What to expect after Breast Augmentation surgery

Discharge Instructions

• You will normally be discharged on the day of surgery. The surgical bra that you would have bought into hospital should be fitted before you go home. Avoid underwire garments as these will ‘dig’ into the scar. You will need to wear the garments for 6 weeks after the surgery including in bed. Avoid sleeping on your side or tummy during this period.
• Have someone take you home and an adult should be with you that night. You would normally be discharged with pain killers and antibiotics. Take the analgesics as instructed and avoid taking alcohol. Do complete your course of antibiotics unless you are unable to tolerate them.
• DO NOT SMOKE. Smoking delays healing and increases the risk of infection.
• Eat a healthy balanced diet.
• Avoid caffeine (coffee and chocolates) as there is some evidence that this reduces wound healing, causes dehydration and increases blood pressure.
• The wounds will be covered with a waterproof dressings which should stay on until you are seen again 2 weeks after surgery. Do not soak in a bath or swimming pool as these dressings will soak off. If the dressings come off early or become soiled, replace with another waterproof dressing.
• It is normal to experience pain in the chest after surgery. This normally subsides after a few days. You may also experience some intermittent sharp, burning or stabbing pains – this is usually caused by nerve irritation (neuralgia) and will take several weeks to resolve. If severe, contact Dr Teh and you may be prescribed a medication to help with this.
• Numbness around the breast and nipple is universal after surgery. Recovery takes several weeks but may not be complete in some cases.

What should my activity level be?

• Avoid staying in bed for prolonged periods. This will help to reduce swelling and lowers the chance of blood clots.
• You may use your arms for activities of daily living for the first three weeks, but do not do any overhead activity until 3 weeks post-op.
• Do not drive for 3-4 weeks. When your chest is sufficiently healed and symptom free to allow for sudden braking, you may resume driving. Do not drive while taking narcotic pain medications.
• Discuss time off work with your surgeon but generally most patients will not return to work for 2-3 weeks unless they are performing purely home-based administrative duties
• NO swimming, heavy lifting or upper body work for 6- 8 weeks. During this time, you will be limited only to light walking/cycling. You should avoid sexual activity for at least 3 weeks.
• After the 6 week mark, you can wear your normal bras including those with underwire.

How do I take care of my incisions?

• Avoid exposing scars to sun for at least one year and always use a strong sunblock if sun exposure is unavoidable.
• Keep your dressings intact (ie steri-strip or tegaderm). However if you begin to develop an allergy to the glue (itching, redness, blistering), please remove the tape and contact the practice.
• for more information on wound care, click here.

What will it look like?

• The newly augmented breast will be swollen after surgery and will look larger than its final size. Swelling will subside over the coarse of 6 weeks and during this time the implant will appear as if it has dropped.
• Expect a degree of bruising which will tend to be worse in the more dependant areas of the breast (ie lower and outer parts of the breast)
• The abdomen will be tighter and flatter in appearance.
• The majority of swelling will subside in 3-4 weeks, but some swelling may persist for up to 3 months.

What follow-up care will I receive?

• Your 1st post-operative visit will be scheduled approximately 14 days after surgery, sutures will be removed during this visit. Please phone Dr Teh’s Secretary to schedule a post-op appointment when you are discharged from hospital if you do not already have one scheduled.
• Your 2nd post-operative visit will be scheduled 6 weeks after surgery and a final visit 6 months after surgery.

When should I call Dr Teh?

• If swelling and redness persists after a few days.
• If you develop increased redness along the incisions.
• If you have severe or increased pain not relieved by medication.
• If you have any side effects to medications; such as, rash, nausea, headache, vomiting.
• If you have an oral temperature over 38 degrees.
• If you have any yellowish or greenish drainage from the incisions or notice a foul odour.
• If you have bleeding from the incisions that is difficult to control with light pressure.

What follow-up care will I receive?

• Your 1st post-operative visit will be scheduled approximately 14 days after surgery, sutures will be removed during this visit. Please phone Dr Teh’s Secretary to schedule a post-op appointment when you are discharged from hospital if you do not already have one scheduled.
• Your 2nd post-operative visit will be scheduled somewhere between 4-6 weeks from the initial surgery date.

What should I look for in the long term?

Breast implants may last a very long time in some patients but they are not designed to last a lifetime. The longer you have implants, the more likely it will be for you to have them removed. In general expect them to require an exchange every 10 or so years. These include:

1. Increasing pain and hardness in the breast may indicate capsular contracture. Contact the rooms for an appointment.
2. Sudden increase in breast swelling is a concern. Causes include chronic seroma, secondary bleeding, infection and anaplastic large cell lymphoma. Contact the rooms for an urgent appointment.
3. You should monitor your breasts regularly while you have implants. If you notice any abnormal changes in your breasts, you should contact the rooms as soon as possible. You will still need to have regular breast mammograms/US/MRI as per the national guidelines for breast cancer screening. You should inform the radiographer that you have breast augments prior to the scan.
4. Rippling may be visible or/and palpable. The risk increases with size and age of the implant. Implant malrotation may occur with teardrop(anatomic) implants. While these issues are not a major risk to your health or the implant, do contact the rooms for an appointment should it become bothersome.
5. Implant rupture may be subclinical but a large tear may alter the shape of the implant. If you suspect a tear, contact the rooms to have an ultrasound or MRI to confirm this. A ruptured implant should not be left inside the breast for too long a period as the silicone may migrate to the breast tissue or lymph nodes in the armpit/axilla.
6. Since the 1960s, there has been a reported link between silicone and autoimmune disease. This syndrome is now termed Breast Implant Illness and symptoms include fatigue, chest pain, hair loss, headaches, chills, photosensitivity, chronic pain, joint aches, rash, body odour, anxiety, brain fog, sleep disturbance, depression, neurologic issues and hormonal issues. It remains a poorly defined entity with no definitive cause as the studies have been hampered by poor design, confounding factors or find no evidence.  Consequently, the debate continues as to whether or not the link is one of cause or effect. More recently, there is some evidence that Breast Implant Illness may be related to a subclinical infection of the breast implants. Contact the rooms for an appointment.
7. Over time, you may wish to replace the implant for a different size or to have them removed and not replaced. If not replaced, you may experience changes to your natural breasts such as dimpling, puckering, wrinkling, breast tissue loss or other undesirable cosmetic changes. Contact the rooms to discuss this further.