Tips on Breast Surgery Recovery

Dr. Loftus' Tips to Speed Recovery

• Obtaining a Sports Bra that fastens in the front: Please purchase two sports bras and bring them with you on the day of surgery. One should be large or xlarge (unless you are a really tiny person getting very small implants, in which case medium or large is fine), and the second should be even larger. Please leave the tags on the bras so that you can return the one that does not work. These bras must fasten or zipper in the front. In particular, you will want a bra that has a loose band. You should get a bra that zips or clips in the front (it will be easier to get off and on). You can find front closure sports bras in most local department stores (bras that open in the front are typically available in the Maternity Section), at Dick’s Sporting Goods Stores, Sears, Target, Walmart, or online at www.marena.com. If ordering online, use product code B/ISB and then select your size. The online option can be delivered within 2 days. If you order from Marena, please get 1-2 sizes larger than the website indicates for you. It is important that the bra is loose. For some reason, sports bras that fasten in the front are harder to find during certain times of the year, so call around before you get in the car. (NOTE: zipper-front bras are not useful for trying sizers before surgery. For sizers, you need two tight-fitting, no-frills, flat sports bras without cups.)
• Wearing your sports bra: Your bra will be placed on you at the time of surgery. There are no hard and fast rules about how much you need to wear your bra after surgery. Most women choose to wear their bra continually for a few days to a few weeks following surgery. Your decision as to how much and how often you wear your bra should be guided by you. If you feel you need the bra for support and comfort, then you will obviously continue to wear it to meet those needs. If, however, you feel the bra is uncomfortable for any reason, then you may either choose to not wear it or, more likely, switch to a looser or more comfortable bra until you feel comfortable going without one. So the bottom line is it is up to you. Our only solid rule is that you need to avoid an underwire bra for four weeks after surgery.
• Upper body exercise: If you work out regularly, try to avoid pectoral exercises (bench press, fly, push-ups) for 4 weeks prior to surgery. Women who do this find that surgery is less painful and their recovery is faster. After surgery, you may resume working out (slowly) after breast augmentation. But, please wait an additional 4 weeks prior to starting pectoral exercises (bench press, fly, push-ups).
• The car ride home after surgery: For obvious reasons, your seatbelt may cause discomfort. Therefore, we recommend that you put a pillow or soft blanket in your car before you leave your home the day of surgery. When you get in your car after surgery, position the pillow or blanket between your breasts and your seatbelt to make your trip home safe and comfortable.
• Sleeping position: Try to sleep on your back or your side with your head elevated for the first few nights. As you recover, you may begin sleeping flat and on your abdomen once you feel comfortable with this. If you are a stomach-sleeper, you may sleep on your stomach as soon as you feel comfortable doing so (just be aware that stomach-sleeping is bad for your neck and leads to chronic neck problems – so this may be a good opportunity to change this habit!)
• Ice: Ice packs on your breasts (for the first 48-96 hours) are optional and may alleviate discomfort. Just be careful not to apply ice directly to your skin. (Your skin may be numb, and you could get an ice burn). Instead, wrap your ice pack in a thin towel or cloth napkin to protect your skin.
• Appearance after surgery: Expect your breasts to look unnatural and oddly shaped immediately after surgery. For 1-2 weeks after surgery, breasts may appear swollen, bulging, or block-shaped. This is normal, and it will improve. Some women feel as though their "milk is coming in." This perception and appearance is common at this point, especially for implants placed under the muscle. As your swelling resolves, your breasts will take on a more natural shape and feel. About 50-75% of swelling resolves by the 2-week mark. About 80-90% of swelling will resolve within the first month. The remaining swelling will resolve over the next few months.
• Hyper-sensitivity: You may find that your nipples seem too sensitive a few weeks after surgery. This will improve with time. Massaging your nipples daily with moisturizing cream (for 5-10 minutes, three times per day) will help significantly – and this should be done consistently.
• Nipple erection: It is not uncommon to have persistent nipple erection after breast surgery. This may last days or weeks, but usually resolves within a few weeks of surgery. Occasionally it will persist longer.
• Shooting Pains: If you develop shooting or sharp pains after surgery, this is most often related to nerve sensation "coming back." So, it is a good thing, but it can be somewhat aggravating. About 10% of patients develop these sensations, and they are usually temporary. They may begin anytime from 1 week to 6 months after surgery. The best way to resolve them and to restore normal sensation is to massage them at their source, which is deep to the breast. Dr. Loftus can show you how to do this, so please call to schedule an appointment in that case.
• Aches: some women have aching sensations in the breasts for days, weeks, or (rarely) months after surgery. If so, please massage your breasts liberally using moisturizing cream. This will help suppress abnormal sensations and restore normal sensations.
• Nipple or breast numbness: Temporary numbness is common after breast augmentation. Most cases resolve, with return of sensation within weeks or months. To expedite and optimize return of sensation, you should massage your nipples and breasts regularly until sensation normalizes. You may use moisturizing cream, but it is not necessary. Simply use your fingers in a gentle circular motion over the numb areas. Try to do this 3 times each day for 5 minutes each time. More if possible. Be aware that the usefulness of this is dependent upon you yourself performing the massage, as doing so completes the "loop" from your breast to your brain to your fingers which is critical in restoring sensation. (In other words, it does not help restore sensation if you ask your significant other to do this for you).
• Swelling of your abdomen: As your breast swelling decreases, you may notice increased swelling in your abdomen. This is common and temporary. Do not distress.
• Lifting and exercise: Try not to lift anything larger than 10 lbs. for 4 weeks – with the exception of your children, no matter how big they are – just lift them slowly. Do not raise your heart rate above 100 for 4 weeks (to reduce risk of post-operative bleeding).
• Arm raising: For some reason, some plastic surgeons recommend that you limit arm motion after breast surgery and not raise your arms over your head. While we agree that you should not use your arms for strenuous activities for 4 weeks after surgery, we feel that it is a mistake to limit your arm motion as doing so will predispose you to stiffness. We recommend that in order to prevent your arms from becoming stiff, you should gently and regularly raise your arms over your head starting the day of or the day after surgery.
• Sloshing: It is common to hear a sloshing sound shortly after surgery. This is due to fluid around the outside of the implant and usually resolves within a few weeks or months, as your body heals around the implant. It is not uncommon to have sloshing on one side but not the other.
• Drainage: If you develop drainage from your suture line at any time, call our office immediately. Do not wait until the next business day. This happens occasionally and is not usually a problem unless it is allowed to continue for several days.
• Dental Work: Avoid routine dental work or cleanings for 3 months following surgery, as there are a few reported cases of implant infection, possibly related to dental work. If you require dental work which cannot wait that long, call our office and we will prescribe prophylactic antibiotics, which you will begin taking the day prior to your dental work. After 3 months following your surgery, this is unnecessary.
• Implant displacement exercises: Dr. Loftus will ask you to begin implant displacement exercises about a week after surgery. These exercises may help prevent capsular contractures and should be performed daily for as long as you have implants. Many women find that performing their exercises in the shower each day is easiest. Dr. Loftus will show you how to do your exercises, but here are some instructions to remind you how to do them:
• Place the fingers of your right hand along the lateral side of your left breast (the side of your breast closest to your arm). Your fingers should be near your rib cage. Then, begin by pressing inward until you can feel your rib cage with your fingers. Then, keeping your fingers on your rib cage, push your implant toward your midline, hold steady, and count to 10 slowly. Repeat with opposite hand & breast.
• Place the fingers of your right hand on the lowest portion of your left breast. Your fingers should be near the crease beneath the breast very close to or on the scar. Then, begin by pressing inward until you can feel your rib cage with your fingers. Then, keeping your fingers on your rib cage, push your implant upward toward your collarbone and count to 10 slowly. Repeat with opposite hand & breast.
• Perform each exercise more aggressively as your discomfort subsides. Continue this daily for the rest of your life.