It’s been three weeks since my breast reduction surgery, and I thought I’d share some of the things I’ve noticed in this time.

First, let me just say that it’s been a huge relief to have my back pain gone. Before the surgery, I was in constant pain—both from the size of my breasts and from the muscle strain they caused when I bent over or tried to lift anything. While I’m still sore in spots, it’s nothing like it used to be. It’s like night and day!

In addition to that, though, there are a couple other things that have really stood out for me:

1) My clothes fit differently now. Instead of having clothes that were too small because they were stretched out by my breasts, they now seem tight—but in a good way! They’re finally fitting properly and making me look more proportionate overall.

2) My posture has improved dramatically. Before, when people would tell me to stand up straight or sit up straight, it was often hard for me to figure out exactly what they meant because my posture was so messed up from years of being hunched over due to these giant boobs (and also because I’ve always been naturally bad about standing up straight). Now

3 weeks post op breast reduction

Recovery after Breast Reduction

Recovery after Breast Reduction

08^thJun, 2021

Breast reduction has become one of the most popular procedures Dr. Richardson performs here at Brisbane Plastic & Cosmetic Surgery. Breast reduction in Brisbane is a medical procedure that involves the removal of excess breast tissue and skin to reduce and simultaneously lift the breasts, raising the nipple position and creating a more perky, youthful appearance. The most common reason for undergoing the procedure is to alleviate the chronic pain of oversized breasts that can have far-reaching implications for physical and mental health. Recovery after breast reduction surgery is an important topic for patients to understand prior to their procedure, as this will greatly impact their patient experience as well as have compounding effects on healing and aesthetic results. This blog post will consider the process of recovery after breast reduction and the important points patients should consider during this time. 

Recovery after Breast Reduction: Immediately after surgery

The first point of recovery after breast reduction is waking up after surgery in the recovery ward of the operating hospital. In the recovery ward, the nurses will help you get dressed and you’ll have your first meal of the day (you will have been fasting prior to surgery). It’ll take some time for you to readjust after the general anaesthetic, but when you are alert enough the nurses will go through all of your post-op instructions again to ensure you are prepared for recovery! You’ll get a refresh about the medications provided in the post-op bag, the info in the post-op booklet, and the nurses will call your partner, friend, family member, or carer that you have chosen to pick you up from surgery and care for you the first 24 hours. 

One of the first things you’ll notice after surgery is the drains. These surgical drains are intended to drain excess fluid and blood from the surgical site and prevent complications such as seroma. The drains are left in for approximately 1-3 days depending on the amount of fluid drained. We monitor your drain levels daily until they’re ready to be removed. Another thing you’ll notice is that you can’t actually see your breasts because they’re bandaged up. These dressings will be left on until your post-op appointment, so it’s important to not disturb them too much early on. The last thing you’ll notice is your compression stockings which will play an important role in preventing DVT and blood clots. These stockings should be left on for at least 4 days for safety. 

When you get home you will probably want to sleep. The first thing you should do before sleeping is take your first antibiotic, provided in your post-op bag. You will need to take one antibiotic four times a day until the box is finished. When you wake up, at lunch, at dinner, and before you sleep is a good schedule that’s generally easiest to stick with. Remember, your antibiotics are the most important medication to take so aim to set some alarms in your phone for the week to remember to take them.  It’s a good idea to play it by ear when it comes to the painkillers and start small, and do not mix and match your painkillers. For some patients, Panadol is sufficient pain relief. While it may be tempting to use the stronger pain relief as a preventative measure, this will have an adverse impact on your bowels and can cause you to become constipated, which in turn can cause nausea and significant discomfort. If you are in discomfort and start taking the strong pain killers you should make sure you’re taking the stool softener provided in your post-op bag, as well as pear or prune juice. 

Now that you have taken your antibiotics and your chosen pain relief (if required), you can have a nap! You’ll probably want to be sleeping and resting as much as possible for the first week, and this is normal – it’s important to take it easy during recovery. Dr. Richardson recommends that all patients sleep elevated for the first week to reduce swelling, reduce fluid build up, maintain circulation, and ensure proper healing. Sleeping elevated on 2-3 pillows is sufficient elevation.

It’s important to keep your circulation after surgery, as you are at a higher risk of developing blood clots during this time. To avoid this happening you should be getting up to walk around the house every hour or so that you’re awake. Light walking is fine, but avoid getting your heart rate up as this can cause complications.

Recovery after Breast Reduction: Day after surgery

When you wake up the morning after surgery you’ll receive a call from the nurses at the clinic to check up on you. They’ll ask you how you’re feeling, make sure you’re staying on top of your antibiotics, make note of what painkillers you are taking, and whether you’ve had any bowel movements. The most important part of this call will be checking your drain levels to see how much fluid drained overnight. If there was a sufficient amount drained, the nurses will organise your drain removal appointment, but for most patients this occurs on the second or third day post-op. 

You might be tempted to hop in the shower after you wake up the next morning, but remember you have drains and dressings that cannot get wet. If you want to have a bird bath you can take off your compression stockings and wash your lower half. You can then use a damp cloth or wet wipes to wipe around your arms, neck and underarms, making sure to not wet the dressings. 

Remember to stay hydrated and rest. Over-exerting yourself in the early post-op period is how many post-operative complications occur so take it slow and steady, and forget about the housework for a few days. 

Post-op appointment #1:

The nurses will call you daily until the time when your drains are ready to be removed. You will come in for your drain removal appointment at the clinic and the nurse will do this for you. Depending on how many days post-op you are, the nurse may also take down your bandages and dressings. If it is too early in recovery, you will need to come back another day to have you dressings taken down.

Post-op appointment #2:

If you have to wait a little longer before your dressings are ready to be changed, you will have a second post-op appointment. After this appointment you will be ready to have a proper shower! Remember, your breasts are still healing and raising your arms above your head is something you need to be avoiding as much as possible in the first 1-2 weeks. If you have to wash your hair, see if someone can help you out or try to minimise the amount of lifting required. When showering you should be avoiding the incision sites. 

At your post-op appointment the nurses will teach you how to change your tapes. Generally it is recommended that you take your tapes off in the shower, pat the incisions dry, and reapply fresh tape to the clean area. You should be changing your tape once a week, or as needed.

1 week post-op:

After one-week recovering you should be no longer needing nor taking any painkillers. As long as you have stopped, you will be cleared to drive and go back to work! If you have a more strenuous job that requires upper body work you should wait at least 2 weeks before returning to work. You will be able to do light exercise such as walking around the block, but nothing to get your heart-rate up just yet. By this point you will have finished your antibiotics and should be feeling pretty good. 

3 weeks post-op:

3 weeks post-op you’ll be feeling pretty much back to normal but it’s important to not get ahead of your self. You’ll have a check-up appointment to track your recovery progress and discuss any concerns you have. You can get back to the gym and start doing some lower body exercise but avoid anything that increases your heart rate considerably as you’re still in the process of healing. You should be back to most normal activity, but proceed with caution and listen to your body.

6 weeks post-op:

At 6 weeks post-op you will be cleared to resume life as normal. You’ll have your routine check-up appointment with Dr. Richardson to assess your results and will be advised of any further appointments required. You can get back into all activities at the gym, get your heart rate up, be fitted for bras, go swimming, and everything in between. You will no longer need to be wearing the tapes after the 6 week mark and can shower normally. The 6 week mark is what most surgeons deem to be the end of your recovery – granted you do not experience any post-operative complications.

how long after breast reduction will i know my size

Risks and complications with breast implants

Complications are unfavourable evolutions or consequences of a disease, a health condition, a therapy or a procedure. The goal of surgery is to have as few complications as possible and the surgeon will try to minimize them, however, breast reconstruction is associated with risks and complications. We have compiled a list of the most common complications, with an explanation and, where appropriate, with recommendations.

• Capsular contracture or capsular fibrosis: When any foreign body is placed inside an organism, the physiological reactions include metabolisation, expulsion or isolation. In the latter case, a capsule is formed around the foreign body, which is what happens with breast implants in the human body. This capsule can tighten around the implant and contract. The contraction deforms the implant shape and thus the shape of the breast. Additionally, the capsule can become very hard and cause pain. This complication is referred to as “capsular contracture” and its occurrence rates vary according to implant surface. A significant capsular contracture will result in implant removal (see also “Breast Implant Types”)
• Seromas: Seromas develop as an accumulation of serous fluid around the implant, which can lead to pain and excessive swelling of the breast(s). Several reasons can cause seromas: intraoperative or postoperative traumatization, excessive postoperative mobility of the implant or infection. Possible treatments: compression, drainage or implant removal, if necessary. Seromas may develop early, immediately after surgery, or late, occurring several months after surgery. See the section on Anaplastic Large-Cell Lymphoma.
• Pain: Pain may occur in the operated area as well as in the chest muscle, shoulder or arm after breast surgery. Continuous pain may be due to improperly sized or placed implants. Over-sized implants, capsular contracture as well as irritations due to excessive implant movement, may provoke pain. Please consult your surgeon immediately to clarify the cause of pain following an operation.
• Reddening of the skin or “rash”: This complication can be observed a low percentage of patients. This reddening of the skin should not be confused with an infection. It differs from an infection by itching and the absence of systemic infection symptoms. It usually occurs 7 to 10 days after the implantation and can last 2 to 3 weeks. The use of steroids may be necessary.
• Chest wall deformity: The rib cage may be deformed due to the pressure exerted by the implant.
• Calcification: Benign calcification around the implant is possible.  
• Infections: Infections may present with fever and/or inflammation. Infections in connection with breast implants are very rare: 0.114%.¹ Infections with unclear aetiology that occur after breast implantation surgery should be treated immediately. The use of antibiotics, drainage or implant removal may be necessary. Not all infections can be treated while the implant remains in the body. The “toxic shock” syndrome has been reported in extremely rare cases in connection with breast implants.
• Inflammation or irritation: Reactions of the body to an infection or injury showing as redness, swelling, pain.
• Implant rupture: Failure of the integrity of the implant shell. Implant damage (intraoperatively, e.g. by too short incisions, by surgical instruments, or postoperatively, e.g. in case of punctures, biopsies etc.), trauma or material fatigue are, in our opinion, the most frequent reasons. After rupture of a gel-filled implant, the consistency of the silicone gel prevents diffusion. However, it is not guaranteed that the gel remains a complete entity. Ruptures may be noticeable (symptomatic ruptures) or not (silent ruptures). Magnetic resonance imaging (MRI) is the most effective method for detecting silent rupture of silicone gel-filled breast implants. If a rupture is diagnosed the implant should be replaced.
• Permeation of silicone: All modern breast implants are equipped with special barrier layers to prevent the diffusion of silicone particles through the shell. While the passage of low molecular weight silicone components through the shell of the implant cannot be completely excluded, the small amounts of gel remain within the tissue capsule that physiologically grows around the implant.²
• Granuloma: Granulomas are localized nodular inflammations, which may result from an implant rupture or from silicone permeation. Granulomas of an unknown origin may require a biopsy or implant removal.
• Swelling of the axillary lymph nodes: Lymph nodes are small structures located all over the body around blood vessels. They are part of the lymphatic system of the body. They can swell and become tender or painful in cases of a local infection, an infection affecting the whole body, cancer or immune disorders. Axillary lymph nodes are the lymph nodes located in the armpit and which drain the breast area of fluid. Some patients with breast implants have been found to have enlarged lymph nodes in the armpit. This is referred to as lymphadenopathy. It has been reported to occur in women with both ruptured and intact silicone gel breast implants. If an enlarged lymph node becomes painful, it may need to be surgically removed. You should immediately report any painful or enlarged lymph nodes to your doctor.

Breast cancer

The extensive studies available show that women with breast implants are not subject to a higher risk of breast cancer than women without breast implants.³ In other words, a breast implant has no influence on the occurrence of breast cancer. While scientists do discuss the theoretical risks of this disease with implants, breast cancer as a direct result of breast implants has not been observed in humans.

It is important that you undergo all the usual breast examinations, such as self-examination and possible imaging procedures (mammary sonography, tomosynthesis, mammogram, magnetic resonance imaging (MRI)) to detect possible breast cancer. Modern imaging techniques such as sonography, MRI or computer tomography (CT) help to find tumours at an early stage.⁴

Make sure to self-examine your breasts at regular intervals. For post-operative self-examination, your surgeon should instruct you on how to distinguish between the implant and your own tissue to enable you to detect nodules yourself. Do not just touch your breasts; also look for swelling, redness and inflammation, as well as any breast deformities, even if these are not painful. If you find any changes, please consult a surgeon.

BIA-ALCL

Reports from regulatory agencies and medical literature have shown an association between breast implants and the development of ALCL, resulting in the term BIA-ALCL or Breast Implant-Associated Anaplastic Large Cell Lymphoma. This means that women with breast implants may have a small increased risk in developing ALCL. There are several different estimates of the risk of developing BIA-ALCL.

The vast majority of cases in literature concern patients with history of use of textured implants.

ALCL is currently classified as a form of non-Hodgkin’s lymphoma (NHL) – a cancer of the immune system. It typically presents as a late seroma – the accumulation of liquid within the capsule –but it may also occur with the formation of a mass. The symptoms may occur well after the surgical incision has healed, often years after implant placement, but there are known cases with a shorter time of occurrence.

ALCL is a rare but serious type of cancer. There are documented cases of death due to the spreading of the disease out of the capsule. When detected early and timely treated, this disease has a positive prognosis.

In most patients, it is treated successfully with surgery to remove the implant and surrounding scar tissue, but for some patients chemotherapy and radiation therapy may be necessary.

It is very important that you continue to attend regular check-ups and perform self-examination. If symptoms such as swelling, pain or a lump in the implant region occur, you should immediately inform your doctor.

If you have breast implants and have no symptoms, you do not need to do anything, but you should continue to routinely monitor your breast implants and follow your routine medical care. Removing the implants is not recommended in women with no symptoms without a confirmed diagnosis of BIA-ALCL.