After care advice post Breast Augmentation? (photo)

why discrepancies in aftercare advice By PS.I had a BA 2 weeks ago. I was a weak A cup before op. 250ccs anatomical over the muscle & local anaesthetic. leaving clinic advice was to wear a front opening sports bra. Told I could lift my baby 19llbs the following day. A lot conflicting opinions bras or not, massaging, lifting gym etc. pretty pleased with the results. PS said no need to massage but I noticed that my right is more triangular in comparison -I've read some ps advising massage. Advice

Doctor Answers 13

Follow the advice of your surgeon - After care advice post Breast Augmentation? (photo)

It does not appear that there are any emergent issues by your photos. You are still very early in the healing phase. If you trust your surgeon, then my recommendation is to follow the post operative instructions provided by him/her. There are many variables to your plastic surgery case that only your surgeon and staff are aware of. Too much advice from outside sources will almost always lead to confusion.Whenever there is doubt, seek the advice from your Board Certified Plastic Surgeon.Good luck!

Phoenix Plastic Surgeon
5.0 out of 5 stars 5 reviews

Post-op Instructions

Thanks for your inquiry, do not massage your breast if your surgeon does not want you to.  There are no cookie cutter operations or recoveries.  Offices and doctors will give protocols based on evidence, training, and experience.  Since your implants are over the muscle, for example, your lifting restrictions may be different than someone whose implants are under the muscle.  Listen to your surgeon and best of luck.  

If it sounds too good to be true, it is

After breast implant surgery, I advise the patients to take one week off from work.  At that point we take out their stitches and teach them the implant massage technique.  We suggest 5 times per day with the massage and no bra for one month.  The patients may return to work, but may not engage in any strenuous activity.  At one month, the patients start to wear a soft cup bra with no underwire and can start low impact cardio.  At two months they can wear an underwire bra and engage in more strenuous physical activity.  Breast massage continues forever, although only once per day.Implant massage is a critical part of the postoperative recovery from breast augmentation (like physical therapy is a critical part of the postoperative recovery from knee surgery).  The space for the implant is meticulously crafted at the time of augmentation surgery, especially when the operation is performed using the surgical endoscope through the transaxillary approach.  However, the distance from the nipple to the inframammary fold needs to stretch out to accommodate the implant (dropping) and the skin and muscle need to relax to give the desired shape (fluffing).  Implant massage allows you to manipulate the pocket from the inside to direct the forces in the appropriate directions to mold the breast shape to the desired outcome.  If the scar that is actively forming around the implant is allowed to heal without the influence of breast massage, the fold will not stretch appropriately (implant stays too high), the scar will attempt to contract in a linear way over the curved surface of the implant (breast shape will remain too flat), and the space will attempt to heal smaller and tighter than the implant (capsular contracture).  Implant massage influences the scar formation on the inside at the most critical phase of the healing, allowing the space to be larger than the implant (mobility which creates the natural feel and bounce).   Implant massage starts at one week at 5 times per day for one minute at a time and continues at this pace until one month.  I often see the patients weekly during this time to reinforce the technique and help the patients who need extra effort to soften the breasts. During this time period, the massage also breaks up the spasm, relieving the discomfort, particularly upon awakening from sleep (morning breast).  During the day, every time there is the sensation of tightness, implant massage breaks up the spasm and relieves the discomfort, minimizing the need for narcotics.  At one month, the force that can be exerted is increased but the frequency of massage decreases to 3 times per day.  As the wound matures, the massage can decrease to once per day forever as maintenance.  The patients integrate this into their shower routine.   Although some patients can get away with no massage, it is a common issue for those who stop the massage and make none of their follow up appointment to suddenly show up years after surgery claiming that they woke up one morning with a capsular contracture and implant malposition.  Of course this did not happen overnight, but was a slow process that could have been prevented with daily maintenance massage and regular routine follow appointments on a yearly basis (which we provide for free, forever). With this type of perpetual follow up, it is possible to identify a problem early that might need a modification in the massage technique.   Implant massage involves moving the device up against the wall of the pocket, holding pressure against the surface of the scar. The specifics are determined on an individual basis guided by what the patient needs. In some patients it is simple and of little significance.  In some patients it is a struggle to get the implants into the right position and to gain softness and mobility, but with the right technique and the appropriate dedication it is a huge success.  For the patients that do not participate in the massage in a meaningful way, some will get away with their lack of dedication because they were going to have soft breasts no matter what.  On the other hand, some patients will squander their opportunity to have an excellent result because they don't believe that the massage is necessary, or because they have been told by their friends or other doctors that they didn't need to perform massage.  Regardless, they often require surgery that could have been avoided by following the postoperative instructions of a surgeon that has performed nearly 10,000 breast implant operations and has seen the healing of each of those patients and integrated the successes and failures of each one into a postoperative plan that really works. I find no use for bands, straps, bras or appliances after breast augmentation surgery.

Post-op instructions following breast augmentation

Great question! Following surgery I have my patients wear a sports bra constantly (24 hours a day), except when showering, for several weeks following surgery.  There is no laying directly on your stomach/chest should be avoided for 3 months following surgery. Patients are advised there is no lifting, pushing, pulling, or straining more than 8 pounds for 6 weeks following their augmentation surgery. Usually, patients can resume aerobic activity by their 3 week follow-up visit. I suggest discussing your post-operative instructions again with your physician to be sure you are following them accordingly. Good luck in your recovery!  

Brian S. Glatt, MD, FACS
Morristown Plastic Surgeon
5.0 out of 5 stars 41 reviews

Post op instructions

I would recommend that you follow the postoperative instructions given by your plastic surgeon rather than by any online consultant. The use of bra, or no bra, massage and other modalities are variable from surgeon to surgeon. It seems prudent in the sub muscular placement of implants to disallow the implant from being trapped in the upper portion of the pocket by wearing a tight fitting supportive, underwire type bra. Here, the sports probably describe is best. Likewise, with an implant on top of the muscle, lifting should have no effect on the outcome. Also, it  does make sense to me to not massage an aggressively textured anatomically shaped implant. Congratulations on your surgery and best of luck on your recovery.

Marc J. Salzman, MD, FACS
Louisville Plastic Surgeon
4.6 out of 5 stars 38 reviews

Aftercare Instructions: Breast Augmentation

Thank you for your question, for providing pictures and for your detailed explanation. I normally ask that my patients wear their surgical bra 24/7 until their first post-operative appointment. If all is well after my evaluation, i allow some patients to switch to a sports bra with a front closure with formed cups. My advise would be to listen carefully to your surgeons instructions and ask all the questions you need to. If you feel you aren't being taken care of, seek a second opinion. Best of Luck.

Post Op Instructions

I recommend that you follow your own Plastic Surgeon's advice and not that of friends or other online consultants when it comes to specifics of your post op care. Some plastic Surgeons do not advise massage and some implants- such as textured/anatomical would not warrant it. The implants can settle and heal at slightly different rates and noting small differences is not necessarily a problem but should be addressed with your own surgeon. Bra use also varies between practices but most Plastic Surgeons will advise that you limit the use of your arms for a time and avoid heavy lifting. In my practice I advise against lifting more than 10 pounds for 6 weeks post op. Your Plastic Surgeon can clarify the details of your instructions for you and provide a timeline for recovery so that you know what to expect.
All the best

After Care of Breast Augmentation

Thank you for your question.
Congratulations on your breast augmentation!  You are right, there are a lot of protocols regarding the after care of breast augmentation.  It's best to follow your doctor's recommendations.  Some implants should be massaged and some shouldn't (anatomic implants SHOULD NOT), for instance.  If you start to follow somebody else's plan, then you could get yourself into trouble.  Best to follow your own surgeon's recommendations as they know you and your surgery best.

Dr. Dan Krochmal
MAE Plastic Surgery
Northbrook, IL

Daniel Krochmal, MD
Chicago General Surgeon
5.0 out of 5 stars 17 reviews

Breast augmentation

Thank you for your question and photographs.  I would follow your plastic surgeon’s post-operative protocol instructions; every surgeon has a slightly different aftercare protocol adjusted to fit the needs of their patients. For example, I recommend that my patients refrain from weight-bearing exercises for at least 4 weeks and to wear their surgical bra around the clock for the first couple’s weeks then after 6 weeks can switch to underwire bras. If you have any concerns about your post-operative instructions then I would talk to your surgeon and have them clarify them for you. Best of luck in your recovery.
Sincerely, James Fernau, MD, FACS
Board Certified ENT
Board Certified Plastic Surgery
Member of ASPS, ASAPS, ISAPS, The Rhinoplasty Society, AAFPRS, OTO/HNS, ASLMS, International Federation for Adipose Therapeutics & Science

James Fernau, MD, FACS
Pittsburgh Plastic Surgeon
4.9 out of 5 stars 65 reviews

After care advice post Breast Augmentation?

Thank you for sharing your question and photographs.  Each physician will have their own recommendations after surgery as your care should be individualized based on your specific procedure.  One thing that can be agreed upon is that with anatomical implants you should NOT be massaging them for the risk of displacing them or rotating them into an unfavorable position.  Follow the advice of your surgeon, only they know the full details of your recovery.  

Nelson Castillo, MD
Atlanta Plastic Surgeon
5.0 out of 5 stars 38 reviews

These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.