New research from the University of Colorado Anschutz Medical Campus suggests that patients undergoing implant-based breast reconstruction after a mastectomy may not need to stay in the hospital overnight.
The study, led by Dr. Christodoulos Kaoutzanis, associate professor in the Division of Plastic and Reconstructive Surgery, found that many patients can safely recover at home the same day as their surgery—provided they are medically cleared for discharge and their pain is well managed.
“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 said. “Hospitals can be noisy places, and patients are often woken up overnight for vital signs or routine checks, which can make rest more difficult.”
A Randomized Approach to Discharge Timing
Published last November in Plastic and Reconstructive Surgery, the study was a randomized controlled trial comparing same-day discharge with overnight hospital stays. Patients undergoing mastectomy with immediate implant-based reconstruction were randomly assigned to either go home the day of surgery or remain overnight for discharge the following day.
“We designed this as a randomized trial because that’s the best way to answer the question objectively,” Kaoutzanis said. “There’s growing interest in same-day discharge, but very little high-quality data looking at outcomes and patient experience.”
Key Findings
The researchers found no significant differences between the two groups in 30-day complication rates, emergency room visits, readmissions, post-operative pain scores, or opioid use. Emergency room visits were uncommon: six patients in the same-day group and four in the overnight group sought care within 30 days, a difference deemed not meaningful.
For patients discharged the same day, the main concern involved learning postoperative self-care tasks, such as managing medications or surgical drains. However, these concerns were reported by only a small number of participants.
Patient Experience Matters
The study also evaluated patient-reported outcomes. Most participants in both groups felt their discharge timing was appropriate. Those who went home the same day cited comfort, being with loved ones, and sleeping in their own beds as major benefits. Patients who stayed overnight valued the immediate access to medical staff but noted disruptions from hospital noise and frequent checks.
“Hospital stays can be reassuring, but they also come with disruptions to sleep and rest,” Kaoutzanis said.
Implications for Recovery Decisions
The findings offer guidance for both surgeons and patients considering recovery options. When combined with Enhanced Recovery After Surgery (ERAS) protocols, same-day discharge can be a safe, patient-centered option for those who are medically stable and have adequate home support.
“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 said. “Many patients heal just as well, if not better, in their own environment.”
