Recovery time after breast augmentation surgery

What is the recovery time after breast augmentation surgery  is a question frequently asked by patients.  To answer  that question  each patient has to be define what they mean by “recovery”. Do you mean “when can I return to work” or “when can I return to unrestricted  physical activity” or does recovery refer to the time period until final results are obtained.

As far as return to work is concerned,   most of my patients can return to work within 48-72 hours of their surgery, provided of course they are not involved in some type of  job in which physical labor is involved (such as overhead use of the arms as in warehouse workers or construction work. Seriously, I have had  patients  who work on road crews and in the construction industry). I tell my patients that as soon as they no longer require narcotic pain medications there is no reason why they can not return to work.  9 out of 10  of my patients use over the counter Tylenol and Motrin  after the first post operative day to control post operative discomfort and use narcotics only at night before bedtime.  I utilize long acting local anesthetics in the operating room so that each patient is pain free upon  completion of their surgery.  This technique  in conjunction with a comprehensive post operative recovery  regime  minimizes  pain  management .  I discuss what all this entails with my patients at their initial consult. I used the “pain pump” after surgeries when they were first brought out on the market years ago, but after extensive experience with both the pain pump and my own post operative pain management regime, my regime is vastly superior to the pain pump. Hundreds of patients can attest to that. In fact I still have several unused, unopened pain pumps in my inventory at my surgical facility.  If a patient is some how sold on the idea of a pain pump after their surgery  I can provide that option.

Regarding return to unrestricted physical activity, the time frame for this  is generally 3 – 6 weeks depending on whether the implant was placed above the muscle or below the muscle. Anything which will elevated the blood pressure or heart rate after surgery will increase blood flow through the area which is trying to heal. This will induce more swelling. More swelling is counter productive to  long term outcome. This is especially true if the implant is placed under the muscle. The muscle swells quite a bit after surgery on its own just by the nature of the procedure;  patients shouldn’t do anything which amplifies this response.  I will allow patients to resume light activity after the second week and see how each patient responds. After three weeks I generally allow for any type of physical activity for submammary augmentation patients and six weeks for submuscular. Also, by six weeks the muscle has healed to the point that strenuous  physical activity can not cause any injury to the muscle which could cause internal bleeding and produce a hematoma (blood collection) around the implant.  Physical intimacy can be resumed as soon as the individual feels comfortable doing so. ( But no “rough stuff” for a couple of weeks! ).  I am perhaps slightly more conservative than some surgeons, but I feel my extremely low re-operation/complication rate speaks for itself.

The last aspect of the recovery phase is how long until the final  results. By final results I mean complete healing and also the appearance of the breast contour. Let me address breast contour first.  Once again this time frame is shorter for submammary augmentation patients than for submuscular because the role the pectoral muscle plays in the post operative breast shape. In both types of surgery patients will experience what is known as “upper pole ” swelling or fullness. ( upper pole  refers to the region of the breast above the nipple areolar complex, the inferior pole is the area below).  The breast tissue itself recovers relatively quickly and it is not uncommon for my submammary breast augmentation patients to have their final shape within  two or three weeks of their surgery. This time frame is longer in those patients who started off with tighter breast tissue and experience what is known as “soft tissue” stretch due to the implant. The more the soft tissue has to stretch to accommodate the implant, the more swelling there may be, hence a slightly longer recovery period. (this is one reason why it is not a good idea to have  an implant which is too larger for your individual breast characteristics. This should be determined and thoroughly discussed with each patient  when  deciding implant shape and size).  The inferior pole often times has to expand somewhat in order to accommodate the implant and this can take a couple of weeks as well. This response to the surgery and placement of the implant is amplified when the implant is placed under the muscle. For submuscular augmentation patients it maybe as long as two or three months before the upper pole swelling resolves completely and the breasts accommodates to  the implant. By six weeks most of the swelling has resolved and the great majority of patients do not appreciate any residual swelling and are extremely happy with their new size and shape. It is when you look at side by side comparisons of pictures taken at 6 weeks versus 12 weeks when these subtle nuances can be seen. And for the most part the differences are quite subtle.

The other aspect of final healing is how long until the numbness from the surgery resolves and the scars fade.  Sensation returns somewhat in the first or second post operative week  and  returns completely by six to twelve weeks. The more soft tissue stretch the longer this may take. Residual numbness can take as long as a year to completely resolve but this is very unusual. Scars tend to be red for  a couple of  months and gradually fade over a year or so. The  blonde,  blue eyed patients tend to have redder scars initially but also tend to fade to the whitest given time. Darker colored individuals tend to develop darker scars which take a year or so to completely fade. Thick or raised/wide scars  are exceedingly rare in my practice for several reasons which I discuss with each patient during their consult.  There are several post operative scar management regimes I discuss with each patient throughout their recovery based on their needs which will maximize the quality of their scars and minimize the visibility. Remember: there is no such thing as a “scarless scar” in the adult patient.  But by and large the long term scars from breast augmentation surgery heal very nicely and inconspicuously.

The last aspect regarding recovery from breast augmentation surgery which I stress with each patient is the need to be vigilant about good support garments to maintain the newly acquired breast contour and the need for pocket exercises to keep  the breasts soft and feeling natural.  If patients are committed to these post operative breast augmentation recommendations they can expect to  achieve the best possible long term outcome  and avoid problems.

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