How long should you sleep at a 45* angle, with the wedge pillow , after your breast augmentation?

I advise my patients that they don’t have to sleep on their back or sit up all night after breast augmentation surgery. They can sleep any way they want from the night of surgery on, including on their stomach, if they are comfortable enough. They won’t pop or displace their implants by sleeping on them; implants are extremely durable. For more information on this and similar topics, I recommend a plastic surgery Q&A book like "The Scoop On Breasts: A Plastic Surgeon Busts the Myths."

As you can see there are a variety of answers.  I have been in practice for 30 years with an extensive breast augmentation experience, and I have never recommended elevation unless the patient felt more comfortable in that position.  Although there will be some effects on swelling in the first week, there is no evidence that it has any impact on the long term result. For a variety of postoperative instructions you will see variations among surgeons. That being said, it is always good advice to follow your surgeon's advice.   Every technique is different, and each surgeon has a preoperative and postoperative routine that has worked well for them.   However, many instructions are based on beliefs rather than firm data.

Elevation of the chest/breast area above heart level is what surgeons are trying to achieve by these type of recommendations, so that gravity can help remove tissue swelling and aid in faster and more comfortable healing.45 degrees is arbitrary, and may be hard to continue for any length of time. I personally tell my patients that head higher than heart is sufficient, and that can be nicely achieved by simply placing a sofa cushion or two side by side under the head-end of the mattress. (Trying to sleep on 2 or 3 pillows doesn't work very well when you roll over or shift in your sleep!) The length of time is also arbitrary, since patients swell, bleed, bruise, and hurt after surgery differently. If every patient had the same exact response to surgery, it would be easier to "set" a precise timetable for these recommendations. Some surgeons might prefer "easy" over "best," and others will recommend what they feel is best for their patients, even though they understand that difficult-to-follow recommendations will NOT usually be followed exactly! So the best recommendations are the ones that both make sense and are relatively easy to follow.That's why I recommend that my BA patients sleep elevated (not 45 degrees, but head higher than heart, as a cushion under the mattress allows) for 2-3 weeks. Longer if there is more swelling and discomfort, shorter if there is less or a more stoic patient.But since every surgeon has their own formula for success, this is one question you should ask your own surgeon. I hope my personal recommendations, and why I make them, sound sensible and can act as a basis for your discussion with your own surgeon. Best wishes! Dr. Tholen