Follow-up Care

Your surgery is now behind you. You’ve made it through the most challenging part of the process
and are now on the road to a healthier and happier you. Relax and take good care of yourself.
Carefully attending to the healing stage is imperative to ensure that your surgery results come
as close as possible to matching the image of yourself you’ve envisioned.

Like all women, your situation and your surgery are unique, and
your surgeon will provide you with an individualized recovery
program. During the next several weeks, you’ll want to follow these
recommendations to achieve optimal results. Still, there are basic
guidelines for what you can expect after breast surgery.

What to Expect
Upon your arrival home, your breasts will be bruised and
swollen; however, you won’t notice this too much because your
breasts will still be secured by your surgical support garment for the
next few days. You can expect your breasts to remain bruised for seven
to ten days and swollen for four to six weeks.

Will I be in Pain?
It’s likely that your anesthesia will not have fully worn off by the
time you get home, so you should not be feeling any pain. Will you
have pain in the days ahead? It is difficult to predict. Many patients
report only mild discomfort after surgery and during the recovery
period; others will have post-surgical pain for which they need pain
medication. If this is the case, it’s important to take pain medication
prescribed by your surgeon.

Sometimes, patients decide to discontinue their pain medication
if they are not feeling any discomfort, thinking that they no longer
need it. This practice is not advisable; however, because often the
medication masks pain, and pain flares up once the medication is
stopped. To avoid the undesirable condition of “chasing pain,” it’s
preferable “stay ahead” of the pain by taking your pain medication as
recommended by your surgeon.

Usually, your surgeon will prescribe pain medication to be taken
every four hours for one to two days, whether or not you are feeling
any discomfort at the time. Beyond the first couple of days after your
procedure, your surgeon most likely will recommend taking your pain
medication whenever you begin to feel a twinge of discomfort.

A concern many patients have about pain medication is becoming
addicted to it. If you take your pain medication in the dosage
prescribed at the recommended intervals, though, you should not
become vulnerable to addiction. Addiction to prescription drugs
occurs only when patients take more than the recommended dosage
or continue with medication longer than is medically necessary.

Will I Need Antibiotics?
Most likely, your surgeon will prescribe an antibiotic for you to
take in addition to your pain medication while you are healing from
your procedure. An antibiotic definitely will be used during your
surgery to ensure that no infection develops, and your surgeon probably
will recommend that you take one for approximately five days after
your surgery. After your procedure, especially if you had drainage
tubes inserted, your surgeon will most likely prescribe a course of
prophylactic antibiotics.

Emptying Drains
You will be responsible for emptying your own drains until your
surgeon removes your drainage tubes at your first follow-up session
three to five days after surgery. A slim possibility is that your drains
may still be gathering too much liquid for your surgeon to feel
comfortable removing your tubes during the first follow-up session. If
this is the case, he or she simply will schedule another session for you
a few days later to remove them.

Emptying your drains should not be painful. You simply will
need to be mindful to empty them as they become full. Even if your
drains are not completely full, your surgeon probably will request that
you empty them twice a day and record the amount of fluid they
contain at those times.

Also, you will not be able to take a shower until 24 hours after
your surgeon removes your drainage tubes at your first follow-up
session. You may, however, take “sponge baths” during the first few
days after your procedure.

Surgical Dressings

After your operation, your surgeon will have wrapped your
breasts in a surgical dressing. These bandages will be covered by your
surgical support garment and will not be your responsibility to
change. You will leave the dressing alone for the first few days following
surgery, and then your surgeon will evaluate your healing progress
during your first follow-up session. During this process, your surgeon
will remove your surgical garment, unwrap your dressing, and
examine your new breasts. This will be the first time that you and your
surgeon will be able to view the results of your procedure. Remember,
your breasts still will appear swollen and bruised, but you should be
able to glimpse the essence of your new look.

Your actual scars will not be visible at this time, however, because
your steri-strips will still be in place. The steri-strips will fall off by
themselves after you start showering. Once your surgeon evaluates
your healing, he or she will change your dressings and replace your
surgical support bra.

After your drainage tubes are removed, you may experience some
light bleeding at the drainage tube sites for 24 hours or so; your
surgeon may cover this area with a small gauze dressing. Twenty four
hours after your drainage tubes are removed, you may shower.
Beyond that, no further dressing should be needed. Your surgeon will
schedule a second follow-up session for you approximately two weeks
after the first one to make sure you are continuing to heal properly.

Support Garments
Once you have worn your surgical support garment for three
to four weeks after your procedure, you’ll be free to choose a more comfortable support bra or lycra sports bra to replace it. You will need
to wear this kind of bra for the next four to six weeks to give your
breasts the support they need to properly heal. You should not wear
regular bras, especially underwires, because they could interfere with
healing. Underwire bras, especially, can continually rub against your
incisions under your breasts and irritate them. This could reopen your
wounds. You may wash your surgical support bra or your lycra bra as
often as you need to.

Sutures
You don’t need to worry about having sutures removed. Today,
most surgeons use internal, absorbable sutures. As mentioned earlier,
your surgeon may cover your incisions with steri-strips.

Recovery at Home
Your initial recovery time will be seven to ten days. Your body
needs time to heal. It’s extremely important to heed your surgeon’s
advice about when to resume your daily routine. If you become too
active too soon, you could open up your stitches and cause excessive
bleeding. This could be dangerous and would delay your healing
significantly.

You should be able to perform nonstrenuous daily activities, such
as cooking, right away. You will not, however, be able to perform
anything strenuous. And yes, driving your kids to school is considered
strenuous after surgery. Avoid lifting heavy objects. You will be
restricted from exercise of any kind for the first two weeks.

You can expect to resume moderate activity, such as vacuuming
or driving, after your first seven to fourteen days post-operation.
You’ll be able to go back to work (assuming your job does not involve any kind of extreme physical labor) two weeks after your surgery.
Around this time, it should be safe for you to resume sexual activity,
as well.

Your complete recovery time will be approximately four to six
weeks. Your plastic surgeon will advise you about the appropriate time
to resume routine activities without restriction, including going to the
gym and exercising.

Avoid the Sun

You should, however, wait at least six months until you
intentionally expose your body to the sun at all, and wait one entire
year before exposing your scars to sunlight, as in sunbathing or going
to a tanning salon. Sun exposure too early can interfere with healing
and cause scarring to appear more extreme. Because sun rays can reach
your skin beneath your bathing suit, you will need to wear a sunscreen
of at least SPF 15 on your scars beneath your bathing suit for at least
one year.

Breast Massage
Another aspect of your healing requires your active participation.
Within two to four weeks after your procedure, you will need to begin
massaging the areas on your breasts where you see scars. Choose your
favorite lotion—maybe one with cocoa butter as a major ingredient—
and gently massage your breasts around the nipples and other scarred
areas. You will need to do this for an entire year in order to significantly
decrease your visible scarring. It sounds like a lot of work, but soon
giving yourself a daily massage will become as routine as brushing
your teeth. And, it will all be worth it when your scars feel soft and
fade quickly.

Touch-up Surgery
Touch-ups are not usually necessary with breast surgery. It’s rare
that breast procedures yield any undesirable effects which would
require additional surgeries to be performed. It is, however, possible.
Rarely, after surgery it is noted that a patient’s breasts are uneven, as
breasts often are naturally. In this situation, a surgeon may use
liposuction to balance the breasts. Very rarely, a small revision surgery
actually may be necessary. Usually, a revision can be done under
local anesthesia.

Another issue which very rarely develops after surgery, but can
require a touch-up, is a condition called hypertrophic scars or
“keloids.” If keloids do develop, surgeons often try other forms of
treatment before operating on them because keloids often grow back
after surgery.

If a touch-up surgery is required, for whatever reason, usually it
is free of cost for the patient, especially if both surgeon and patient
agree that an improvement needs to be made. Ordinarily, patients are
responsible for only the anesthesia and surgical center charge if a
touch-up is needed, although this practice may not be universal.
Be sure to discuss this issue with your surgeon before committing
to surgery.

Table of Contents
Previous: Chapter 6. Breastlifts
Next: Chapter 8. The New You!