a chest infection and a clot in the leg. Sitting up, walking and breathing exercises start on the first day, with help. Rest matters, but it is rest between walks, not instead of them.
"He is breathless, so the operation must have damaged the lung."
Early breathlessness is almost always pain, a stiff chest wall and unfit muscles. The lung itself is usually untouched or has lost only a small wedge. It improves week by week.
"Painkillers will slow the breathing, so take fewer."
Uncontrolled pain slows breathing far more, by stopping you breathing deeply at all. Take what has been prescribed, on time. If you feel drowsy or very constipated, tell the team so the dose can be adjusted. Do not change it on your own.
Being straight with you
Who recovers more slowly, and what this page cannot tell you
This page cannot tell you how your own breathing will be. That depends on how much chest wall was removed, where, how it was rebuilt, and above all on how your lungs were working before the operation. Your surgeon and anaesthetist have those numbers from your pre-surgery tests, and they are the people to ask.
Who tends to find it harder
People who smoke or have long-standing lung disease. People who had several ribs removed at the front or side, or the breastbone. Older people with less muscle to begin with. Anyone who also lost a wedge of lung. For these readers the early weeks are tougher and the long-term change more noticeable. It means the exercises matter more and the team will watch more closely.
What to ask at your follow-up
Whether a repeat lung function test is planned. Whether the amount of breathlessness you have is what the team expected for your operation. Whether a physiotherapist can see you. And what number to call if breathing changes between appointments.
If you were a smoker, stopping now still helps your lungs recover. Ask the team for help with it.Questions we are asked
Common questions about breathing after chest wall surgery
Why does one side of the chest move less than the other?
Because the repaired patch is stiffer than rib and the muscles around it are sore. The lung underneath still fills. The difference is most obvious in the first weeks and becomes less noticeable as you recover. A patch that moves inwards on breathing in, rather than simply less, needs to be seen.
How long will I need the chest drain?
Until the fluid draining from around the lung slows to a trickle and the X-ray shows the lung fully expanded. That is usually a few days. Having it removed feels strange but is quick. Breathing often feels easier straight afterwards.
Can I climb stairs when I get home?
Yes, slowly and with a rest at the top. Stairs are good for the lungs. Being breathless on them is expected in the first month. Sharp pain, dizziness or breathlessness that does not settle after a rest is not, and should be reported.
Will my lung function ever be the same as before?
Usually close, but often not identical. Tests months later tend to show a modest drop compared with before the operation. In daily life most people notice little, and those with good lungs beforehand often notice nothing. Your team can compare your own before and after readings.
Is it safe to sleep lying flat?
Many people breathe more comfortably propped up on pillows for the first few weeks, and that is fine. Sleep in whatever position lets you breathe easily and does not press on the wound. If you cannot lie down at all without gasping, tell the team the same day.
When can I go back to farm work or a job that needs lifting?
Not in the first weeks while the repair settles. Most people return to physical work gradually after a few months, once the surgeon has checked the chest. Ask for a specific date at follow-up rather than guessing, because it depends on what was rebuilt and how.
Do I need oxygen at home?
Rarely. Most people leave hospital breathing room air. If your oxygen levels are still low when you are ready to go home, the team may arrange oxygen for a short period. Buying a concentrator or oxygen cylinder without being asked to is not needed.
Can a physiotherapist visit at home in a district?
Home visits are not always possible outside the city. Before discharge, ask the physiotherapist to show your family member the exercises and write them down, with a phone number to call if you are unsure. Video follow-up can be arranged through the helpline where a visit is not.
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MBBS (AIIMS), MS (Surgery) (AIIMS), DNB (Surgical Oncology), MRCS (Edinburgh)
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Dr. Vinay Mamidala
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Sources
- Macmillan Cancer Support — Surgery
- Cancer Research UK — Surgery for lung cancer
- NHS — Lung cancer treatment
- American Cancer Society — Cancer Surgery
This page is general information, not a prescription. Do not change or stop any treatment based on what you read here. If anything is worrying you, contact your own treating team — or call our helpline and we will help you reach the right specialist.
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Worried about breathing after the operation?
Call the helpline and tell us what you are noticing. A nurse or oncologist will say whether it sounds expected or needs to be seen today. One helpline serves every CION centre.