This article has been medically reviewed for accuracy by Rockville, MD board-certified plastic surgeon, Dr. Adam Tattelbaum on September 15, 2020.
Plastic surgeons have a penchant for trademarks—which has always struck me as curious, this naming and claiming of medical treatments. Are there brain surgeons out there, patenting fancy craniotomy maneuvers? It’s hard to imagine, but I digress. In aesthetics, branded treatments are everywhere—and generally designed to make a procedure seem unparalleled, in both innovation and ease.
Savvy (or merely skeptical) patients realize, of course, that incisions can never truly be “scarless” and even operations with cute names carry consequences. Still, with certain procedures, separating medical fact from marketing fiction can be challenging. Breast augmentation, for instance—the most popular cosmetic surgery in America—is commonly christened with one of the following synonymous descriptors: “Flash Recovery,” “rapid recovery,” “fast-track recovery,’ or the most precise of promises, “24-hour recovery.”
It’s natural to be dubious: after all, breast augmentation with silicone or saline implants is a general-anesthesia operation that involves slicing through skin, fat, and muscle, stretching and separating tissues, to insert a pair of foreign objects. Yet this physical trauma, we are to believe, can be overcome faster than, say, the average head cold.
The thing is, these swift-recovery vows appear on the websites of some of the most esteemed breast surgeons in the world—the very doctors known to rail against unethical marketing. For us, this fact lends some degree of credence to the claims—enough to warrant further digging. Ahead, everything you need to know about rapid recovery breast augmentation—from the evidence supporting the carefully orchestrated procedure to what you can expect in the hours after.
What is Flash Recovery Breast Augmentation?
These promotional names are actually rooted in science. Between 2002 and 2008, two board-certified Dallas plastic surgeons, Dr. John Tebbetts and Dr. William P. Adams Jr., published a series of papers detailing steps surgeons should take—before, during, and after surgery—to standardize and refine breast augmentation for more predictable results. (Dr. Tebbetts’ two-part study, here and here, laid the groundwork; Dr. Adams built on it and cemented the particulars.) “The 24-hour recovery is a by-product of this process,” explains Dr. Adams, referring to the methods he mapped out in his 2008 paper, “The Process of Breast Augmentation: Four Sequential Steps for Optimizing Outcomes for Patients.” At the outset, however, the goal of his work wasn’t necessarily to shrink downtime—“it was about decreasing the complications of the surgery and having outcomes be better for patients,” he says.
In his study of 300 primary augmentation patients, 97% “returned to full normal activities of daily living, including washing and drying hair, getting dressed, picking up children younger than 3 years old, [and] driving a car,” within 24 hours of surgery. The process was also shown to dramatically slash reoperation rates.
Over the past decade-plus, the rituals of the 24-hour recovery have come to represent a gold-standard baseline for breast augmentation—one that most modern-day board-certified plastic surgeons have adopted and evolved according to their own firsthand experiences.
The rules of rapid recovery extend beyond the operating room, influencing every stage of care, and demand a solid partnership between patients and doctors. Here, an overview.
Before breast augmentation surgery
The 24-hour concept kicks off at consultation. “Patient education is the most important thing,” according to Dr. Adams, since “the more a patient knows, the better they do.” In his practice, patients have a lengthy discussion with a dedicated patient educator in order to learn the ins and outs of the procedure, including the risks involved, the various types of implants and their defining characteristics, and what’s to be expected post-op. They later meet with Dr. Adams, who systematically analyzes and measures the breasts and “picks an implant that fits their tissues.”
In other words, objective breast dimensions steer patients to implants that are appropriate for their anatomy. This kind of “careful pre-operative assessment is very important,” says Dr. Ashley Gordon, a board-certified plastic surgeon in Austin, Texas. Selecting an implant based on measurements before surgery—rather than playing the once customary trial-and-error sizing game with patients under anesthesia—keeps everyone on the same page, saves time in the OR, and lends to a speedier recovery by guaranteeing a good fit.
“Using an implant that’s too large for the patient’s tissues could make the recovery longer and more painful [by causing] excessive stretching of the muscle and the skin,” Dr. Gordon explains.
Beyond improving downtime, “thorough preoperative planning and ensuring the patient is comfortable, [is] fully educated about, and [has] consented [to] the planned procedure is also extremely important in reducing reoperation rates,” adds Dr. Umbareen Mahmood, a board-certified plastic surgeon in New York City.
During breast augmentation surgery
Dr. Tebbetts’ papers lay out surgical guidelines concerning general anesthesia and other intraoperative drugs; the use of specific tools, like electrocautery, to decrease tissue damage; and strict techniques, to control bleeding during dissection (blood breeds inflammation and pain) and avoid touching sensitive structures, like ribs, when placing the implants. “By standardizing every micro movement, the procedure is more efficient, the surgery is shorter [roughly 30 to 60 minutes], and recovery time and complications are reduced,” says Dr. Michelle Lee, a board-certified plastic surgeon in Beverly Hills, California.
In Dr. Lee’s estimation, the most crucial elements of the flash formula—those integral to minimizing hiccups during healing—are “meticulous surgical technique, gentle tissue handling, and placing an implant that is proportional to the body and does not stress the tissue,” she says.
While certain core tenets of the 24-hour recovery may seem intuitive to today’s breast surgeons, they are nevertheless essential to a successful operation. “It still surprises me that someone had to publish an article telling surgeons to be gentle with tissues and to minimize bleeding,” says Dr. Gordon (though apparently “blunt dissection”—tearing through breast tissue with fingers—was common back in the day). Still, Dr. Gordon adds, “the points about bloodless dissection and not touching the ribs with retractors, as it leads to unnecessary pain, are valid and important”—for curtailing both the immediate recovery and long-term issues, like capsular contracture, which can be triggered by residual blood in the implant pocket.
Like many plastic surgeons, Dr. Gordon centers her breast augmentation approach around published protocols, then customizes it based on the latest research and her own expertise. “For me, the key components of a rapid recovery breast augmentation include full muscle relaxation during dissection, dissection under direct vision, meticulous hemostasis [to prevent bleeding], and placement of the implant using a no-touch technique with a Keller funnel,” she says. “All of these minimize trauma to the tissues and decrease inflammation. With less inflammation and muscle spasm, there’s less pain and swelling, and the implants settle into position faster.” (The no-touch trick also helps prevent implant contamination and related problems.)
Barring general anesthesia, there isn’t a universally agreed-upon strategy for the administration of meds during surgery, but Dr. Gordon has found that giving IV ketamine and injecting the breast pocket with a long-lasting local anesthetic before placing the implants can “reduce the need for narcotics in the recovery room and in the post-op period”—which is another major goal of the Flash Recovery Breast Augmentation.
Related: The Best Bras to Wear After Your Breast Augmentation, According to RealSelf Members
After breast augmentation surgery
Addiction dangers aside, “narcotics are not great pain meds—all they do is mask the pain,” says Dr. Adams. “They make patients nauseated and sleepy, which works against what we’re trying to accomplish [with the 24-hour recovery].”
In an effort to curb patients’ reliance on narcotics, “many surgeons give a regimen of Celebrex [an anti-inflammatory], gabapentin [for nerve pain], and Tylenol,” Dr. Mahmood says. (There may also be a muscle relaxer in the mix.) “A rapid recovery [also] means dissolvable sutures and no unnecessary drains, bandages, or surgical straps. Patients are allowed and encouraged to shower the next day as well as resume all their daily activities and practice range-of-motion exercises with their arms and shoulders.” They can typically drive the day after surgery, so long as they don’t have narcotics or muscle relaxers in their system.
The only real post-op limitation, notes Dr. Mahmood, relates to exercise: no vigorous physical activity or heavy lifting for three to four weeks. Dr. Gordon tells patients to avoid lifting anything over 10 pounds for at least a couple of weeks, to avoid any bleeding in the pocket and to encourage the pectoral muscles to relax as quickly as possible, she says. (For the record, doctors have different opinions about when it’s safe to resume strenuous activities.)
Some surgeons send patients home with more exacting instructions. “My patients have about eight hours to get into fast-track recovery,” Dr. Adams explains. “They go home, take a nap, take a hot shower. We give them gentle arm raises to do, to keep the soft tissues moving and the pectoralis muscles from getting stiff and sore.” Many patients even go shopping or out to dinner the same day, he adds—but “they can’t just go home and lie in bed for a couple of days.”
That said, breast augmentation recovery stages can vary with the individual. “Some patients just have a more difficult time, and we never identify why,” says Dr. Gordon. Patients with well-developed pectoralis major muscles may suffer more muscle spasm and discomfort, she notes. Those with tuberous breasts or otherwise tight breast envelopes, whose tissues require more stretching and manipulation during surgery, may have a slightly longer recovery.
It’s also worth noting that “patients perceive pain differently, even if all other variables are equal,” she adds, and some women do lean on narcotics in the days following surgery.
Is rapid recovery breast augmentation more than marketing?
Truthfully, yes. While these descriptions are, no doubt, used to woo patients, there’s strong evidence supporting an abbreviated recovery when doctors (and patients) follow rigorous blueprints for up-front counseling, best practices in the OR, and post-op orders.
Of course, even recognized guidelines are open to interpretation, and “it can be difficult to assess what ‘rapid recovery’ means to one surgeon versus another,” notes Dr. Lee.
There’s also the risk of having patients misconstrue the lingo or take catchy claims too literally.
“I call our [version] the ‘rapid recovery protocol,’ because I don’t think it’s realistic that every woman will feel back to normal in 24 hours and I don’t want to set that expectation. I still like for them to take a few days off work, just in case,” says Dr. Gordon, who finds that, with the exception of exercise and heavy lifting, patients usually bounce back in about three days.
“What’s critical to remember,” adds Dr. Lee, “is that even if you do feel great at 24 hours, it doesn’t mean you’re all healed and able to go to the gym the next day.” Regardless of the label one slaps on a boob job, complete “recovery after breast augmentation still takes three to four weeks. If a patient goes back to full activity too soon, it will actually slow down recovery.”
When consulting with doctors, ask which aspects of their breast augmentation surgery allow for an expeditious recovery. Inquire about medications used during surgery and prescribed afterward. Press for a realistic back-in-action timeline and make sure you understand your role in your recovery. Above all, prioritize the name of your surgeon over the name of the surgery.
Ultimately, “the goal of most board-certified plastic surgeons is for their patients to have the easiest, fastest, and safest recovery,” says Dr. Gordon—whether they advertise that fact or not.
