How long would I have to wait to go back to work, or even lifting my child after a BA?

Question

I do heavy lifting at my job as well as constantly moving and bending over countless times, and my child is older but still needs me to help them but i’m curious how long is the recovery? The first week and so on. I understand some surgeons like to use drain tubes and some don’t. Why is that? Is there a higher risk not having drain tubes or vice versa? Thank you!

S. Larry Schlesinger, MD, FACS · Answer

What a great question!  I have been asked this question at least three times per week.
The answer to your question depends on where the incision is made - peri areolar, inframammary or transaxillary, whether the implant is above or below the muscle, also whether this was a primary or secondary procedure.  
If you were my patient and I placed your implant through your armpit under your muscle, I would think it appropriate to lift small babies after 5 days.  As to when you can return to work with heavy lifting, somewhere between 10 days to 3 weeks, depending on the variables above and what you consider heavy lifting.  
With reference to drainage tubes, some surgeons use them and some don't.  I happen to belong to the group of plastic surgeons that use drainage tubes known as Jackson-Pratt drains.  I believe the #1 cause of hard breasts after a breast augmentation is blood around an implant.  This blood is a perfect culture media for bacteria.  Non-pathogenic bacteria get into the pocket no matter how careful the plastic surgeon is, no matter how much antibacterial wash is used, and no matter how careful you are changing to sterile gloves and using the Kellar funnel,  Still some non-pathogenic bacteria get in, and if there is blood present, they will multiply at a very rapid rate.  If there is any blood in the pocket.  I believe that levaging the pocket just before the drain is placed will allow the last little bit of blood to be pulled into the drain, decreasing the red blood cells present, and therefore decreasing the chance of ultimate capsular contracture.  I normally leave the drains in only 24 hours except for certain circumstances such as a total capsulectomy, then I normally leave my drains in for 3 days.  
I believe some surgeons feel that no drainage tubes are safer because they historically leave drainage tubes in too long.  I believe if drainage tubes are removed before 72 hours, the benefits far outweigh the potential negative results.

Christopher J. Davidson, MD, FACS · Answer

Thank you for your questions.  Although post operative instructions do vary from one plastic surgeon to another, I advise my patients to not lift anything greater than 15 pounds for 4 weeks following breast augmentation.  Drain placement in a breast augmentation is not common practice.  Best of luck.

Dallas Buchanan, MD · Answer

Thank you for your questions. Every surgeon has his or her own protocol for recovery but some of the details are going to depend on your surgery as well. For the standard dual-plane (sub-muscular) augmentation, I usually recommend that patients do not do serious heavy lifting for 6 weeks. So for your job, you might need light duty for awhile when you go back. If you have an implant above the muscle, this restriction would be less. As for the drains, I think that the majority of surgeons do not use drains for a standard breast augmentation as there is little evidence to support their use.Hope this helps!

Ted Eisenberg, DO, FACOS, FAACS · Answer

More than 90 percent of my patients are back to work in an office setting by the 5th day after surgery. Others who use their arms a lot by the 14th day. Children are safely lifted by the third day to be transferred from crib, high chair or car seat. Always a good idea to check with your surgeons protocol. I never use drains for breast augmentation surgery. Drains are commonly used for reconstructive procedures.Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author

Vincent N. Zubowicz, MD · Answer

It's highly unlikely you'll have drains after breast augmentation. Convalescence will be determined by your own surgeon. In my practice patients are going about their daily routines within a couple of days. There permitted to drive as soon as they can do so safely. Taking a child would be permitted as soon as it is comfortable. Athletic activity that would involve any significant movement of the breasts would be permitted after four weeks of uncomplicated convalescence.

Daniel Barrett, MD · Answer

Dear jjeennyy,the majority of breast augmentation patients need one week of downtime. Depending on the work environment (heavy lifting, etc) more time off may be necessary. Patients are encouraged to walk immediately after surgery to avoid blood clots in the legs. I suggest that you follow your plastic surgeon’s post-operative instructions, especially on the level of activity that you can do and your scheduled follow up checkups, for faster and recovery.Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Edmund Ek, MBBS, FRACS (Plast) · Answer

I appreciate your good question! Drains can be placed after breast surgery – the primary reason is to ensure sufficient drainage of fluid to prevent build-up and possible infection. It is difficult to say whether drains will be a part of your protocol since there are a variety of factors that might play into this decision. As far as lifting, you will want to avoid heavy lifting and exercise for a few weeks after breast surgery to allow the incisions ample time to heal. Depending on the placement of the incisions and the rate at which your body heals, that timeframe could be anywhere from four to six weeks. Good luck on your breast augmentation!

Steven Varkony, MD · Answer

Every surgeon has their own recommendations for post-operative care that is dependent on the patient and the procedure done. It’s important that you follow your surgeon’s instructions to ensure the best results. We recommend scheduling a follow up appointment with your doctor to further discuss your results.

Curtis Wong, MD · Answer

varies by surgeon to surgeon as does drain use.  I would only use drains if I was using textured implants but there are many that do not.  Drains only add one more risk to your recovery in my opinion.  As for returning to work, my patients can resume activities as desired at 3 weeks post-op, starting slowly and working their way up to their normals.  Some surgeons will have you want 6 weeks.  So if you want to return to work asap, find a surgeon whose protocols match your needs as you want your surgeon to stand by their recommendation and if you have a problem because of your activities you were released to, you want your surgeon covering your back and not blaming your for causing this problem.

Eric YK Li, MD · Answer

Generally speaking, you need to wait a full 6 weeks before returning to full, unrestricted activities.  Any lifting over 15 pounds is also not allowed during the first 4 weeks.  If you want to return to work earlier but have a physically demanding job, you may need to return with modified light duties.  Most surgeons don't use drains after a primary breast augmentation, but some reasons for using it would be greater than normal amounts of bleeding encountered during the operation.  When drains are used properly and removed in timely fashion, the added risk of infection is negligible.  Hope this helps!

How long would I have to wait to go back to work, or even lifting my child after a BA?

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