What to Expect
“The better your surgeon performs and the better you follow instructions, the more rapidly you will recover. Over 90 percent of our patients are able to be out to dinner the evening of their augmentation, and 96 percent return to full, normal activities within 24 hours.1”
Your recovery experience is the best indicator of the amount of tissue trauma and bleeding that occurred during your surgery.
Recovering from an augmentation is different from preparing for it. During preparation, there were many things that you could actively do to change the course of events. During recovery, your body does most of the work automatically, provided you don’t expect everything to happen quickly and provided you don’t tamper with the autopilot! If you understand what’s normal, what to expect, and some of the reasons behind the dos and don’ts, the recovery process will be smoother.
Recovery is a team effort and depends on two key factors: what the surgeon does during the operation and how well you follow the surgeon’s instructions postoperatively.
- The better your surgeon performs, the less the trauma to your tissues, and the less bleeding during surgery, and
- The better you follow instructions following your augmentation, the more rapidly you should recover.
Recovery Is Variable
Is recovery similar from patient to patient? The answer varies from patient to patient and from surgeon to surgeon. If you understand some of the reasons for variations in recovery, the whole process should be easier.
Your body and your breast tissues are different from other women’s. The tighter your breast skin envelope and the more surgical manipulation required, the more tightness and tenderness you can expect following surgery. Everyone has some tightness and tenderness, but the amount varies according to what’s required of your tissues. Generally, if you’ve had children prior to your augmentation, your tissues have been previously stretched, and you’ll feel less tightness for a shorter time. If your skin is very tight and has never been stretched by pregnancy, you’ll feel tighter longer.
Some patients are more tolerant of discomfort than others. Some patients are better able to get moving after surgery despite discomfort. Some patients follow instructions better than others.
Your individual pain tolerance, motivation, and ability to follow instructions will affect your recovery.
Adopt a positive attitude, follow instructions, get moving early and get well sooner!
A surgeon can’t change what you bring the surgeon to work with. But how the surgeon works with what you bring can significantly affect your recovery. The less surgical trauma the surgeon causes to your tissues, the easier and shorter your recovery.1 The less bleeding the surgeon causes while creating the pocket for your implant, the easier and shorter your recovery. Hopefully, you learned from chapter 8 how to ask the right questions about recovery before surgery to help select a surgeon who minimizes surgical trauma.
In the previous edition of our book, we told you that if your tissues are thin and submuscular placement of the implant was necessary for adequate tissue coverage of your implant, you’ll have more tenderness compared to patients whose implants are placed over the muscle. With new, dual plane2 and 24-hour recovery1 techniques that we have published, you can experience the same 24-hour recovery whether your implant is over or under muscle.
With optimal techniques and instruments, today there is no difference in pain or recovery if your implants are placed submuscular or submammary.2
Even if you choose a surgeon whose techniques still cause more post-operative discomfort if your implant is under muscle, this is a short-term inconvenience for long-term protection against seeing edges of your implant and possibly a greater risk of capsular contracture. If your surgeon used blunt dissection techniques, you can expect more tenderness and the possible inconvenience of drain tubes for a few days.
The easier your surgeon expects your recovery to be, the shorter the list of postoperative instructions.
The more the surgeon can do in the operating room, the less you’ll be burdened with after surgery.
Surgeons’ postoperative instructions vary a lot. The most important thing to remember is to follow your surgeon’s instructions! A surgeon knows what is done in the operating room and because of that, what needs to be done or not done after surgery.
Don’t try to outthink your surgeon! Follow your surgeon’s instructions.
And don’t follow your friend’s postoperative instructions if she had a different surgeon.
If you personally know other patients who have had breast augmentations, especially subpectoral breast augmentations, one of your greatest difficulties will be in believing that 24-hour return to normal activities is even remotely possible. We assure you that this rapid return to normal activities is possible whether your implants are over or under the pectoralis muscle.
If you talk to several women who’ve had breast augmentation, you’ll find a tremendous amount of variation in their recovery experiences. If your surgeon is giving you instructions that sound a lot simpler than what you’ve heard, be grateful! Your surgeon is probably doing a lot of things in the operating room that allow you to have an easier and shorter recovery. If you hear from another patient that you shouldn’t lift your arms, lift your child, or drive your car, and your surgeon is telling you it’s okay to do all these things immediately, go for it! Your surgeon just made your life easier. On the other hand, if your surgeon tells you not to do these things, the surgeon probably has reasons. Always follow instructions.
Your Surgeon’s Staff
Your surgeon’s staff is an extension of your surgeon. The goal is to help you get better sooner, so it’s important to follow the staff’s advice and instructions. When a person calls to check on you, listen carefully to that person’s questions and instructions. The information you convey will help the staff make the best recommendations to speed your recovery. The more knowledgeable the surgeon’s staff, the better they can help answer your questions and give you optimal advice. If you’re in doubt about anything after speaking with staff, ask to speak directly with your surgeon or ask for an appointment to see your surgeon.
The Most Important Do’S
The following is a checklist of the most important do’s that apply to almost all postoperative augmentation patients:
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1 Tebbetts, J. B. Achieving a predictable 24-hour return to normal activities after breast augmentation. Part II: Patient preparation, refined surgical techniques and instrumentation. Plast. Reconstr. Surg. 109: 293-305, 2002.
2 Tebbetts, J. B. Dual plane (DP) breast augmentation: Optimizing implant-soft tissue relationships in a wide range of breast types. Plast. Reconstr. Surg. 107: 1255, 2001.
3 Tebbetts, J. B., and Adams, W. P. Five critical decisions in breast augmentation using 5 measurements in 5 minutes: The high five system. Plast. Reconstr. Surg. 116(7), 2005.
4 Tebbetts, J. B. Achieving a zero percent reoperation rate at 3 years in a 50 consecutive case augmentation mammaplasty PMA study. Plast. Reconstr. Surg. 108(6): 1452-1457, 2006.