How Long to Recover from Dual Plane Breast Augmentation?

Question

I am going for surgery next week, and would like to know how long is a sufficient time to recover. I do not want to rush anything, and want the surgery to be successful. Is 3-4 weeks really long enough? Would 6-8 or longer be better? I am reading so many different things, and am quite confused.Thank you for all your feedback.

Larry S. Nichter, MD, MS, FACS · Answer

Recovery varies from person to person and often indivisulaized by your plastic surgeon. Here are some general guidelines:You can usually drive after all pain and muscle relaxation medications have stopped, and you feel comfortable with this activity, usually within the first week following surgery. Many patients can return to work in a few days, unless their occupation requires particularly strenuous movements and lifting. In such a case, up to 6 weeks may be required depending on the physical demands of your job. The final appearance, shape, and movement are not exactly the same as normal breasts. The surgically enlarged breasts do not move in the same way as normal breasts. They tend to be firmer. The contours are usually somewhat different than normal breasts. In some patients these discrepancies may be rather noticeable. Although every effort is made to place the implants symmetrically, complete symmetry is rarely achieved. Immediately after surgery, the breasts are swollen and firmer. The final shape and size is approximated after 2 to 3 months, but up to one year may be required for the end result. Initial discomfort is controlled with oral medication. Sutures dissolve in 7 to 14 days. Light activities can be resumed as tolerated. Light exercise can be started in about 2-3 weeks, and strenuous exercise after 6 weeks. Your doctor may require you to move or massage the implants within the breast pockets during the postoperative period. Textured implants do not require breast massage.

Jaime S. Schwartz, MD, FACS · Answer

I appreciate your question.  
Typically, my guideline is, the first week is the hardest. By the second week you feel better, at four weeks you feel 100% and at six weeks you can go back to complete normal routines and exercising.  
Four days after surgery, I would be careful as you are still at risk for bleeding. If you are taking any pain medication, I would not drink alcohol.  With my 'Schwartz Rapid Recuperation' recovery, most of my patients are out to dinner the following evening.
The best way to assess and give true advice would be an in-person exam.  Please see a board-certified plastic surgeon that specializes in aesthetic plastic surgery. 
  
Best of luck! 
    
Dr. Schwartz 
Board Certified Plastic Surgeon 
#RealSelf100Surgeon 
#RealSelfCORESurgeon

Jerome Edelstein, MD · Answer

Recovery guidelines vary according to the surgeon, that's why it's best to ask your surgeon for their advice. It also depends on what you'd like to do. Generally, I recommend patients wait 5-7 days before returning to sedentary work, and 3 weeks before resuming cardiovascular exercise. You should wait 6 weeks before resuming upper body strength training and heavy lifting. Your results can be assessed at 3-4 months.

Asif Pirani, MD, FRCS(C) · Answer

It really depends on a few factors.  Adequate pain control is likely the most important.  Individual pain tolerance differs greatly.  I find that women who have had children generally have less post-op pain, as they have a much higher pain tolerance. From a surgical point of view, there are several things the surgeon/anaesthesiologist can do to decrease your post-op pain.  I generally perform breast blocks prior to making any incisions with a mix of short- and long-acting local anaesthetics.  I have found this greatly reduces post-op pain.  I also encourage patients to take the prescribed pain killers regularly every 4 hours especially for the first 24-48 hours. If you don't stay on top of the pain in the immediate post-operative period, it is extremely difficult to "catch-up".  Most of my patients experience very little post-op pain after breast augmentation.Of course, the type of augmentation you have will also determine your post-operative discomfort.  Larger implants, and subpectoral implant placement will also increase post-op discomfort.  This doesn't mean you shouldn't get large implants, or place them under the muscle - you simply need to know what to expect.  Many women also experience difficulty with sleeping in the first few weeks after augmentation due to the weight of the implants on their chest.  This is more significant in back-sleepers.To answer your question about time off work, my experience has been that there is a huge  range.  I have patients that go back to work the next day (against my advice), and I have had patients take as much as 2 weeks off of work.  It really depends on what you do for work, and how you feel.  As for taking care of your kids, if your implant is placed under the muscle, it will be a few weeks before you feel comfortable enough to pick them up.As for scars, I tell patients it will take a year to see the absolute final result.  Practically, however, by 3-6 months the scar will be very close to the final result.  I suggest 3M paper taping, and have a specific scar massage protocol I use to help speed scar resolution.I hope this helps.  Good luck!Sincerely,

Thomas Fiala, MD, FACS, FRCSC · Answer

The dual plane technique is our usual method of performing this surgery.  Most of our patients are back at work in a week, and back at the gym in 3 weeks.  Most use their pain pills for the first 2-4 days.  Usually very little bruising. 

	So yes, I think 3-4 weeks, as you have suggested, really is enough, unless you have some unusually active job or hobby.

	 

	All the best,

Brian Coan, MD, FACS · Answer

Thank
you for your question. I have included some typical expectations of breast
surgery recovery and signs to watch for following breast augmentation:
Stiffness, swelling
and bruising in the chest region: These are normal experiences as the skin,
muscles and tissue heal. Pain medication and muscle relaxants will help you
cope with any discomfort. Consistent sharp pain should be reported to your
board-certified surgeon.Hypersensitivity of
nipples or lack of sensitivity: This is normal and will gradually resolve over
time.A mild to severe itchy
feeling of the breasts is possible as healing progresses. An antihistamine like
Benadryl can help to alleviate severe, constant itchiness. If the skin becomes
red and hot to the touch, contact your board-certified surgeon
immediately.Asymmetry, the breasts
look different, or heal differently: Breasts may look or feel quite different
from one another in the days following surgery. This is normal. No two breasts
in nature or following surgery are perfectly symmetrical.Discuss returning to
work with your board-certified surgeon, in our office it is typically 3-5
days post-surgery but you may not overexert yourself or do any heavy lifting.You may resume
exercise and your normal routine at six weeks unless your surgeon advises
otherwise.

Pablo Prichard, MD · Answer

Thank you for your post. There are a lot of variables to account for after breast augmentation and what to expect in the recovery process. Done well, breast augmentation can have a very long lasting beautiful result. The following is an outline of what to expect after augmentation based on some of these variables.  In general, treat 'dual plane' augmentation as very similiar to 'sub-muscular' in the recovery process.1. Pain: In general, breast augmentation is tolerated very well. When the implant is placed sub-facial or sub-glandular, i.e. above the muscle, there is very little pain post-operative. The muscle is left in place and in general, when I perform this technique, women have surgery on Friday, and are back to work (as long as they are not lifting heavy objects) on Monday. When the implant is placed sub-muscular, then there more pain and soreness as the muscle has been elevated which is similiar to having a pulled or torn muscle. This creates more swelling and takes longer to heal. In these case, most women take at least a week off of work.2. Swelling and Size: It is very common to be about a size bigger right after surgery than what your final result will be. Swelling starts to occur right after surgery and tends to peak in the first week. After about a month you will have lost most of the swelling, but still not completely at baseline. After about another 3 months or so, you will have lost 99% of your swelling, but still have a pretty good idea of your final size at 1 month. I wouldn't spend a lot of money on bras until 3 months though, as they might not fit perfectly after all the swelling goes away. Also, the more activity you have, the longer the swelling stays, the more that needs to be done as far as lift etc. with surgery, the longer your swelling stays. As stated above, going below the muscle tends to produce more swelling and lasts for longer.3. Scars: The natural healing process undergoes multiple phases, but in general, the first phase is the inflamatory phase were any scar will be firmer and may turn red or darker initially. This tends to last for 3 months. After this phase is the resolution phase where the scar inflammation goes away and all scars will be at their baseline at 1 year. The scars are mostly at their baseline at 6 months. The scars should be minimal if placed well, and sutured properly. I also like to protect the scars from stretching or widening in the first few months with surgical skin tape. The incision will be weak at first and susceptible to stretch or widening.4. Massage: Your doctor may recommend early or late massage, depending on what is trying to be accomplished. In general, early massage is to manipulate a high implant or stretch a constricted area, such as in tubular breast syndrome, and late massage is to help fight capsular contraction. Search 'Breast Massage' to find my recommendations on this.5. Exercise: In general, I ask my patients to keep away from aerobic activities in the first 2 weeks following surgery. Increased activity can increase swelling and hyper-swelling can cause stretch marks. Following this, 'non-bouncing' aerobic activity is fine, such as speed walking or cycling, but would like to keep the implants from moving too much until the capsule that forms around the implant has a chance to heal and become stronger. At 6 weeks, I clear any type of activity.6. Infection: Infection after augmentation is very rare. Most surgeon give post-operative antibiotics to help protect you from infection.7. Hematoma/Seroma: These are also very rare after augmentation. If the pocket for the implant that is made during surgery is a hand in glove fit, then there is very little room for any fluid to collect. It is important that the surgical pocket be free of any bleeding prior to closure to keep a hematoma from happening. If a hematoma does occur, it is important to drain the hematoma to prevent capsular contraction.8. Sleeping: I ask women to sleep on their backs with their post-operative bra on after surgery to keep the implants in their proper position until the capsule that forms around the implant has a chance to heal.I hope this has answered most of your post-operative questions.Best Wishes,Pablo Prichard, MD

Steven Wallach, MD · Answer

Everyone heals a bit differently, and it also depends upon what type of surgery you have doen. In my practice, patients often fell better within a few days and can go back to desk work within a week. I usually have them limit aerobic activity for 3-4 weeks and heavy liftng for 6-8 weeks.

Ralph R. Garramone, MD · Answer

In my practice most patients are over the initial discomfort in about 3-4 days and most patients with a desk type of job usually return to that job about 5 days after surgery. I usually let patients start light aerobic work outs at about 10 - 14 days after the breast augmentation but they may start a bit earlier or they may be out walking around their neighborhood after just a few days.

	I usually have patients start lifting weights at 4 weeks and they have no restrictions at 6 weeks. So its a gradual return to activities. Most patients have some hypersensitivity of the skin of the breast or of the nipple at one month.  This resolves over the next several weeks. At three months it is rare to have any hypersensitivity and nearly all patients at that time feel as though the breast implants are part of their body.

	I hope you find this helpful.  Thank you for the question and good luck.

Herluf G. Lund, Jr, MD · Answer

In my practice, I have not found any signifigant differences between patients who are having a dual-plane release and those who are having another version of a breast augmentation.  Most patient can return back to a desk job in 2-3 days.  Brisk walking can begin at that time.  In 7-10 days, they can start light aerobics.  At 3 weeks, I let my patients return to almost all of their normal activities with the recommendation, start slow and work your way back up to where you were before your surgery.

	Swelling after breast augmentation will vary from patient to patient and also depending upon the technique used for the surgery.  Blunt dissection techniques tend to have longer period of swelling than other techniques.  For the most part, the majority of swelling should be gone at three weeks post-op and the remainder gone over the next month or so.  

	Best of luck.

How Long to Recover from Dual Plane Breast Augmentation?

Answers (12)

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