The healing time following breast augmentation varies according to each patient. The following represents a general idea of what to expect after your surgery. Individual patients may experience variations from this course.
The first few hours after surgery
When you awake from your surgery you will be in the recovery room, where you’ll remain for a few hours under the watchful eye of your dedicated team of nurses and doctors. You will have a bra on, and possibly a tensor band wrapped around the upper portion of your breasts. If you are not staying overnight (as is the case for most patients), you will be able to go home when you have fully recovered from the sedation. You will be given a prescription for pain medication and antibiotics. It is extremely important you take the antibiotics to prevent infection during your breast surgery recovery time.
The first 24 hours
A few patients react negatively to the anesthetic after surgery. You may feel nauseous and vomit. This usually lasts less than 24 hours and should be treated with lots of fluids, Gravol and rest.
Although it is best to sleep on your side or back initially, sleeping on your front should not cause injury or rupture to the implant.
Immediately following surgery, you’ll find that your newly enhanced breasts appear very full and swollen, especially in the upper portion above the nipples. Your skin will most likely look very tight, and your nipples may point slightly downward as well. The shape and overall appearance of your breasts appear will probably appear unnatural. This is because when breast implants are first put into your body, they typically sit higher up in the chest as it’s the path of least resistance–your body requires some time to adjust to their presence, regardless of whether they’re sub-mammary or sub-muscular. (They will become more natural in appearance over time, usually by about three to four months after surgery.)
The second day
You’ll be able to take showers from the second day after your surgery. When taking a shower, remove the bra (and tensor bandage, if necessary). Take off the gauze and Vaseline mesh that is taped over your incision. The small white tapes (steri-strips) that are under the gauze directly over your incision should be left on.
Wet and soap yourself everywhere, including the tapes and your incisions. Use mild soap such as Dove, Ivory, or Zest. Pat yourself dry using a towel (do not rub) and put your bra and tensor back on. You don’t need to cover the small white tapes over your incision. This daily routine will help keep the incisions clean, and will promote wound healing.
It is VERY uncommon, but a soft drain may be placed under your breast that will be removed within a day or two. This helps to minimize the risk of blood collecting around the implant in patients who appear to bleed a lot during the surgery. However, this is unusual, even when the incision is placed in the armpit (trans-axillary).
The first three days
For the first three days you should try to restrict your arm movements. Move your arms slowly and avoid sudden jerky movements of the chest and breast area to prevent complications from occurring.
We encourage you not to spend all your time in bed during your breast augmentation recovery. This will minimize the risk of deep clots in your leg veins.
After three days
You will be able to resume relatively normal non-strenuous activities, however avoid lifting.
The third to fifth day
Maximum swelling occurs at this time.
After five days to a week
You may be able to go back to desk work, although this can vary from person to person.
You may need to wait a little longer if your work is physically challenging.
Although implants can rupture in extreme circumstances (e.g. high speed car accident), normal physical activities and contact will not significantly increase the risk of rupture and should be enjoyed within reason.
A week to 10 days
If you are advised to do massage, it would be a week to 10 days after your surgery. This is because your body is still recovering from the trauma of surgery. It is still “raw” inside, and massaging your breasts too early may cause bleeding, increasing the risk of capsular contracture. It also hurts! When textured implants are used, it is also important that the texturing on the implant integrates, or attaches to, your own tissues. Massage will interfere with this and could lead to fluid collections called seromas, or rotation of a tear-drop (anatomic) implant.
If you are instructed to do massage exercises, it is important to remember that a slow steady stretch is more effective than a quick jerky movement. Don’t worry about injuring the implant, you cannot cause a rupture with these breast exercises.
- Press the breasts slowly and maximally inwards (towards your breast bone) and hold for 10 seconds, then release.
- Repeat 4 times.
- Press the breasts apart slowly and maximally outwards and hold for 10 seconds, then release. Repeat four times.
- Repeat for downward movement.
- Repeat for upward movement.
Perform these exercise two times per day after your breast augmentation procedure. Your surgeon will keep a close eye on you. If your surgeon thinks that one breast is not softening normally, only then will a treatment regime that includes massage, prescription medication, and several supplements be recommended.
The purpose of breast massage after augmentation exercises is to keep the scar tissue that forms around your implants following breast augmentation as soft and pliable as possible. You can help soften the internal scar, minimize the risk of significant capsular contracture and maximize the likelihood of a soft, natural feel and appearance to your breast. However, since we are able to achieve beautiful, natural-looking results and our rate of capsular contracture is so low, you do not need to do any massage unless your surgeon tells you so. 99% of our patients are advised not to massage, a recommendation we have been giving for over eight years.
After 10 days to two weeks
The ends of sutures may be trimmed if necessary. Some patients may receive extra support from a tensor bandage, wrapped around the chest at the top of the breasts. This bandage would be worn for the first two weeks.
By the end of two weeks
Most bruising and swelling will resolve by this time. You may also feel discomfort and pain, which is generally well controlled by pain medications. Most patients experience a moderate degree of discomfort for up to 7-14 days.
After two weeks
You will be able to submerge yourself in a bath, swimming pool, or whirlpool after two weeks. If you have been wearing a tensor bandage wrapped around your chest, it will be removed.
After three weeks
You may begin your regular exercise routine 3 weeks after surgery, except upper body weight training. You will also be able to resume sexual activities at this time.
After six weeks
You may being upper body weight training and push-ups. Particularly when implants are placed under the chest muscle, upper body weight training before 6 weeks could cause bleeding and subsequent hardening (capsular contracture).
After eight weeks
It’s essential you wear a soft cotton sportsbra, without underwire, to provide support for your breasts throughout the first eight weeks of recovery. You should wear your bra day and night. This prevents the implants from falling to the sides or “bottoming out” (when the implants move unfavourably downward). Although this complication isn’t common, some patients develop weaker scar tissue, providing less internal support for the implant. Surgeons are unable to determine who is at risk for this issue until implant displacement occurs, which would necessitate revision surgery (capsulorrhaphy). Wearing a bra helps to provide extra support during the healing process.
Underwire bras can cause unnecessary complications and should be avoided for the first two months following surgery. These complications include irritation caused by the wire rubbing against the skin (something that you may not notice due to possible numbness). Patients who have an infra-mammary incision should be especially careful as an underwire bra is capable of displacing the implants if it is worn too often or too soon. The underwire is often improperly shaped and provides inadequate support of the breast shortly after surgery.
Once it’s time to begin shopping for new bras, patients will find that they have to greatly adjust their previous size and style choices. Many bras no longer fit comfortably after breast augmentation due to the changes in shape that come with implants. On the other hand, many bras that didn’t work for you before may now look great! When picking a bra, women should keep a few key fitting tips in mind:
A band that rides up in the back is a sign of a poor fit. The band of the bra should remain at the same level as the front.
Bra straps should not have to be shortened in order to lift the breasts. If this is the case a smaller size may offer a better fit.
Any excess space between the nipple and the cup of the bra is a sign of a bad fit.
Patients may want to consider being re-measured to find out their perfect fit.
After three to four months
By this time, your breasts will have “dropped and fluffed”. “Drop and fluff” refers to the gradual movement and change in shape that occurs to breast implants following breast augmentation. As your body accommodates to your new implants, you’ll notice that your breasts will gradually look more and more natural–the way you hoped they’d be! Over the course of about three to four months, your body creates new skin to accommodate the additional volume of your implants. This natural process is called “tissue expansion”, and relieves the tightness you may be experiencing. It allows for the implants to settle more into a better position with the help of gravity. A gradual redistribution of volume from the upper to the lower breast occurs, resulting in an enlargement and rounding out of the lower breast.
Although it’s often called “dropping”, it is more like “redistribution”. The “fluffing” part refers to the impression that the lower breast enlarges and that your skin softens with the creation of new tissues. The extent to which this occurs depends on several factors, including the implant size, the tightness of your skin, and your body shape.
Patients who experience this phenomenon at a higher rate typically:
- have a smaller body frame
- are tighter skinned
- haven’t had children
This is in comparison to a larger breasted, post-partum woman. Patients who have had implants placed in the sub-muscular position may find that their dropping and fluffing is more dramatic.
Follow-ups and monitoring for anything unusual
The quality of your results may be compromised if you fail to return for any scheduled post-op visits, or follow the pre- and post-operative instructions and breast augmentation recovery tips provided to you.
Don’t hesitate to report any unusual or concerning changes while healing after breast augmentation. If you are unable to contact your plastic surgeon and you have an urgent post-operative concern, contact the plastic surgeon on call through the hospital paging system, or, proceed to your local emergency department.
Implants do not cause cancer but may obscure its detection. Mammograms should be performed at a facility familiar with the special techniques needed for implants. You will need to let your mammogram technician know about your augmentation during future check-ups. Though the implants won’t interfere with your mammograms, it’s important to inform your technician so he or she can use a special technique that provides accurate readings.