I had a double mastectomy a week ago. I have swelling under my arms. Should I use an ice pack to relieve the swelling?

Some physicians avoid ice packs for postmastectomy swelling, but I find cold packs in the axilla are comforting, and relieve pain and swelling without compromising blood supply. The breast flaps are more vulnerable to blood supply problems so I wound not use cold on the chest wall. Since your sensation may be abnormal, make sure the packs are not too cold nor kept on the skin for too long - 10 minute intervals are generally safe and soothing. Swelling in the axilla may be due to fluid accumulation which may be aspirated or likely will resolve with time. Are your drains still in? if so they may not be draining the axilla well. If the swelling is associated with pain, a hard mass or redness, or enlarging, consult your doctor immediately to rule out a hematoma (bleeding) or infection. Good luck and take care.

In general I advise my post-mastectomy patients not to use an ice pack, and there are several reasons for this. The cold may compromise blood flow to an already compromised area, thus leading to delayed wound healing. Another possibility is that you can get frostbite, as the nerves in your under-arm area may have been affected by the surgery and unable to warn you when your skin is getting too cold. Of course every surgeon has his/her own preference, so I would defer to your reconstructive surgeon to definitively answer this. There is no right or wrong answer.