Breast Augmentation Recovery Protocol

Posted On 10 May, 2017 - By Robert Hardesty - With 0 Comments

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Breast Augmentation Recovery Protocol 

Every plastic surgeon has his or her specific instructions for each patient and would defer to yours.

Pain is what limits most patients from returning to work or their normal daily routine. And every patient’s pain tolerance is different.

In my practice, over 95 percent of implants are placed under the muscle. The implant acutely stretching the muscle is the cause of the majority of the pain. I personally inject the muscle with long-acting local anesthetic and offer a non-narcotic pain pump that drips local anesthesia into the breast pocket for three days.

The local anesthetic agent (Marcaine) is slowly administrated 24/7 by the pump. Thus most patients use much less narcotics and are able to use the computer or even legally drive because the local anesthesia isn’t a narcotic.

There are several different local anesthetic agent brands (On-Q is a common one). With the use of the non-narcotic pain pump, patients usually return to work in two to three days for non-physically demanding jobs. Without the non-narcotic pain pump, the recovery is extended to three to five days.

Postoperative protocol

First day
    •    Icing the breasts
    •    Start non-narcotic (Ibuprofen) and narcotic (Percocet) for breakthrough pain

Second day
    •    Start implant-displacement exercises as pain allows
    •    Use what’s referred to as the 5-5-5 protocol — 5 times per day for 5 minutes for 5 weeks — until the breas
         implants "seat" (is in the position the patient likes)
    •    Start "walking the wall with fingers"

Third day
    •    Remove non-narcotic pain pump                                                                                                        
    •    For those who don’t have to use their upper body, it’s OK to return to work; allowed to use upper body
         muscles as long as pain is tolerable (for next six weeks)
    •    No high-impact activities
    •    Wean off all narcotics
    •    Continue exercises and using the 5-5-5 protocol until the implants seat

Third day to six weeks
    •    May return to work for those who require upper body use if there’s no pain or pain is tolerable
    •    No high-impact activities
    •    Continue exercises and using the 5-5-5 protocol until the implants seat
    •    May need special compression straps, “tabletop” exercises, and/or "shoe string" support to facilitate the implants "seat" properly
    •    Placement of silicone gel strips (Biodermis, NewGel, etc.) on top of the incisions to minimize scarring

Beyond six weeks
    •    No restrictions for upper body (even if some pain)
    •    May start high-impact exercises but only with good support garments
    •    Wear a sports bra (or even two) during high impact activity and a well-fitting underwire bra 99 percent of the time to prevent sagging (ptosis) of the
          breasts (caveat: the bigger you go the faster you’ll drop)
    •    Continue exercises and using the 5-5-5 protocol until the implants seat
    •    After implants have “seated," then do displacement exercises for 30 seconds three times a day for life (to prevent capsular contracture, when internal
         scar tissue forms around an implant and causes misshape or hardening)
    •    Continue the silicone gel strips for three months to optimize scar appearance


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