It takes about 3 weeks to feel like yourself again.
Usually one day after surgery, my patients come into the office so I can remove their initial dressing, and put them in a post-operative bra, which clips in the front, making it easier to maneuver and put on or take off. Once the large surgical dressing is off, you can apply ice to the chest to help with swelling and any discomfort.
This surgical bra is to be worn for 3 weeks after surgery, except you may remove it to wash it, and/or to shower.
Head elevation is useful for the first 48 hours to keep swelling away from the surgery sites. Diet is normal as tolerated.
Pain will be worse while your breasts are swollen which is maximal 36-48 hours after surgery. You will have pain pills to take to help with this.
For the first 3 days after surgery, I recommend keeping the arms near your sides and not reaching for things, to minimize pectoralis muscle motion, and therefore minimize the risk for bleeding.
After 3 days, I encourage arm motion to avoid any limitation in shoulder motion. The goal is to raise both hands straight above one’s head so the backs of the hands touch each other. Once there, you are good to go.
Then the only limitations are to avoid any medications for 2 weeks before and 2 weeks after surgery that could “thin” the blood and increase the chances of bleeding. I will provide you with a list of what medications to avoid.
Also smoking should be avoided for 3 days before and 3 days after surgery to optimize the chance of successful wound healing.
The last restriction is to keep the wound clean and dry until sutures are out (about 10-14 days post surgery). Now there are some excellent bandages on the market (e.g., Nex-Care) that you can put over the wound and dressing (usually Steri-Strips), shower and then remove. If it still gets wet, use a hair dryer to blow it dry.
There are some types of dressings which allow showering right away (Dermabond – a clear adhesive), and is now able to be used in most cases. This will gradually peel off on it’s own as you shower over the following days.
Once sutures are out, there is no further limitation in activities. Go ahead and do what you want, but always let pain be your guide. If it hurts, wait, and try again in a few more days. If it’s comfortable, then proceed.
You can drive after about 5 days, once you are sure you could slam on the brakes if you had to stop suddenly. Remember, one can’t predict what other drivers will do.
When you can go back to work depends on the job. I would avoid heavy lifting (20 pounds or more) for 3 weeks. If there is no heavy lifting, then as soon as you feel up to it, probably in about 1-2 weeks.
If your implants are placed on top of the muscle, they don’t hurt as much, since your muscles don’t have to stretch, and usually you can work in a week.
No underwire bra for 6 weeks after surgery. You may find you don’t even need one at all due to the new look and position of the breasts.
