Some surgeons advise their patients to sleep upright for some extent of time after breast augmentation surgery. The reasons for doing so are:1- potentially helping the implants to "drop" more quickly due to the increased gravity and weight at the lower breast2- gravity helping to clear some of the swelling and fluid in the upper breast more quickly3-- sleeping upright makes it more difficult to roll on one's sides while sleeping, thereby potentially decreasing shifting of the implant while it is healing during the first week or two. However, my personal opinion is that none of the above reasons or scenarios are actually going to affect one's final outcome. The final position and appearance of the result will depend almost exclusively on the technique and dissection performed at the time of surgery. Sure, the implant will drop over time, and the swelling will settle over time, but having to sleep upright for one or more weeks may only slightly speed up that process, if at all. For many patients, the nuisance and potential backache associated with sleeping upright simply aren't worth the hassle if, in the end, the result will be no different. I personally do not include it as part of my postop instructions.So, I would check in with your surgeon and ask if it is OK to start sleeping on your back again. At one week out, and with and active backache, my guess is that he/she will have no problem with it. Best of luck!Dr. Subbio