Breast Augmentation Recovery: What Can I Expect?

QS: My biggest worries about breast augmentation is the recovery from surgery.  What can I expect?  How much time off work does breast implant recovery require? When do scars really begin to fade?

What to expect following breast augmentation: general post-operative course

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.

Otto Joseph Placik, MD 

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