Post-op instruction were to abduct arms over head every hr to keep pectorals stretched. Am I causing more harm than good?(photo)

Just had surgery 10/28. Bilateral under muscle, peri-arreolar incision, 360 saline mp. Post-op instructions include to abduct arms above head x6 every hour to keep muscles stretched. My concern is that I've been seeing that most women say they were told to limit their arm movements, or not put them above their heads at all. Am I causing more harm than good? I know it's more important to listen to MY surgeons instructions.. I think I'm just looking for reassurance.

Doctor Answers 6

Are my arm abductions right this early after surgery

Thank you for your question about your breast augmentation.

This is a very interesting question because there is no controlled study to answer it.
Typically because of the pain, women are advised not to move their arms.
But recently - since stretching the muscle reduces the pain from muscle spasm and prevents a frozen shoulder and should allow the implants to settle faster - more surgeons are suggesting upper arm stretches. 

Your photo suggests you have good arm motion. If you have no pain but it doesn't feel right for your implants, discuss with your surgeon. 

Be sure to consult a Board Certified Plastic Surgeon.
Hope this helps. Have a great day.


Arm Movement Is Probably OK

If that is what your surgeon likes to instruct for post-op care and he/she has predictable results with it than it is probably OK.  My question is what is the purpose of keeping the pectoralis muscle stretched?  That is never a concern of mine with post-op augment patients.

I tell my patients that they can use their arms immediately post-op to care for their hair, brushing and when ready washing and drying.  But I tell them not to reach higher than that, example I use is to not reach for things in high cabinets.  Getting to the head is usually enough to keep should range of motion normal.

So I do it differently than your surgeon, but your instructions from your surgeon could be perfectly fine.

Gordon Telepun, MD
Decatur, AL

Arm movement after breast augmentation--good or bad?

I understand your question, as this is indeed one of those "some do, and some don't" issues, just like implant "massage" or displacement exercises.

I also note you are wearing a tight surgical or sports bra--is that to minimize the risk of bleeding from excessive arm movement? Just kidding--a bit.

I recommend movement for my patients, but NOT stretching or extremes of movement. Suppleness is good, but stretching to the limit may actually pop a few blood vessels and cause increased risk of bruising, bleeding, hematoma, or even capsular contracture, some of these requiring re-operation and compromising your result.

Some surgeons recommend that their patients lay on their chests to stretch the implant pockets (I do not), and some surgeons let their patients go dancing a day or two after surgery (why, that must be some special surgeon whose patients heal faster than everyone else's). With that kind of marketing, maybe they don't care about a higher hematoma re-operation rate!

Assuming most patients are normal, have adequate nutrition, and heal pretty much like everyone else, there is NO special surgical technique other than careful tissue handling, precise hemostasis, and attention to detail that will give any surgeon's patients any better or faster healing healing than another's. Of course, rough tissue handling, blunt pocket dissection, and lots of bruising and bleeding requiring Ace compression bandages or tight surgical brassieres does take longer to heal. But there is no unique "overnight" breast augmentation, "flash recovery" or other snappy-named procedures that are "better" than good surgery by a skilled surgeon. And following your surgeon's recommendations, since  it is to him/her you will go if there is a problem!

I understand your concern, but your surgeon is the one to ask the question of--ask for his/her hematoma rate with this regimen. If it's under 1-2%, then you should follow your surgeon's instructions. If it's higher, I think you're right to question this activity. Motion is lotion, but excessive activity is hematoma and re-operation. Best wishes ! Dr. Tholen

Richard H. Tholen, MD, FACS
Minneapolis Plastic Surgeon
4.9 out of 5 stars 239 reviews

Arm Movements After Augmentation

I agree with your surgeon.  I instruct my patients to move their arms above their head beginning in the recovery room and I think this helps a lot with the recovery.  I think it is unlikely that arm movement will displace the implant out of position and to depend on immobilization to accomplish what proper pocket dissection did not is likely wishful thinking.  Despite this, however, I realize there is a difference of opinion amongst plastic surgeons and patients should definitely follow the instructions of their surgeon.  After all, if you had enough confidence to trust your surgeon to perform surgery you should also have confidence in their postop instructions.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 73 reviews

Post-op instruction were to abduct arms over head every hr to keep pectorals stretched. Am I causing more harm than good?

Honestly I sure your concerns.  I suggest that you contact your plastic surgeon and make certain that these are the exact instructions and tell the plastic surgeon that you were concerned about pain, bleeding and other problems with extreme overhead stretching of your arms after a sub-muscular augmentation.

In my practice I asked my patients to avoid extreme upper arm stretching until you're further along in their recovery.

Arm abduction

Thanks for your question and photo. When it comes to postoperative instructions we all differ a little bit. I allow my patients to raise their arms for daily activities such as hair washing and brushing, but ask them not to lift heavy objects. Stretching your muscle gently should be fine. I suggest you follow your surgeon's protocol as it has worked for him/her. Good luck!

Jeffrey Umansky, MD
La Jolla Plastic Surgeon
5.0 out of 5 stars 36 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.