is extreme swelling on one side 5 days after breast augmentation safe/normal? (Photo)

Swelling after breast augmentation is normal. So is muscle spasm and pain. What is not normal is "EXTREME" swelling, to use your words. It is very likely that your swelling is not a concern, especially because it is the same on both sides, however, if any of my patients claimed to have "extreme" swelling, I would want them to be seen immediately - no matter what time or day.  I am sure that your surgeon (and everyone else on this site) would feel the same way. It is best that you are seen if you are concerned so that your surgeon can make sure that you do not have a hematoma or bleeding. 

If your implants are under the muscle it is not uncommon to have some muscle spasms which can be quite uncomfortable.  Extreme swelling  needs to be evaluated by your surgeon to make sure there  has not been blood or fluid accumulating around your implant(s).  If the swelling and tightness is about the same on both sides then bleeding is less likely to be the cause.  I would certainly limit the use of your arms until otherwise instructed by your surgeon. Hopefully things will improve in the next few days but keep in close contact with your surgeon if you have concerns.