Hi Iowa Gal,If your seat belt is comfortable, you shouldn't need any padding. I don't want to contradict your PS, so follow their instructions to the letter. If your PS wants you to have a pillow, then get specific instructions. We use a quick recovery approach which can avoid extra steps postop. See video and web reference below. Be sure to see only a board certified plastic surgeon (by ABPS - The American Board of Plastic Surgery) who is a member of ASAPS (The American Society for Aesthetic Plastic Surgery) and or a member of ASPS (The American Society of Plastic Surgeons). Also, ask if they have an established, high volume breast augmentation practice, performing several hundred breast augmentations each year. I wish you the best of luck, Dr. Joe.