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Breast Augmentation recovery: What to Expect

Waking Up After Breast Augmentation: Anesthesia

After you wake up and are brought into the recovery room, a nurse will monitor you until you are ready to be released. How long this will take is dependent on many factors, but usually takes at least 2 hours. As the anesthesia wears off, you will feel a bit sore and possibly confused. Your vision may be blurry and you may nod off to sleep and wake up again several times.

Some patients feel no different waking up from anesthesia than if they were waking up from a good night's rest. They are lucky. Many people do not, however.

Coming out of anesthesia can play games with your emotions. You may feel upset, cry a little, be a little annoyed, start giggling for no reason, or you may be ecstatic beyond words that you finally have boobs. It all depends upon your personality and your reaction to the meds. If you feel any pain, you can ask for a pain reliever.

While you are recovering from breast augmentation surgery, you may also feel very cold and start shivering. This is usually from the medications, more than likely epinephrine that is used as a vasoconstrictor, and the slightly cold saline that was been introduced into your system for the last few hours. Operating rooms are usually very chilly and, after breast implant surgery, you may have ice packs across your breasts, so how could you not be cold?  The recovery room staff usually has wrapped you in a warm blanket, but if not, request one. It can make things more tolerable. You may even be lucky enough to have heating lamps!

If you have had general anesthesia, you may feel a little nauseous and sick. Many surgeons give you something to lessen this nausea. If you feel you are going to throw up, alert the recovery room staff. You will probably be given a plastic kidney-shaped bowl to throw up in.

During your breast augmentation recovery, you will be swollen and bruised and will more than likely be wearing some type of compression garment, surgical bra, or elastic bandages binding your breasts to your body.

When you are released, you must be driven home by your spouse, a friend, or by another responsible adult. You will not be allowed to drive yourself home. You may not be able to even see well, let alone be able to drive yourself home! Some hospitals and surgical centers will not release you unless there is a responsible adult to drive you home.

Icing Your Breasts After Breast Implant Surgery

Your surgeon may instruct you to put cold compresses or ice packs on your breasts for the first 48 hours after surgery. Some surgeons, instruct you to do so even longer. For my second breast surgery, I was told to ice for 48 hours and switch to warm compresses after that until the bruising and swelling was gone.

You can buy cold compresses and ice packs at any drugstore or pharmacy. Buy two or three so that you can rotate them in and out of the freezer to keep them cold. A bag of frozen peas or berries can also be used. You can also make a homemade ice pack by mixing one part rubbing alcohol with three parts water. Place this mixture in a Ziploc® bag and seal it and then place that bag into another bag and seal it and put the whole deal in the freezer for a few hours.  The water will freeze, but the alcohol will not, leaving you with a slushy ice pack.  Add more water for a more solid, icier pack if you find it too slushy, and less water for a slushier concoction. These homemade packs are inexpensive and are moldable to fit around your breasts.

Drains For Your Breast Augmentation Recovery

Your surgeon may have placed one or more drains in your incision. A drain is a plastic tube with one end inside the incision and the other leading to a plastic bulb that looks a bit like a see-through grenade. Drains give fluids a way to exit from the surgical site while you are recovering from breast augmentation and prevent a build-up of pressure that can compromise healing.  You are more likely to have a drain in your incision if there was excessive bleeding during the surgery or if you are having other procedures, such as a breast lift, in addition to breast augmentation.

Surgical drains may be left in place for a few days or a week after surgery, depending on how much fluid they are collecting. You will be given instructions on how to care for them and empty the bulbs. The bulbs detach and you empty them and then squeeze them a bit before you reattach them to the tubes. This squeezing creates a bit of suction that helps with drainage. You may be asked to measure how much liquid the bulbs contain each time you empty them. The fluid may look pinkish or brownish. This is normal.

Drains are usually removed at your first follow-up appointment, as you are recovering from breast augmentation surgery. The surgeon removes the drain simply by pulling the tube out. Patients have described this experience as either pain-free and nothing to worry about, or as an odd feeling, or as a brief pain. There may be a little irritation around the edges of the incision by the drain.

Caring for Breast Implant Incisions

Keep your incisions/suture line dry. Your surgeon may have placed Steri-Strips on top of your incision line and sutures or you may have has internal sutures with tissue glue to bind the incision edges.  Either way your surgeon will give you specific care instructions for your incisions in writing at your preoperative appointment or before you are sent home after your surgery. It is best to read and make sure you understand this information beforehand instead of having to learn at the last minute.

Take care to not get creams or lotions, or topical arnica into the incision. These products can cause inflammation.

Monitor Your Temperature

Take your temperature regularly during cosmetic plastic surgery recovery. An elevated temperature could mean you have an infection.

Antibiotics

Take your antibiotics on time. Take all the antibiotics that your doctor prescribes for as many days as the prescription says. To stop short on the prescription can lead to a resistant infection. Don't forget that some antibiotics can interfere with birth control pills, so in the event that you do have relations, use another form of protection as well.

Soreness and Pain After Breast Augmentation Surgery

If you chose subglandular placement (“overs”), breast implant recovery is usually shorter and less painful than if you choose partial or full submuscular placement (“unders”).  However, this is a rule of thumb and depends on several factors, including your own threshold of pain. You will feel discomfort, but you should be able to control it with the pain medication your surgeon prescribes.

Pain tolerance varies from person to person, but you will feel tender, stiff, and sore for a few days and will more than likely not want to move too much. This will subside.

Be sure to take your required medications and follow the precise instructions provided to you by your surgeon. Do not hold off on taking your pain medication because you think you will be a wimp if you take it. You will end up using more pain medication that way than if you took it on a schedule. Besides, pain actually impedes healing. If you are uncomfortable, take a pain medication. The less pain you have, the better your experience and the faster you will make a full recovery.

Common prescription pain medications include Vicodin, Vicodin ES, Tylenol with codeine, and Percocet.  You may also take plain Tylenol (acetaminophen) if that controls your pain. Do not take pain relievers with aspirin or ibuprofen until your surgeon says that it is OK to do so since they can cause excessive bleeding.

Swelling (Edema) After Breast Implant Surgery

With breast augmentation surgery, swelling (also called edema) will be an issue. This is a fact and you might as well relax about it. Swelling is a normal reaction by the body to any injury and is one way the body heals itself.

You may be swollen for up to 3 to 4 months, but the bulk of the swelling should subside within 2 to 3 weeks with the rest resolving slowly. Towards the end of your breast augmentation recovery, swelling with be very slight and may only be noticeable to you.

Treatment for swelling includes increasing your fluid intake (preferably water), a low to normal sodium diet, and mild exercise such as light walking. Make sure you drink enough water, which will actually help with swelling. You should not take diuretics unless you are specifically instructed to do so. This includes natural diuretics as well.

While some swelling is normal, severe swelling can be a problem. More severe swelling may need treatment. If you experience sudden swelling in the days after your surgery, call your surgeon.

Bruising

You will probably have some bruising after your breast implant surgery, but the amount varies greatly from person to person and depends entirely on the patient and the surgical technique used.

No matter how badly you think you are bruised, bruises almost always fade with time. You can ask your surgeon about arnica or bromelain, which are herbal remedies for bruising and swelling, or about vitamin A and C to improve healing. Warm compresses starting several days after surgery can resolve bruising by dilating superficial blood vessels, which helps the body flush out the area. Before using warm compresses, ask your surgeon because using warm or hot compresses too early can be damaging.

Most bruises fade with time, but in rare cases, bruising is permanent. If you have discolorations after several months, you should speak with your surgeon. There are several treatments for permanent bruises, including some laser and pulsed light treatments.

Sleeping With Your New Breasts

Sleeping is going to be difficult right after your breast implant surgery. You have to sleep on your back with your upper back and head elevated. This position helps reduce swelling and pain in your breasts. 

Some patients say they slept in a recliner chair for the first week or so during their breast implant recovery, but if you don’t have one, don’t worry. You can sleep in a bed with 2 to 3 good-sized pillows under your upper back and head to keep yourself elevated. You can also buy a wedge-shaped foam pillow that will elevate your upper body. If you want, you can even rent a hospital bed for the first few days of your recovery.

Many patients also place a pillow under their knees to help prevent rolling over during the night. Some also place pillows alongside them and create a sort of recovery nest. See Kathy B's Pillow Fort for Sleeping After Breast Augmentation  for more information.

You might want to have a bottle of water on your bed stand while you recover. Sleeping on my back with my head and torso elevated made my mouth fall open while I slept. Talk about dry mouth! I would wake up and sip some water and go back to sleep.

Many surgeons offer their patients a prescription of Ativan or Valium to ease pre- and postoperative jitters, sore muscles, and to help with sleep difficulties.  I personally found Valium very helpful in falling, and staying, asleep. My back was a little sore due to sleeping upright for two weeks so the Valium eased this as well.

Just be sure you get enough sleep. Your body heals itself better with rest. Besides, sleeping is a good way to pass the time during breast augmentation recovery. Be sure to have someone wake you up to take your meds, eat some healthy meals, and drink your fluids.

Bathing

You will have to sponge bathe until your surgeon says you can take a shower. Usually, this will be after your incisions are completely closed and your sutures have been removed. He or she will also tell you when you can take a nice soak in the bathtub, too, but this may be a week or two after you are allowed to shower.

You should wash your hair the night before your surgery and either braid it or hold it back in a ponytail if you can. This will keep your hair clean and out of the way when you are eating or if you get sick.  You may not be able to wash your hair for a week because you should not raise your hands over your head for that period of time.  If you need to wash your hair, get a friend to assist you and wash it in the sink or with a hand-held showerhead.  Or go to the salon and have your hairstylist wash your hair for you.

Activities During Breast Augmentation Recovery

Even though you may not feel like it, you should get up and walk around as soon as you are able while recovering from breast augmentation surgery. Your surgeon will more than likely advise you to walk a bit a few times the day after your surgery. Walking around a bit two or three times each day will help prevent development of blood clots and can help relieve swelling. 

You will be instructed not to exercise strenuously or engage in strenuous activities for at least 3 to 4 weeks. Don’t do anything that would raise your blood pressure, which can cause bleeding, and you don't want that. Don't lift anything over 5 pounds (and that includes your kids and your pocketbook!) and try not to raise anything over your head until your surgeon releases you for activity. If you have small children, you might want to have some help with them for the first week or so after your surgery because you should not pick them up.

Breast Scars and Keloid Prevention

Your incisions will heal slowly and scars will form. These scars will look worse before they look better and will take several months to heal completely. They may be raised and red before they eventually flatten and become paler.

Some people are prone to scarring badly. Instead of flat scars, they form lumpy raised bumps called keloids. People with darker skin are more likely to form keloids.

For help with keloid prevention and to help flatten scars, some surgeons recommend applying sheets of silicone gel sheeting to the incisions after they have closed. These sheets are available in the shape of common incisions used for breast augmentation or breast lifts or as sheets that can be cut to size.

Ointments and gels like Mederma and Xeragel may not be as successful as silicone sheeting at helping to flatten and fade scars because they can be rubbed off and don’t put pressure on the scar, which is beneficial in flattening. Ask your surgeon about using a combination of silicone gel to keep it soft and moisturized and then silicone sheeting over that. Please see our Scar Treatment Section for more information.

Numbness and Loss of Sensitivity

You may lose some sensitivity in the nipple or the skin over your breasts for a time after breast augmentation surgery. This lack of sensation will usually subside within a few weeks, but in rare cases, loss of sensation may be permanent. 

As sensation returns to your nipples and breasts, you may experience sharp pains, itchiness, heat, tingling, prickling, etc. These sensations are due to the returning function of the nerves and they will also pass.

Nipple Oversensitivity

Many women complain of very erect and sensitive nipples after getting breast implants. It happens often. You may not be able to stand having your clothing rub up against your nipples. To protect your nipples, try using a Band-Aid (especially the large round ones), large corn pads, or nursing pads to cover your nipples. These pads will protect your overly sensitive nipples from the abrasiveness of your clothing as well as shield your erect nipples from the eyes of the public. 

Some women have used numbing creams designed for breastfeeding mothers, but ask your surgeon first if you can use something like that.

Breast Noises: Squeaks and Gurgles

Your breasts used to just lie there and be quiet, so when previously silent parts of your body start to make noise, it can be a bit odd. Do not be alarmed if you hear gurgling, buzzing, or crackling noises coming from your augmented breasts. These noises can be from fluid build up or air bubbles within the implant pocket or because the implant has not settled in. Give it a few weeks. I had gurgling, squeaking, and sloshing noises for a few weeks, but things finally quieted down.

What Will My Breasts Look and Feel Like?

In the days and weeks right after your surgery, your breasts will be quite firm and will sit high up on your chest. Don’t worry. They will soften up and will drop. This dropping is sometimes called “fluffing.”

Remember that your breast implants will drop a bit and fall into a more natural position with time. Some surgeons advise the use of an elastic bandage called a strap that is wrapped around your upper chest, under your arms and over the top half of your breasts. This bandaging pushes the implants down, but even without the use of a strap, your breast implants will usually drop.

Some of the firmness is from swelling, which is a natural reaction to a wound of any sort. It is one of your body's ways of repairing itself. Using cold compresses on your breasts will significantly reduce the swelling, as will keeping your head and torso elevated.

If your implants were placed under the muscles, those muscles will be traumatized somewhat and be all knotted up and tense, which causes an even firmer feel. This muscle tightness will work itself out and you will notice softer breasts in a few weeks. The breast on your dominant side (your right side, if you are right-handed) may not drop as fast as your left breast.

Be forewarned. Your newly augmented breasts may be, for lack of a better explanation, a bit odd looking. You may think your new breasts are too big, too small, too round, not round enough, too odd shaped, too square, too itchy, too high, too low, too ugly, too sensitive, too this, and too that. This is because your skin has been stretched over the implants, making your breasts very firm and high. This will pass. Your breasts have a lot of healing to do.

The full results of your breast augmentation won’t be seen completely for many weeks.  Don't jump to any conclusions just yet; you might think you don’t like them at first.  Please be patient.

Visit our Breast Augmentation Message Board for support and conversation from other women with breast implants.

Breast Implant Surgery Complications: What to Look For and What to Do

The vast majority of breast augmentation surgeries go well and give excellent results. But breast augmentation is serious surgery and even after the operation is finished things can go wrong. These complications may not happen to you, but you must be on aware that they can happen and know what to look for and what to do.

When you are sent home, you will be given phone numbers to call if there are any problems. These numbers will include a number to contact your surgeon and an on-call physician. You will also receive a list of things to look out for, such as elevated temperature or bleeding from the incision. If those instructions are different from the ones we give here, follow them and not ours. Our instructions are general and may not match the list your surgeon uses. At all times, follow your surgeon’s instructions!

Contact your surgeon or the on-call physician immediately if you notice any of the following:

• Excessive bleeding from your suture lines
• Pus or cloudy discharge from your incision areas, nipples, or elsewhere
• A foul odor from your incision areas, nipples, or elsewhere
• Uncontrollable pain
• Blisters not caused by adhesive from bandages
• Implant extrusion
• Bottoming out of the implant
• Displacement of the implant
• Temperature over 101° F
• Inability to pass waste (both liquid and solid)
• Numbness of the legs
• Uncontrollable dizziness
• Deflation

Please contact your surgeon or the on-call physician AND go to the emergency room as soon as possible if you notice any of the following:

• Blood in urine or feces or spitting up blood
• Abrupt and severe swelling and discoloration
• Blackening of the skin (which is clearly not a bruise)
• Uncontrollable vomiting
• Loss of consciousness or fainting
• Temperature over 105° F
• Convulsions

What to do in case of a complication:

• STAY CALM
• Have your emergency numbers handy and call (or have your caregiver call) your surgeon or the on-call physician to tell them the problem as soon as you can.
• If you are going to the emergency room, don't forget to tell your surgeon which hospital you are going to.
• Bring all of your medications with you to the hospital.
• It may be a good idea to keep an overnight bag packed and ready "just in case"
• If you are able, keep a written journal (and if possible photos) of your symptoms and complaints.

Click here for a print out of breast augmentation complications of these instructions.