After Surgery

Breast Augmentation Post-op Guide

Normal symptoms experienced after breast augmentation surgery are usually minor and subside rapidly. Contact your plastic surgeon's office immediately if you believe you may be experiencing a complication.

Most women are up and around almost immediately and can quickly resume most normal activities. Scars left from the incisions are usually small and discreet.

This information is of a general nature only — you should always follow the guidelines and advice offered by your plastic surgeon.

Normal Symptoms

Normal symptoms experienced after breast augmentation surgery are usually minor and subside rapidly with proper care, as outlined in your post-operative instructions. These symptoms include:

• Moderate swelling and bruising, which are normal after any surgery. Swelling can make your breasts feel very firm and the skin may take on a shiny appearance. Swelling may take several weeks to subside as the breasts soften and become more natural. Use ice packs as directed by your doctor to reduce swelling. Any bruising that occurs should abate 7 to 10 days after surgery.
• Mild to moderate discomfort and pain, which is normal after any surgery. Take your pain medication as prescribed, limit your physical activity and any pain should diminish rapidly during the first few days. Back pain caused by lying and sleeping with your upper body propped up can be treated with a heating pad, hot water bottle or microwaveable pack.
• Crusting along the incision lines, which can usually be treated with an antibiotic ointment, depending on your doctor's instructions. To reduce redness and excessive crusing, clean your incisions twice a day with 3% hydrogen peroxide and cotton or a cotton swab.
• Itching, which many women experience as nerve endings heal. Ice and skin lotions or moisterizers often help to provide relief from itching. Keep in mind to avoid getting lotion in an incision.
• Numbness, which is due to the severing of small sensory nerves. Sensation gradually returns during the first couple of months.
• Tingling, burning or shooting pains, which are common (especially in the nipples) as the nerves regenerate during the first few weeks.

Possible Complications

Contact your plastic surgeon's office immediately if you experience any symptoms you believe may indicate a complication. These symptoms may include swelling, bruising and discomfort or pain in the breasts that is beyond normal levels. Use a thermometer to take your temperature frequently in the first few days after surgery, as fever can be a sign of infection. For complete information, see our section on the risks and possible complications of breast augmentation surgery.

Although complications from breast augmentation surgery are infrequent, all surgeries carry some degree of risk. Your surgeon and his or her staff will use their knowledge and expertise to avoid complications as much as possible and attempt to quickly solve any problems that arise.

Medications

Your plastic surgeon will provide you with specific instructions for medications and vitamins to take after the surgery. It is very important that you follow all instructions given to you by your doctor. Fill your prescriptions and get your over-the-counter medications prior to surgery, and use a pill case or medications list to help you take your medications and vitamins on schedule.

If you are not already doing so, your doctor may ask you to begin taking a multivitamin and vitamin C prior to surgery to help with healing afterward. You may also be advised to take vitamin E, which may help to prevent capsular contracture, beginning 2 weeks after surgery.

Avoid alcohol entirely until you have stopped taking your pain medication. The combination of alcohol and pain medication can be very dangerous. Also remember not to drive after taking pain medication.

Contact your surgeon's office immediately if you experience any unusual symptoms that could be related to the use of your medications.

Resuming Your Activities

Always follow your plastic surgeon's advice on when you can resume your normal activities. Most women are up and around the day after breast augmentation surgery and can resume most normal activities within a few days. More vigorous physical activity, such as upper body weight training, should be delayed for up to 6 weeks.

The important thing during the first 24 to 48 hours is to get plenty of rest, which is very important to the healing process. Depending on the specific instructions received from your surgeon, you may shower the day after surgery. You can usually perform small physical tasks within a couple of days if they cause no discomfort or pain — let your body tell you what it can and can't do. Most women can drive and return to work within a few days if their job isn't too physical. Sexual activity may be resumed as your body allows.

Avoid straining or extending your arms over your head for about a week after surgery. This allows tissues around the breast implants to heal faster. Prior to surgery, take things in your home that you have to reach up for (for example, things on a high shelf or cupboard) and put them on a countertop or table.

Generally, you should avoid strenuous physical activity, which can raise your blood pressure and possibly cause bleeding, for at least 3 weeks after surgery. Upper body weight training and push-ups should be avoided until 6 weeks after surgery, particularly when the breast implants are placed under the muscle (see our section on implant placement), to avoid causing the implants to be pushed upward. Once you do resume exercising, start slow and let your body tell you what it can handle.

Scarring

A scar is a part of the body's natural healing process. Scars left by breast augmentation surgery are usually small and well-hidden in the crease beneath the breast (inframammary fold incision), around the nipple (peri-areolar incision) or in the armpit (transaxillary incision). Your scars will be firm and pink for several weeks and begin to fade after several months. They will never completely disappear but should be very discreet. It may take up to a year for the scars to take on their permanent appearance.

A few women experience problems with a scar due to factors such as medical conditions, infection, injury to the incision site, age, poor nutrition and exposure to sunlight. Your doctor may recommend vitamin E, silicone sheeting or silicone gel to diminish the appearance of a scar. If a scar doesn't respond to these treatments, scar-minimizing procedures such as dermabrasion, collagen injections, cortisone-like injections, laser resurfacing and surgical revision can be used.

Protect scars from the sun during the healing process. Even through a bathing suit, a good deal of sunlight can reach the skin and cause damage. Wear a sunscreen with a skin protection factor (SPF) of at least 15 when in the sun and be extremely careful if areas of your breast have reduced sensitivity.

Post-op Odds & Ends

• The surgical technique used, such as the incision type and the implant placement site, can have an affect on your recovery time. Your surgeon will also take into account individual factors such as age, overall state of health, medical conditions and lifestyle (exercise, smoking, drinking, etc.).
• Make sure that someone will drive you home, stay with you the first night and be available to help you out for a few days.
• Your breasts will be bandaged after surgery to provide support and protection. Keep your dressings as clean and dry as possible until the dressings are removed in a few days. You should wear a bra for support at all times for 2 weeks and during the day for 4 to 6 weeks after surgery. Many women are comfortable in cotton sports bras without underwire or a post-surgical bra.
• Use ice packs as directed by your doctor to reduce swelling, bruising and pain. You can use ziplock bags filled with water and frozen, packs of frozen fruits or vegetables or the reusable gel packs available at drug stores.
• Post-operative nausea is fairly common and can be caused by your pain medications. To avoid nausea, drink plenty of fluids and eat small, frequent meals that are light on the stomach.
• Wear comfortable clothing, including loosely-fitting shirts that open in the front (avoid pull-over shirts). Sweat pants, pajama bottoms and other pull-on pants work well.
• Make sure you have plenty of pillows on your bed and arrange them so that you can sleep on a smooth incline. The important thing is to keep your upper body elevated for a few days after surgery to help your breast implants stay in position during the initial healing process.
• Keep a journal to track your progress and record your day-to-day thoughts. Write down or type in everything from how you are feeling physically to how you feel about your new appearance. Journals can also come in handy when you return to see your doctor.
• Avoid smoking, or cut back as much as possible, during the first 10 days after surgery. Smoking reduces oxygen levels in the blood, interferes with healing and increases the risk for complications.
• It is quite common for the two breasts to heal differently. One may swell more, one may feel more uncomfortable or the shapes may initially differ. After complete healing, they should look remarkably similar and natural.
• You will have a follow-up appointment with your plastic surgeon about 7 to 10 days after surgery to remove your stitches (unless your surgeon uses dissolvable sutures) and undergo a post-operative examination. This and any other routine follow-up appointments are usually included in the total fee for the operation.
• After breast augmentation surgery, your breast tissues must stretch before the implants settle into their permanent position. This may take several weeks or even several months for women with small breasts.
• Nipple sensation is normal in some women immediately after breast augmentation surgery. Others may experience numbness or hypersensitivity as the nerves regenerate. For most women, sensation levels return to normal over time. Use a topical anesthetic cream, or numbing cream, for relief if your nipples become overly sensitive.
• You may hear and feel "sloshing" in your breast after surgery. This is due to air that is trapped in the space around the breast implant and the natural fluid that accumulates after an operation. Sloshing usually dissipates within a few weeks as the air and fluids are naturally absorbed by the body.
• Women may experience a brief period of "letdown" after breast augmentation surgery. This mental state can occur for many reasons and usually goes away quickly as the healing process takes place. Some women may subconsciously expect to achieve their final result immediately after surgery, even though they know this is unrealistic.
• Support from family and friends during recovery is very important to the healing process. However, some people may be unsure if they should discuss what they may perceive as a very personal matter. This can lead to feelings of disappointment that "no one noticed." If you are comfortable talking about your surgery, let your family and friends know that it's ok to show interest and provide emotional support.
• Breastfeeding is usually possible after breast augmentation surgery. However, the chances of successful breastfeeding are reduced if the nipple incision is used to insert the breast implants. Women who receive breast implants as part of a breast reconstruction procedure are usually unable to breastfeed.