Breast Augmentation

Again, most all the implants placed in my office are placed below the muscle. We call subpectoral breast augmentation. Occasionally, we do put them above the muscle for very specific indications, very specific reasons, such as a bodybuilder, someone who competes in the athletic bodybuilding competition. They can’t have that implant under the muscle because their pectoralis muscles need to be activated and very big and large, and when they flex, the implant would shift too much. But your average workout girl can certainly have implants under the muscle, which is what I generally prefer. The reason we prefer that is it does add some padding. It’s going to add about a centimeter and a centimeter and half a thickness. It also blends the edges of the implants in, so it’s a more natural look.

The other benefit is it also holds the implant against the chest wall, so the implant has some support. If the implant is literally just under your skin, it’s going to really feel the effects of gravity quickly and end up maybe looking like a rock in a sock. Of course, that’s not what you want for your breast augmentation. So silicone implants are a little bit lighter than saline implants. The benefit, they have much less rippling and wrinkling than most saline implants. And for women who don’t have a lot of soft tissue coverage, they really feel and look more natural.

Most of our patients, we’ve had them clean their skin the night before surgery and then the morning of the surgery with a special cleaning compound that we talk about in our preoperative visit. You can anticipate to have your driver, who’s going to drive you to the surgery center, be there about three hours for a breast augmentation. The surgery center typically gets you there about an hour before your surgery time. Then I’ll come and mark you right before surgery, draw some blue lines on you. Your surgery generally takes about one hour for breast augmentation. Then you’ll head to the the recovery room. They’ll give you a Popsicle, something cool to drink, monitor your vital signs. After about an hour, you’ll go home.

So the first day after surgery, you’re going to be wrapped up in a big what we call double ACE wrap. It’ll be tight, it’ll be sore, and you’ll remove that after 24 hours. You’ll look in the mirror and your implants are usually high and tight. Why? Because we put them under your breast muscle, the pectoralis major muscles. So the implant is under your muscle and that muscle is going to spasm. It’s kind of be like a Charley horse, so it’s pretty sore. Occasionally, there are some people where implants are perfect the next day, but that’s far and few in between. So the first day muscles are sore. It’s a squeezing sensation, kind of like you’ve been to the gym and did a hundred extra pushups when you usually do one pushup, so it’s pretty sore.

The next really big area I would say is a week. The next week you’re going to get better every day. Every day gets a little better, a little easier. Most people stop their pain medications within three or four days. We’re really utilizing an approach to try to decrease the amount of narcotics people use, and so we have some special medications that we use to help minimize narcotic usage and that decreases… Actually, it improves your speeds to recovery, decreases kind of the feeling lethargic and tired because some of those medications just don’t make you feel good. So after about a week, you’re back driving a car probably three or four days. In a week, you’re probably able to walk on a treadmill. You might be walking around your neighborhood, but that’s really all you should be doing at a week.

At a month, you’re really able to do much, much more. You’re probably doing a stair climber, cycling, running. You’ll be wearing a sports bra to help keep those breast implants in position and not really bounce up and down because that still might be a little sore. In a month, you’re really doing most normal activities with the exception of pushups, pull ups or bench pressing. We don’t want you to really activate those pectoralis muscles for about two months. The reason is they’re pretty strong and they can push the implant to an unfavorable position, which you don’t want. You don’t want your implant to pop out the bottom. You don’t want it to pop out the side. So after about two months, you can get back to the gym and start doing more vigorous chest muscle exercises.

The third week, yeah, you’re probably on a bicycle, you’re on a treadmill, and you’re doing a moderate amount of exercise. The key is if it hurts, don’t do it. The fourth stage I really tell people is think of this, you’re really only healed 10% a month. So one month, you’re 10% healed. At four months, you’re 40% healed. You can probably do anything you want. But during that time frame, from one month to four month, you really have to be careful. And depending upon the surgery we’ve done, you just have to limit the exercise that activates that muscle.

For breast augmentation, you can’t use your pecs for really at least two months. For a tummy tuck, same thing, can’t really use the abdominal muscles for two months. You really want to let those muscles heal before you overdo it and cause some problems that you would regret.