ACA’s Question of the Week this week comes from a Facebook follower in Boca Raton, and asks, “My biggest worry about breast augmentation is the recovery from surgery. What can I expect? How much time off work does breast implant recovery require? When do scars really begin to fade?” Dr. Thomas A. Pane, our founder and Chief Medical Officer, gets this question a lot, and it’s a great question because of how much different ground it covers.
Dr. Pane says there are a lot of variables involved in this type of procedure. Factors that may affect how breast augmentation recovery proceeds include personal health and healing factors, the attending surgeon’s skill and the techniques used, whether it is a first or subsequent augmentation procedure and the type of augmentation that is performed. Typically, a first procedure where an artificial implant is placed over the pectoral muscle and beneath the breast tissue will be the sorest. This is because no scar capsule has formed and the body has to adjust to the presence of a foreign object. In most cases the surgical site will be painful for the first 3-5 days and then subside.
Some people experience no or minimal discomfort and return to work within a day or two, especially if their occupation involves desk work. People whose jobs entail a lot of physical activity or who have moderate or higher soreness in the surgical area may require up to a week off work, followed by return on light duty. Naturally, any occupation that requires a lot of lifting, especially weight over 25 pounds, would fall under the latter category.
Dr. Pane points out that he has a very low incidence of postsurgical complications from breast augmentation patients. It’s not zero, but very close, largely because of the emphasis on aftercare and ensuring the patient resumes light activity as soon as possible. Light activity allows the body to adjust more quickly to the presence of the implant, whereas too much activity can cause bleeding in the pocket created to place the implant. This can affect the healing of the surgical site and may also lead to complications later in the healing process, as well as altering the shape of the breast. One component of breast augmentation aftercare is doing exercises designed to allow the body to more readily accommodate the implant and relieve the swelling and discomfort after the procedure.
In a second or later breast augmentation procedure, where the implant pocket and scar capsule have already been created, or where the breast is augmented through fat transfer or an implant into the fascia rather than resting on the pectoral muscle itself, the area will not be as sore. Technique makes a big difference here, because how the implant is placed is often just as important as where. Dr. Pane says he prefers to work slowly and cautiously, to minimize postsurgical discomfort and the risk of complications including bleeding, abnormal swelling or implant rejection. When fat transfer is used, the soreness is very different and the soreness is usually present in the area from which the fat is harvested, not where it is placed. However, as fat transfer is generally less invasive overall, it is also less likely to result in the kind of soreness that most patients would consider prohibitive for basic activities.
With the scarring, most scars tend to start fading by about 6 weeks and then over the course of another 3-6 months. One major determining factor is how the scars are tended in the first weeks after surgery. Bear in mind that scars take 1-2 years to fully mature and fade, but red, “angry” scarring should begin to fade well by about week six postop. A great deal depends on the patient’s skin type and the technique used to place the implants, as well as the patient’s natural ability to heal, because some people are more prone to lingering scars than others. Good aftercare can help reduce this, although there is no way to completely erase scarring in current medical knowledge.
If you have a question for Dr. Pane or the staff of Atlantic Coast Aesthetics, we invite you to follow us on Facebook, call us at (561) 422-4116 or email us at https://acplasticsurg.com. Your question could be ACA’s next Question of the Week, which Dr. Pane will answer in person in an upcoming Google Hangout! At ACA we believe there is only one bad question, and that’s the one you don’t ask. An informed patient is the best kind, because they’re the most likely to advocate for their own care, so ask away!