I am assuming this varies from doctor to doctor and I plan on asking my PS these questions as well, but I was wondering how the majority would answer these questions. Will I need to buy a post op bra or will/should it be provided by my surgeon? I've heard about "silicone" bandages or something along those lines for scarring after surgery. Are these good to use? Amica Montana pills, vitamin E and B? Are these reccomended and safe?
Post Op Bra and Medications?
Doctor Answers (5)
Post op bra and meds for breast augmentation
Every surgeon has a different approach. I have my patients buy a bra that meets my specifications (we have a list of acceptable bras, no underwire but firm-fitting band in the inframammary fold), I put them in a bandeau to stabalize the implants initially but how long depends on what I am trying to accomplish, which varies from patient to patient in terms of tissue tightness, need to stretch a tight or constricted lower pole, etc. I have my patients on antibiotics post-operatively, I start them on Vitamin E after they are out of the bleeding risk period at 2 weeks, and I have been using Singulair (off-label) to try to reduce the risk of capsular contracture. I also have patients massage the breasts, but the maneuvers depend again on their anatomy and what I need to accomplish in their specific case. There are some other things that I do as well, but again, everyone has their own methods. If there was one known best approach, eveyone would be using it!
After Breast Augmentation Garment and Vitamins
Each office will have their own policy, but I provide a soft cup, front opening bra that is placed on the patient before waking up from surgery. Once the incision has healed I recommend silicone sheeting to be used over the incision for scar management. Arnica Montana is a homeopathic remedy that many believe helps with swelling and bruising. I inform my patients of this but it is optional. I do recommend that my patients take a good multiple vitamin that does not have more than 400 units of vitamin E which can thin the blood. Be sure to inform your surgeon of any supplements that you are taking as many of them can have blood thinners in them and that is something to be avoided two weeks before and two weeks after surgery.
Breast Implants, Bras, and You
Yes Post op Bras are incredibly helpful early in the post operative course. Sports bras are forgiving as the material in the bra allows for patient swelling.
After 1-2 weeks, patients that have had sub glandular should use underwire. Sub muscular should NOT use underwire simply becuase sub muscular implants tend to ride higher. As the new capsule is forming, we don't want to hold the breasts up to high.
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Breast Implants, Post Op Bra, and Medications
You are correct, every plastic surgeon will have their own postoperative breast augmentation protocol regarding the use of bra use, scar management, massage, etc...
If your surgeon wants you to use a specific post operative bra, this will usually be provided by the office. If, however, your surgeon does not have a preference regarding your post operative breast augmentation bra, he/she may suggest you simply buy the sports bra, or other bra, of your choice.
I do not routinely recommend silicone sheeting for scar management unless patients currently have, or have a history, of hypertrophic or keloid scarring. Silicone sheeting can be initiated within the first several post operative weeks and may be helpful up to a year post operatively. I do not recommend Amice, Vitamin E, or Vitamin B for scar management. These medications have not been proven to reduce scar formation. The most important thing you can do to ensure the best scar possible is to avoid sun exposure for at least a year and to initiate scar massage when your plastic surgeon allows.
Jaime Perez, M.D.
Breast Implant Specialist in Tampa, Florida
Plastic Surgery Center of Tampa, Florida
Good questions for your consultation
The use of garments is at times necessary to control implant postion in the early post operative period. The need to use such garments depends on the tightness of your breast envelope, whether the implant is position under or overtop of the muscle, and the philosophy of your treating doctor. For example, tight lower pole of the breast along with submuscular implant placement often pushed the implant too superiorly in the early post operative period. This high implant position can be prevented or improved by use of specially designed compression breast garments to push the implant downwards in the early first 6 weeks after surgery. Siicone sheeting can often help scars soften and mature if used in the first 6 months following surgery and worthwhile to consider using starting 2-3 weeks after surgery. I am not a fan of using Amica or Vit E. They are not proven but probably not harmful.