Do patients who undergo implant-based breast reconstruction following a mastectomy need to stay in the hospital overnight following the procedure?

New research from Christodoulos Kaoutzanis, MD, associate professor in the Division of Plastic and Reconstructive Surgery at the University of Colorado Anschutz Department of Surgery, suggests that for many patients, an overnight hospital stay may not be necessary. The study found that patients can recover safely and comfortably when they go home the same day as surgery, as long as they are medically appropriate for discharge.

“If your surgical team determines it is safe to go home and your pain is well controlled, many patients do very well recovering in their own bed,” Kaoutzanis says. “Hospitals can be noisy places, and patients are often woken up overnight for vital signs or other routine checks, which can make rest more difficult.”

A randomized look at discharge timing

For the research published last November in the journal Plastic and Reconstructive Surgery, Kaoutzanis and his team conducted a randomized controlled trial. Patients undergoing mastectomy with immediate implant-based breast reconstruction were randomly assigned to either go home the day of surgery or stay overnight and be discharged the following day.

“We designed this as a randomized trial because that’s the best way to answer the question objectively,” Kaoutzanis says. “There’s been growing interest in same-day discharge, but very little high-quality data looking at outcomes and patient experience.”

The study found no significant differences between the two groups in 30-day complication rates, emergency room visits, readmissions, post-operative pain scores, or opioid pain medication use.

“We found that emergency room visits were uncommon in both groups,” Kaoutzanis says. “Six patients who went home the same day and four patients who stayed overnight visited the emergency room within 30 days, which was not a meaningful difference.”

Among patients discharged the same day, the most common concern involved learning postoperative self-care tasks, such as managing medications or surgical drains, though these concerns were reported by a small number of patients.

Beyond the numbers

The study also focused on patient-reported outcomes, including how patients felt about their recovery and discharge timing. Most patients in both groups felt their discharge timing was appropriate.

Patients who went home the same day most often cited being in the comfort of their own home and with loved ones as the biggest benefit. Patients who stayed overnight appreciated having medical professionals nearby to answer questions, but many reported difficulty sleeping due to hospital noise and frequent interruptions.

“These are important things for patients to know ahead of time,” Kaoutzanis says. “Hospital stays can be reassuring, but they also come with disruptions to sleep and rest.”

Decision point

The study provides valuable information not only for surgeons, but also for patients deciding what recovery option feels right for them. Having clear data can help patients feel more confident that going home the same day, when guided by Enhanced Recovery After Surgery (ERAS) protocols, can be a safe and patient-centered option when recommended by their care team.

“Our overall finding is that patients maintain high quality of care and satisfaction whether they go home the same day or the next day,” Kaoutzanis says. “If a patient is comfortable, medically stable, and has support at home, same-day discharge can be a very good option. Many patients heal just as well, if not better, in their own environment.”