Posted: June 3, 2014
Breast Augmentation is one of the most common plastic surgery procedures performed at Desert Hills Plastic Surgery Center. All patients who undergo this surgery must be compliant with post-operative activity restrictions to ensure a successful and uncomplicated recovery process.
Regardless of whether your breast implant is saline or silicone, submuscular or “over-the-muscle”, the recovery process is the same. Patients who have implants placed under-the-muscle do not have a harder time recovering than those whose implants are “over-the-chest muscles”, even though that is a common misconception. Everyone heals differently, and individuals experience different degrees of discomfort after surgery irrespective of the technical details of the procedure.
During surgery, a pocket is dissected around vascularized tissue to accommodate the breast implant. The walls of the pocket take time to form, and it is important to avoid pressure, shear, or tension forces around the implant during this time to prevent bleeding, swelling, malposition, and incisional healing problems. The capsule (breast implant pocket) normally begins to form at 7-14 days after surgery. This is a smooth layer of scar that continues to remodel and provide full support around your implant by 2 months. The capsule is a normal immunologic response to a foreign body.
It is important to sleep on your back for at least 3 weeks and avoid heavy upper body exercise and aerobic activity. This includes heavy lifting (>10lbs), bending over and straining, and reaching high above your head or out to the side. Any activity that can increase blood pressure or blood flow to the breast and chest area should be avoided. Mothers: it is perfectly OK to take care of your babies. However, try to get help for at least one week after surgery. There may be a situation where you have to change a diaper, get your baby out of the crib or car seat, and you will have to carefully perform these tasks. Toddlers and small children are smart without much perception of time; they will understand that you have an “booboo” to avoid hugs, lifting and physical interaction for what seems to them, a short time. Don’t worry; most responsible moms do not have complications after surgery. Plan ahead and use good judgment and common sense.
Most hematomas (bleeding complications) occur within the first few days after surgery. Therefore the first few days are critical with respect to protecting your chest. Move about and take care of yourself, but keep your arms near your sides and avoid any upper body activity that tends to activate the chest muscles. After 2 weeks, hematomas can still occur but are much less common. After 4 weeks they are rare. I allow patients to perform light exercise such as indoor biking, light dancing, and Pilates starting at 4 weeks after surgery. At this point, listen to your body and how you feel. Often, the best guide to your activity level is paying attention to how your breast and chest feels. If there is no pain, no swelling, no pulling or unusual sensations, it is probably OK to do that particular activity. Start lightly, and each day or so very gradually work things up to your normal routine. Yoga can also be resumed but use care and avoid certain postures that feel straining. If you are unsure, stop what you are doing, let your body rest, and try again in one week. Running and jumping has the most effect on the healing breasts, so joggers and those who do heavy upper body or aerobic activity such as gymnastics or Zumba classes may not be comfortable doing these activities for 6 weeks or longer. Contact sports or aggressive summer or winter sports such as skiing, snowboarding, surfing, and water skiing are also probably best not attempted before 5-6 weeks. Extremes of temperature are often uncomfortable and not recommended during this time because of temporary sensitivity, so hot tubs, sun bathing, and saunas should be avoided. Swimming in temperate waters is fine at 4 weeks using sunscreen on the chest and breasts if outdoors.
For patients with breast implants that are subpectoral or “under-the-chest muscle”, I do not recommend heavy or weighted upper chest work outs at the gym that tend to activate and contract the pectoralis major muscle. First of all, the muscle is pushed forward from the presence of the implant, so it looks prominent and well developed. In my opinion, further prominence of the pectoralis major muscle in this situation does not enhance the female figure. Secondly, strengthening this muscle does not enhance your result or bra size. Lastly, repetitive chest muscle contractions squeeze the implant, and can transiently affect breast contour. While the implications of this are unclear, and can be related to your underlying musculoskeletal anatomy, I feel that it adds an element of unnecessary stress on both the implant and the breast pocket itself. In women whose implants are over the muscle or subglandular, I do not oppose them doing these exercises if they desire.
In conclusion, exercise is generally restricted one month after breast augmentation. Sorry folks, sex is like exercise, so be careful! Patients are encouraged to walk immediately and strict bed rest is not advised. However, sleep on your back and protect the surgical site for at least 3-4 weeks. After that time, use your judgment and good common sense while listening to your body. Telling me you went to Magic Mountain and rode the roller coasters 1 week after your surgery does not impress me, and can hurt your results. After investing time and money into your procedure, and going through the discomfort and recovery associated with breast augmentation, do not sacrifice your result by trying to hit the gym too soon after surgery. Time passes quickly and before you know it, you will be doing everything you loved to do before you had great breasts. Patient compliance with post-operative activity restrictions is not only essential for a successful outcome, but also to avoid complications that could require reoperation. And don’t expect your insurance company to cover additional costs that go along with a secondary urgent surgical intervention.