Breast Augmentation Recovery: What Can I Expect?

* Video for post-op breast implant displacement exercises (also called breast massage)

These are general observations and by no means exhaustive nor completely exclusive.

Days 1-4: Inflammatory period: Swelling, pain, discomfort. Early risk for bleeding in first 24 hours.This is the period that requires the vast majority of medication. Move arms (if allowed by surgeon to minimize spasm pain). Bruising may appear. Fluid retention is common as is weight gain.

Days 4-10: Generally OK to shower and get wounds briefly wet if permitted by surgeon. Belly may be swollen as the swellng moves down your body. Possible constipation due to pain meds. Pain tends to diminish during the day with less need for meds. However, pain tends to occur at night from 3-6am and is worse with submusclular placement. Bruising stable. Begin implant displacement exercises if permited by surgeon* (see video link below). Between 7-10 days be aware of signs of bleeding or infection

Days 10-21: lowered risk of infection and bleeding. Increased physcial activity such as low impact exercises avoiding upper extremity resistance excersises. Vast majority of initial capsule formation occurs during this period. Vast majority of swelling begins to subside. Occasional pain at night.

Nerves begin to wake up (resolving dysesthesias) and may cause "pins and needles" sensation to nipple area. Normal to have some areas of skin numbness. More aggressive implant displacement exercises are begun.

Days 21-42: Generally a plateau period in terms of wound healing. Not alot of changes as the remaining 20% of the capsule tends to be formed during this period. Rare to require any pain meds. Generally ok to switch to ibuprofen or tylenol but consult with your physician first.

May begin transition from low implact activities to higher impact aerobic activites and begin a slow but gradually progressive course of upper extremity resistance exercises. Many surgeons disagree at which point you may be unrestricted *(anywhere from 6 wks to 3 months).

Days 42-9 months: Progressive relaxation of scar tissues and softening of the initially firm result with descent of the implant and resolution of the remaining 5-10% of swelling. It is at this points that the breasts generally become softer and develop a jiggle.

During this time most patients take "ownership" of the implants and they become part of their body image but this varies tremendously among patients. This is also a common time period where patients may feel that they didn't go big enough.

Although the breasts become stable in their appearance, it is important to realize that they are never stable and always changing with the greatest amount of change occuring with pregnancy, weight gain, and menopause.

PS: Everyone heals differently and not all surgeons would agree with this summary.

I hope this helps.

It really depends on a few factors.  Adequate pain control is likely the most important.  Individual pain tolerance differs greatly.  I find that women who have had children generally have less post-op pain, as they have a much higher pain tolerance. From a surgical point of view, there are several things the surgeon/anaesthesiologist can do to decrease your post-op pain.  

I generally perform breast blocks prior to making any incisions with a mix of short- and long-acting local anaesthetics.  I have found this greatly reduces post-op pain.  I also encourage patients to take the prescribed pain killers regularly every 4 hours especially for the first 24-48 hours. If you don't stay on top of the pain in the immediate post-operative period, it is extremely difficult to "catch-up".  Most of my patients experience very little post-op pain after breast augmentation.

Of course, the type of augmentation you have will also determine your post-operative discomfort.  Larger implants, and subpectoral implant placement will also increase post-op discomfort.  This doesn't mean you shouldn't get large implants, or place them under the muscle - you simply need to know what to expect.  Many women also experience difficulty with sleeping in the first few weeks after augmentation due to the weight of the implants on their chest.  This is more significant in back-sleepers.

To answer your question about time off work, my experience has been that there is a huge  range.  I have patients that go back to work the next day (against my advice), and I have had patients take as much as 2 weeks off of work.  It really depends on what you do for work, and how you feel.  As for taking care of your kids, if your implant is placed under the muscle, it will be a few weeks before you feel comfortable enough to pick them up.

As for scars, I tell patients it will take a year to see the absolute final result.  Practically, however, by 3-6 months the scar will be very close to the final result.  I suggest 3M paper taping, and have a specific scar massage protocol I use to help speed scar resolution.

 

I hope this helps.  Good luck!

 

Sincerely,

Asif Pirani, MD, FRCS(C)
Plastic & Reconstructive Surgeon

The recovery from subpectoral breast augmentation used to be a rather unpleasant experience, but it no longer has to be. A space for the implant must be developed behind the pectoralis major, and a portion of the muscle's inferior origin must be released. Surgery on a muscle in most cases produces significant postoperative pain, and that is certainly true for breast augmentation. However, by using a local anesthetic infusion device (the On-Q 'Pain Buster') for the first two to three days after surgery, the pain associated with this procedure can be reduced quite dramatically.
While breast augmentation patients in this practice receive a prescription for a mild narcotic pain medication for use after surgery (just in case), most of them never take it. Most patients report little to no pain in the evening following surgery, and perhaps some mild discomfort on Postop day one and two. Patients can resume all normal, non-strenuous activities of daily living immediately after surgery, and can begin pec major range of motion exercises on the evening of their procedure.
Patients are seen in the office the day after surgery, and again on Friday for removal of the Go-Pump catheters (which is painless). Working patients usually return to work the Monday following the surgery; stay-at-home moms may need some help with toddlers for the first two to three days after surgery. Exercise is limited to walking only for the first two weeks; in weeks three and four some light exercise is permissible. Patients can gradually increase their exercise/workout level in the second month (weeks five through eight), however it is a full eight weeks before patients are allowed to return to activities that require forceful, repetitive, sustained pec major contraction - such as pushups and heavy weight lifting. It is important to ensure that the breasts are well supported in snug fitting sports bra (or two) when returning to impact exercise such as running or aerobics.

Each surgeon's recommendations will vary, but here are some general guidelines.

1. Plan on 3-5 days of no obligations to rest after your surgery
   1. Get help for your little ones during this time
   2. Don't plan to drive during this time
   3. Time away from work depends upon the physical activity requirements of your job
2. Avoid lifting more than 15-20 pounds for about 4-6 weeks, after surgery
   1. you may lift your children carefully, if you keep your elbows close to your side
3. Scars take 18 months to mature
   1. They will look their worst from 3-9 months, then fade, soften and flatten
   2. Use of scar therapy cream can be helpful

Because each surgeon has their own preferences to optimize your recovery, it is important you follow your surgeon's instructions diligently!

If your implants are placed submuscular (under the muscle) then I suggest no gym for 6 weeks. If they're over the muscle then you can get back almost right away.

Take off about 3 days to get back to work and don't drive while you're taking the prescribed pain pills but this won't be more than a few days (everybody is different). Let the kids get up on your lap then take them from a sitting position. Don't lift them from a standing position because it's a little too much force on the pectoralis itself. I've seen people develop blood collections as far as 3 weeks out from surgery for being a little too rough on the implants so force yourself to take it easy during this time.

Best wishes,

DoctorMeade

Hello,

Recovery from breast augmentation depends on a number of factors including how tight your breast tissue is, how big the implant is, and whether the implant is under the muscle or on top of the muscle.  

Pain:  In general, pain from augmentation on top of the muscle is minimal and recovery is about 1-2 days at most.  Augmentation under the muscle results in more discomfort and may require up to a week to feel back to normal.  

Scars: Scars should be negligible if done properly. 

Lifting/activity:  In general you should refrain from heavy lifting or vigourous activity for 1-2 weeks.  This is designed to prevent additional swelling or the collection of fluid during your recovery.

All the best,

Dr Repta

Initially, you can expect to feel tightness and pressure if the implants are placed under the muscle. Pain medication and muscle relaxants can ease this. Only use as much as you need to reach a point of "tolerable discomfort." Trying to become pain free with medications is not possible and will only lead to taking too much of the drugs prescribed to you.

This tightness eases significantly over the first week and most patients are off medications by then. Returning to activities that elevate your heart rate and blood pressure is possible at the 2 week point after surgery.

The swelling should be largely gone by 6 weeks and usually there is no bruising at all. The final size and appearance should be seen by 3 months.

Most patients who undergo breast augmentation are actually surprised to find that they recovery is smoother than anticipated. I find that a majority of patients are most concerned about side-effects related to the standard oral narcotic medications.

To help reduce the need for these following surgery, I not only inject the breasts with numbing medication during the procedure, I also wash out the implant pocket with antibiotic solution and additional numbing medicine. Most importantly, I also perform an Intercostal Nerve Block immediately before surgery which I feel is extremely effective in reducing immediate pain following surgery.

As a result, a majority of my patients transition to non-narcotic pain medications within 24-48 hours following surgery and continually remark to both myself and my staff that their recovery was easier than anticipated.

As far as activity restrictions, I recommend that they not lift anything heavier than 6-8 pounds for one week after surgery and that they hold off on any aggressive physical activities for the first few weeks during their recovery.

Planning for adequate recovery is an important part of any plastic surgery procedure. With breast implants, this is especially true as we want to minimize trauma and inflammation in the breast to decrease the chance of capsular contracture (capsular contracture is a tightening of the lining that your body forms around an implant that can require reoperation to treat). Accordingly, I am more cautious with return to activity after breast implants.

During surgery, I place a long-acting local anesthetic block to the nerves that supply the breast, and I believe this provides huge benefits the recovery period and need for pain medication (See my answer to the question "General Anesthesia Vs. IV Sedation for Breast Augmentation?" for more information).

Here are my guidelines for recovery and return to activity:

• 3-5 days - Return to non-physical work and light activity. Plan to still have some soreness and know that you will be tired more easily. I do encourage patients to use their arms and gently stretch (as long as this can be done without pain) so as to maintain full range of motion of the arms.
• You can return to sexual relations and regular daily self-care activities as long as these can be done comfortably. Unfortunately, it often takes longer for the breasts to become more comfortable for sexual play.
• 1 week postop visit - If a bra is being worn, we will assess whether to continue its use or discontinue the bra and apply an elastic band (if we are desiring more downward movement of the implant). You visit with our massage therapist for a 1hr appointment and she will begin very light lymphatic and breast tissue massage and give teaching for performing self massage.
• 2 weeks - Return to moderate activity. Light-impact cardio exercise and some yoga postures and stretching are appropriate, and elliptical trainer or spin bike are a good place to start. Begin to increase light massage of the breasts.
• 4 weeks - Begin a graduated return to full lower-body activity. You may start back to running if the breasts are comfortable while wearing a supportive athletic bra.
• 6 week postop visit - We evaluate for implant position and relaxation of the breasts and come up with a plan for you accordingly. Sometimes we are near optimal position and go into a support bra. Other times we need more movement and step up the downward massage of the breasts.
• 8 weeks postop - Begin a graduated return to full activity, including upper body.
• 6 months - okay to stop breast massage.

For patients perform physical work, especially with the arms (such as a waitress, hairdresser, surgeon, etc), it is critical to plan extra time for return to work. It is important to discuss this issue in detail when you visit with a surgeon, but in general, plan to allow for at least two weeks off.

The basic bottom line for recovery is this -- increase activity gradually as you listen to you body for how it is responding. With breast implants, I would rather error on the side of caution for returning to full, strenuous upper body activity.

Hope this helps.

The recovery for a breast augmentation is going to be different for each individual patient.   For most patients you are quite sore for a few days.   In our practice, after your breast augmentation you will leave the surgery center in a post-op bra.   You may shower the following day and will take it easy for the next couple of days.  Most people can drive at 3-5 days.   The tightness and discomfort can last up to 14 days.   Most patients are back to 100% at 8-10 weeks.  My patients that have had children say it feels like when your breast milk first comes in.   They describe the discomfort as the pressure and an engorgement feeling.   My patients that have had children typically have a slightly higher pain tolerance and recover quite quickly.   My patient who have not had children, but are athletic and go to the gym regularly describe the discomfort as if they did a hard chest workout or too many push-ups.   It is that deep muscle soreness and not really pain. In terms of going back to work, it really depends on the type of work you do.   We regularly have patients with desk jobs that have surgery Wednesday or Friday and return to work the following Monday.  They are sore of course, but can easily manage the discomfort with ibuprofen during the day.  Patient that perform heavy lifting or my patients that are nurses and have to turn patients and that type of thing typically take 2 weeks off of work.