What To Expect During The Recovery Period
Pain & Medication
(In terms of medication, these are my guidelines and what I do in my practice, but you should consult with and follow your own physician's instructions.)
You will be sore the first couple of days. The primary reason for the pain is the muscle being elevated from the procedure.
It is very likely that you will be taking narcotic medication for the pain in the first two days.
Typically, by days 3-5, patients wean themselves off of narcotics and feel much better. There is a lot of variation from patient to patient. Some may be done with narcotics by day 3, others continue on.
After a week, there should be no major pain. If you experience any discomfort after one week, Tylenol should be sufficient to manage it.
(Note, this is for breast implants placed under the muscle. The only difference is that the duration of healing and pain lasts slightly longer since muscle is being elevated. Along with many other doctors, I believe that implants should always be placed under the muscle because it minimizes the risk of certain complications and improves the results.)
I also prescribe my patients 3 days’ worth of antibiotics for the first few days following surgery.
Daily Living Activities
Your daily living activities include basic functioning like brushing your teeth, combing your hair, opening doors, making a meal.
Technically, by day 1 you should be able to do daily living activities. However, you will feel less energetic than usual so you may opt to be less active. This is normal.
After surgery, you will feel slight pain when you lift your elbows away from your sides. The average time of when you will be able to lift your arms completely above your head is somewhere between 48 hours and one week after surgery.
If you have a newborn, be sure to lift your baby with your elbows pegged to your body. This technique will minimize the strain of lifting.
Do not drive while you are taking narcotics. Once you have completely weaned yourself off of pain medication, you can resume driving.
Days 3-5 you will have the energy to move around the house and do basic things. There is a one-week follow up at the office to make sure everything is OK and that you are feeling well. In the weeks that follow, you can gradually introduce more activity to your body.
There should be ABSOLUTELY no smoking or drinking for at least two weeks after surgery. Smoking interferes with the healing process and alcohol may cause increased bleeding.
Try to sleep on your back with your head slightly elevated after surgery [for how long?]. This will help with the swelling.
But, if you really want to sleep on your side and feel comfortable doing so, it’s ok.
I do NOT prescribe sleep medication because it is not needed. Especially if you are taking narcotics for pain, I do not suggest mixing both.
The only reason you would have problems sleeping is because you are in pain. There are three things to do to manage the pain properly.
1. Do not wait to be in pain until taking medication. Instead, stay ahead of it, otherwise you will be suffering until the medication kicks in.
2.You may be taking less than the recommended dosage of medication. For example, if your prescription says to take 1 to 2 pills and you are only taking 1.
3.If you wake up in pain, consider taking your pain medication right before going to sleep at night.
Following this protocol, a patient without pre-existing problems sleeping should be able to sleep comfortably, even in the first few days.
Showering & Bathing
You may begin showering on the second day following surgery after taking sponge baths the day after surgery.
Do not submerge yourself under water (e.g., bath, pool, ocean) for the first three weeks after surgery.
Your first week out of surgery, you will have medical grade tape over the scar.
After the tape is removed in your one-week, post-op visit you can expect the scar to be a little red, raised, and hard.
Over a week to 1 month, the scar will be softer, will flatten out, and won’t be red but the pigmentation may be darker.
In 1-6 months everything improves but it takes up to a year for the scar to “mature”. The last thing to resolve is the dark pigmentation. It takes up to a year for the scar to lighten up and camouflage better with your skin.
I recommend to patients certain skin creams to help with this process.
In your first week expect minor bruising. Note that the healing process is asymmetric. That means it is possible that one breast may look more swollen, be more bruised, or be slightly higher than the other. This is completely normal and will go away with time.
Exercise / Activity
You may walk around after surgery, but you will find that you do not have the same energy level that you had prior to surgery. This is absolutely normal and disappears somewhere between the first and second week.
In the first week following surgery, you can do light activity. This includes walking on a treadmill or elliptical with low intensity.
For for at least two weeks following surgery, avoid any strenuous physical activity or heavy lifting.
After the first or second week, you can add lower body resistance. And in the third week, low intensity upper body exercise can be added to your routine.
After week 4 you may be totally healed.
But again, everyone’s body is different. Listen to yours. If something doesn’t feel right, stop and give it a few more days. Do not push yourself to the point of discomfort.
Post-op, a surgical bra will be provided to you. Wear your surgical bra during the day for the first three weeks following surgery.
Immediately after surgery, a the patient is placed in a surgical bra that is given to them. the surgical bra will provide support and be snug but not tight or compressive. Additionally, the surgical bra will not have an underwire.
At the one week follow up, I instruct my patients to continue wearing the surgical bra if they like it or are comfortable with it. That said, they can wear any sports bra they like as long as it is snug, provides support for the breast, but not be too tight or compressive, and does not have any underwire.
The reason you don't want an underwire is because the underwire can dig into the incision while it is still healing.
The patient can return to a wired bra once the incision has healed. This is typically at 4 to 6 weeks. By this time, the patient will have had their one month follow up.
Starting on the 7th day after surgery, you will also want to perform breast massages as directed, two times a day. Breast massaging may prevent scar formation, assists the skin in accommodating the implant and helps you get used to the feel of your new breasts.
In the first week, your breasts will be swollen and sit high on your chest. This gives some patients the impression that they are “bigger” prior to dropping.
From the first week to one month, the skin will relax and there is less swelling, so the implant begins to drop. Usually by your third month, you will have the final result.
You will spend a lot of time looking at your breasts. Many thoughts can come to your mind, but regret should never be one. I have made a special note on this . . .