Post Operative Breast Augmentation Instructions

If you have breast augmentation, it is important to follow postoperative instructions carefully. Do not lift anything heavy or exert any sudden force on your new implants as this might alter their shape. If you experience pain or swelling, contact your surgeon. The amount of time it takes for full recovery will vary for each individual but the average time is about 6 weeks.

In this guide, we review the aspects of Post Operative Breast Augmentation Instructions, itchy breast years after implants, signs of infection after breast augmentation, and when can you remove tape after breast augmentation.

Post Operative Breast Augmentation Instructions

Dr. Pousti and his staff are dedicated to providing you with excellent care. To make sure your post operative breast augmentation recovery is smooth and successful, please follow these instructions carefully:

Post Operative Breast Augmentation Instructions from Dr. Pousti

Dr. Pousti is a board certified plastic surgeon who has been performing breast augmentation for many years. Dr. Pousti’s office is located in Beverly Hills, CA and he sees patients from all over the world.

Dr. Pousti wants you to know that it’s important to follow all of his post operative instructions carefully so that you can heal properly and be happy with your results!

Day of Surgery

On the day of surgery:

• You will be asked to arrive at our office or hospital an hour prior to your scheduled procedure time. This allows time for you to complete paperwork and meet with our staff member who will administer your anesthesia.
• Please bring a valid photo ID with you on the day of surgery as well as any medications that you are currently taking, including vitamins or supplements, even if they are herbal or homeopathic in nature.
• We recommend wearing loose-fitting clothing that is comfortable for being seated upright for several hours (jeans are acceptable). A breast form can be worn under clothing if desired but not required; however, if you do choose not to wear one during this time frame we recommend bringing along something soft like an extra pillowcase so that your incisions can rest comfortably against something soft rather than hard surfaces such as plastic chairs or tables during these initial hours after surgery when swelling has begun but before swelling has subsided enough where there is more room inside clothes without discomforting pressure points being pressed against them due simply having larger breasts now than before undergoing augmentation procedures by either saline implants placed inside each pocket underneath each breast mound (submuscular placement) versus silicone gel implants which sit just above top layer muscle tissue layer directly underneath skin surface area making them less noticeable unless someone looks closely enough at person’s chest area where incision lines appear clearly visible even though scars will eventually fade away over time once healed completely without any trace left behind except maybe slight discoloration around edges depending upon how much bleeding occurred during procedure itself.”

1st Day Postoperative

• Pain is normal and expected. Your breasts will be sore for several days, but you should be able to take pain medication as prescribed by your doctor.
• Keep the breast area clean and dry; avoid heavy lifting or strenuous exercise for at least a week after surgery (you can resume normal activities after 2 weeks).
• Avoid sleeping on your stomach for at least one week following surgery, as this may cause swelling in the lower portion of each breast that could delay healing of incisions made during surgery

2 Days after surgery

• No heavy lifting.
• No strenuous activity that can cause you to sweat, such as aerobics or jogging.
• No smoking or drinking alcohol for at least 2 weeks after surgery, and then only in moderation (1 glass of wine per day).
• The first 2 days after surgery: Keep your arms elevated above your heart whenever possible; this helps with swelling and pain management. Use ice packs on the breasts for 15 minutes every hour for the first 24 hours post-op; afterwards use heat packs instead if needed. Do not take any pain medications other than what your doctor has prescribed unless instructed by him/her to do so (this includes ibuprofen).

3 Days after surgery

• Pain: You will experience mild to moderate soreness in the area of your incision. Your doctor may prescribe pain medication to help manage your discomfort.
• Swelling: Swelling is normal after surgery and will gradually subside over time. It’s important not to massage or rub this area because it can cause bruising and swelling that lasts longer than necessary, which could delay healing and recovery time for you. You should also avoid wearing tight bras or clothing on top of the incision site for at least two weeks after surgery; doing so could increase swelling in that area as well as create pressure on your new implants, making them more likely to shift out of place during recovery.* Dressing changes: Your surgeon will remove sutures (stitches) from inside each implant pocket six days after surgery to minimize risk of infection.* Activity limitations: You must avoid strenuous activity such as running or jogging until both breasts have fully healed–usually three months after breast augmentation surgery.* Medication changes: If any medications were prescribed prior to surgery (such as birth control pills), please inform us if those medications need adjusting once we begin postoperative care.* Diet Changes: While we encourage our patients’ participation in their own recovery process by eating nutritious foods during this period–particularly vegetables rich with antioxidants such as tomatoes and spinach–we ask that they avoid spicy foods since these may irritate sensitive tissue surrounding stitches/sutures within each breast pocket.”

4 Days after surgery

You can shower, but avoid putting any pressure on your breasts. You should also be able to lift your arms above your head without pain. If you need painkillers, take them as prescribed by the doctor. Do not take aspirin or ibuprofen (Advil) because they thin the blood and could cause bleeding complications in the surgical area.

Your doctor will give you specific instructions about what foods to eat or avoid after surgery–these will differ depending on which kind of implant was used during surgery. Most surgeons recommend starting with clear liquids such as broth or Jell-O when eating again after 4 days; solid foods may take longer than 7 days before returning to a normal diet if this is necessary for recovery from breast augmentation surgery

5 days after surgery

Five days after surgery:

• Avoid lifting anything heavier than 10 pounds.
• Take pain medication as prescribed.
• Avoid strenuous activity, including exercise and sex, for at least two weeks after your procedure.

If you have an exercise routine that includes heavy weights or resistance machines, wait until your doctor gives you permission to resume these activities (usually three weeks after breast augmentation).

6 days after surgery to 1 week after surgery

• You will be able to shower on your own, but it’s important to avoid getting water in the incisions.
• You may start to feel some pain as the anesthesia wears off.
• You may have some bruising and swelling, especially around the area where your drains were placed. If you do experience a lot of swelling or pain, contact your doctor immediately for advice on how to manage it at home or in an emergency situation (if you go back into surgery).
• It’s also normal for patients who’ve had breast augmentation surgery not being able to sleep well because they’re uncomfortable from their new breasts pressing against their chests while lying down flat on their backs; this discomfort should gradually lessen over time as the implants settle into place and become accustomed with their new environment inside your body

1 week to 10 days after breast augmentation surgery

You can shower and wash your hair one week after breast augmentation surgery. This is an important part of the healing process, as it helps remove any pus or blood from the incision site. You may choose to wear a bra for 2 weeks following surgery; however, if you feel more comfortable without one do not hesitate to go without!

You can start exercising again within 2 weeks of your procedure. This includes walking, jogging and swimming but no strenuous activities such as weightlifting or running until 6 weeks have passed since surgery.

Start wearing regular clothes again once you feel confident enough in how they fit over your new breasts!

11-14 days after breast augmentation surgery

You can shower and bathe as long as the incision sites are dry. You should not soak yourself in a bathtub or hot tub until your scars have healed completely.

Do not lift anything heavier than 5 pounds for at least 6 weeks after surgery; this includes grocery bags, kids, and other heavy objects.

Your breasts will still be swollen but less than before your surgery. Your body will continue to heal and change over time so don’t be surprised if you notice subtle differences in size or shape as each day passes by (this is normal).

This is a guide for what to expect with breast augmentation

• What to expect with breast augmentation:
• Rest and recovery (the first 2 weeks)
• Physical activity (after 2 weeks)
• Sex and intimacy (after 6 weeks)

itchy breast years after implants

In this case report we describe a 55-year-old Caucasian female who had developed an itching, erythematous plaque on the right breast seven months after she received a permanent tissue expander. Topical corticosteroids had no effect upon which a capsulectomy was performed and the complaints disappeared.

The number of breast reconstructions with implants, after mastectomy, has increased over time. It is a safe method and results in significant benefits in body image, self-esteem, sexuality and quality of life [1–3]. A common cause for breast reconstruction failure (e.g. resulting in implant removal) is infection . Other complications are seroma, capsular contracture, necrosis, hematoma, chronic pain and BIA-ALCL . More rare examples of complications consist of hypersensitivity to various chemical compounds, contact allergies to rubber compounds or a benign inflammatory response elicited by silicone [6,7]. Here we describe a case where skin complications of a patient resolve after removing her permanent tissue expander, without any evidence for underlying causes.

Case presentation

A 55-year-old Caucasian female had a medical history of ductal carcinoma in situ (DCIS) on her right breast. A mastectomy on the right side was performed in a nearby hospital, followed by an immediate reconstruction using a permanent tissue expander (Mentor SiltexTM Contour ProfileTM BeckerTM 35 Expander/Breast Implant Cohesive IITM). No additional oncologic treatment was performed.

The expander was filled periodically by injecting saline solution and methylene blue through the distant fill port. After seven months the exact location of the fill port could not be determined anymore, and several attempts were made before succeeding. The next day the patient developed an itching, erythematous plaque on the lateral side of the right breast, caudally to the injection site. There were no systemic symptoms. The patient had no prior history of atopic dermatitis or contact allergies. The diagnosis irritant contact dermatitis was determined and treatment with medium potency topical steroids was initiated.

One year after the reconstruction the patient was referred to our outpatient clinic with persisting complaints of erythema and itch. The clinical findings consisted of a moderate bordered, nummular erythematous to brown macule with fine bran-like (pityriasiform) squamae (see Figure 1(a)). No urticaria or blisters were seen. There were no signs of induration, sclerosis or infection.

(A) The first clinical presentation where a moderate bordered, nummular erythematous to brown macule can be seen with pityriasiform squamae. (B) The clinical presentation after 3 months of topical therapy.

Our differential diagnosis consisted of erythema chronicum migrans, morphea, allergic contact dermatitis and a granulomatous (foreign body) reaction. An ultrasound showed nothing unusual. Laboratory results showed e.g. erythrocyte sedimentation rate (ESR; 40), Hb (8.4), leukocytes (6.4) and alanine aminotransferase (ALAT; 19). The biopsy showed a superficial and deep perivascular dermatitis consisting of mainly lymphocytes and plasma cells (see Figure 2). The polymerase chain reaction (PCR) on the fresh biopsy was negative for Borrelia as was Borrelia serology. Furthermore, the safety sheets (SDS) of the permanent tissue expander were requested and patch tests were performed with our extended European Baseline series, cosmetics series, fragrance series, metal series, plastic glues series and the acrylates series. The patient only reacted positive to hydroperoxides of limonene which was considered to be irrelevant.

The histopathology with a superficial and deep perivascular dermatitis consisting of mainly lymphocytes and plasma cells.

Since the skin complaints started a day after the difficulties finding the fill port, it seems to be related. Therefore, our work diagnosis was a foreign body reaction to (components of) the permanent tissue expander. Topical therapy was started, which reduced the itch/erythema (clobetasol cream, triamcinolone and tacrolimus 0.1% ointment, see Figure 1(b)). The medical staff of the expander manufacturer advised to start levoceterizin 5 mg daily, which seemed to reduce the itch slightly. However, while the skin symptoms were reduced, the patient still suffered from discomfort because of a Baker grade 3 capsular contracture and she was not content with the esthetic result of the implant. Eventually, 2 years after onset of the symptoms, a capsulectomy was performed together with a change of the expander with a silicone implant (NatrelleTM Style 410MF) together with a symmetrizing mastopexy on the contralateral side. During surgery the expander was found to be intact. Within a few weeks all the symptoms disappeared, even after quitting the corticosteroid ointments (see Figure 3).

(A) The clinical presentation after removing the expander. (B) A detail photo where a subtle brown macula can be seen.

Discussion

In this case report we present a patient with a permanent tissue expander in her right breast who developed an itching erythematous plaque after seven months. The skin complaints started the day after a visit to the outpatient clinic where the fill point could not be found easily. Eventually the problems resolved after removing the permanent tissue expander.

In this paper we stated that the most common cause for breast reconstruction failure is infection. In this specific case there were no clinical (or systemic) signs of infection. However the ESR was slightly increased this can be seen in any inflammatory process, for example a foreign body reaction . Whenever there would be an acute infection one would expect increased leukocytes, lowered Hb and increased ALAT. Unfortunately there was no CRP determined, which is a limitation of this paper. A last possible option would be a subclinical infection but the histopathology of the biopsy showed no neutrophil granulocytes at all which is expected in a bacterial infection. Therefore we excluded an infection as underlying cause.

Previous research showed that silicone is a chemically stable compound but also, that they are capable of inducing an antigen-specific lymphocyte-medicated response to the silicone gel like a type IV hypersensitivity reaction [7,9]. When a patient has had a prior history of reactions to adhesives the possibility of a type IV hypersensitivity reaction to a silicone implant increases. Histologically lymphoid cells and granuloma are present on the implant capsule. In our patient the histology of the removed capsule with expander showed granulation tissue, fibrosis and an infiltrate consisting of lymphocytes, plasma cells, eosinophil en neutrophil granulocytes. This reaction can be seen as a reactive inflammatory process to the foreign-body. Since the histological findings were not specific and our patient did not had a prior history of reactions to adhesives, the type IV reaction seems to be unlikely.

A hypersensitivity reaction is possible when there is contamination with sensitizers such as rubber of metal compounds during manufacture . Since we excluded contact allergy to rubber and metal this does not seems to be relevant here.

Since the symptoms developed one day after the broaching of the metal valve failed seven times consecutively the suspicion of a relation between this procedure was high. However, the broach site was on the upper outer quadrant of the right breast whereas the exposed site was more to the caudal side. A possible explanation for this discrepancy is gravity. Furthermore the question is which fluid would have caused the skin reaction since the fill fluid consisted of methylene blue and saline. When the methylene blue was concerned in this matter the skin would have turned blue as well, which was not the case. Also the fact that saline would give such a reaction is unlikely, unless it was contamination with micro parts (e.g. plastic).

In summary we have presented a woman with a permanent tissue expander who developed an itching erythematous plaque after seven months. Although no underlying cause was found the implant was removed because the patient continued suffering from her symptoms. After removing the implant her complaints disappeared within a week. However we do not have a solid explanation for this causal connection, our work hypothesis is a foreign-body reaction without granulomas. Furthermore, this case shows that replacing the implant can solve the symptoms. It can be worth performing in specific cases where no other underlying cause can be ascertained. .

signs of infection after breast augmentation

Getting breast implants can change a person’s life for the better. But in recent years, some people have suspected that their breast implants have made them very ill with diseases such as:

Older studies showed no clear scientific evidence connecting these conditions to breast implants — silicone or saline-filled. However, newer studies from different sources have found an association between silicone breast implants and certain autoimmune diseases.

These studies suggest that silicone breast implants potentially raise your risk of developing an autoimmune disease such as rheumatoid arthritis, Sjögren’s syndrome, scleroderma, and sarcoidosis.

On the other hand, another source notes that the FDA is not able to say there’s a direct relationship between silicone implants and autoimmune diseases.

The same source notes that other experts don’t think the evidence is strong enough at this time to conclusively show an association between these breast implants and autoimmune disease.

The World Health Organization and the U.S. Food and Drug Administration have identified another possible cause for concern. This relates breast implants to a rare cancer called breast implant-associated anaplastic large cell lymphoma (BIA-ALCL).

Additionally, breast implants are known to cause other potential risks such as:

Scientists say the exact causes of BIA-ALCL aren’t well understood. However, it does appear that textured implants are associated with more cases of BIA-ALCL than smooth implants.

Scientists say this could be due to the fact that textured implants have a greater surface area on which a bacterial infection can form. Infections could trigger a type of immune response that ultimately, in very rare cases, results in BIA-ALCL.

Regardless of implant type, smooth or textured, it’s essential to prevent infection. Infection is a much more common illness related to breast implants. Any surgery comes with infection risks, including breast augmentation. Infections can occur when a surgery site isn’t kept clean or if bacteria enters your breast during surgery.

Besides infection, other complications associated with breast implants may occur. These include:

BIA-ALCL is often contained inside the tissue surrounding the implant. However, it can spread to other parts of your body’s lymphatic system, including the lymph nodes. The main symptoms include:

Symptoms of other breast implant complications vary. As noted above, infection is one complication associated with BIA-ALCL. It’s important to treat any breast implant complications that arise. If you experience any of the following symptoms, call your doctor right away:

Regarding autoimmune symptoms to look for, one study notes that silicone breast implants can cause symptoms of autoimmune diseases in some patients. These symptoms include:

Silicone also has the potential to leak from the implant throughout the body, possibly leading to a chronic inflammatory condition.

If you experience any of the connective tissue inflammatory symptoms above, let your doctor know.

BIA-ALCL is classified as a T-cell lymphoma. It may develop following the surgical insertion of breast implants.

T-cell lymphomas are cancers that form in your T cells, a type of immune system white blood cell. These cancers tend to be fast growing per the American Cancer Society. The outlook for a person diagnosed with BIA-ALCL depends on the stage of their cancer at diagnosis and how aggressive it is.

Half of all reported cases of BIA-ALCL are reported within 7 to 8 years of the insertion of breast implants. Because the symptoms of BIA-ALCL are relatively nonspecific, experts say these diagnoses may be complicated and delayed.

But as scientific knowledge about it has grown in recent years, experts have begun to establish diagnosis standards.

When a doctor suspects BIA-ALCL, they’ll run a variety of tests to rule out any other causes of your symptoms. These tests may include:

For autoimmune disease, various blood tests can be performed. These are done alongside a thorough history and physical examination. Doctors look for the clinical symptoms and signs occurring for each individual. Depending on the type and location of inflammatory symptoms, imaging testing may be of use as well.

If you’re diagnosed with BIA-ALCL, your doctor will recommend a PET-CT scan. This imaging test checks for signs of lymphoma in other parts of your body. This cancer, while rare, may be aggressive and can spread.

For most people with BIA-ALCL that’s confined to the tissues surrounding one or both breasts, surgical removal of one or both implants is necessary. With an earlier stage 1 diagnosis, implant removal is typically enough to stop the progression of the disease.

However, for cancer at stage 2 or higher that’s spread, more aggressive treatment is necessary. In addition to implant removal, chemotherapy may be able to slow or stop disease progression.

Other complications associated with breast implants are typically treated on a symptom-by-symptom basis. Antibiotics are often used to treat infection, though in severe cases, surgery might be necessary to remove the implants that have caused infection.

Regarding potential autoimmune response, one study noted that for 75 percent of patients affected, removal of their silicone breast implants provided significant relief of systemic symptoms. Symptoms included arthralgia, myalgia, fatigue, and neurological symptoms, during an observation period of 14 months following removal of the implants.

However, making a diagnosis and forming a treatment plan — whether medical or surgical — needs to be a well-thought-out process between a patient and their doctor.

The survival rate for people with BIA-ALCL is relatively high at 89 percent at 5 years, in general for any stage of this cancer. The survival rate is even higher for people with stage 1 cancer who have a complete removal of their affected implant or implants and cancerous breast tissues.

However, cancer treatment is challenging, expensive, and not always effective.

Although there are risks associated with breast augmentation, it’s still considered a safe procedure. Before your procedure, make sure you understand your risks for complications. Keep in mind that the risk for BIA-ALCL is exceedingly rare.

Regarding the risk for autoimmune disease, recent research shows an association with breast implants, silicone in particular. However, the conclusiveness of the data is controversial and will likely require further studies to more specifically investigate and pinpoint a definite direct cause-and-effect relationship.

To minimize your risk for infection, implant rupture, and breast cancer illness, closely monitor your breasts after your procedure. Follow your surgeon’s aftercare instructions closely. See your doctor right away if you notice any changes in your breasts or health, especially if you experience signs of infection.

when can you remove tape after breast augmentation

Recently undergone breast or body surgery with Dr Moncrieff? As a crucial step in your scar management regime, we recommend taping your incision from 6-12 weeks post-surgery. Practice Nurse Alecia Baker explains.

To minimise your plastic surgery scars, for the first six weeks post-surgery you should focus on wearing your support garment, keeping your dressings in place and limiting movement. In this period, you will undergo two complimentary Healite LED Light Therapy treatments to assist with scar minimisation and faster healing. At three-weeks post-op, your dressings will be removed and replaced. At six weeks-post-op, you will visit our rooms for your dressing removal. From this point, we recommend you continue to apply tape to your incisions for a further six weeks until you reach the 12-week post-op mark.

What are the benefits of pressure/tape on my incision?

Adhesive paper tapes such as Micropore are proven to reduce the possibility of scars becoming raised and are effective in applying gentle and constant pressure to the incision, protecting and supporting the wound. Taping the scar also has the advantage of providing UV protection while in the healing phase.

How do I tape my scar?

The tape should be placed directly over the length of the incision. Our nursing team will demonstrate application at your six-week post-op appointment. The tape should be left in place for one week at a time. After one week, you may remove the tape for a short period of time and massage the incision with Vitamin E before reapplying the tape. Dr Moncrieff recommends taping your scar until 12 weeks post-op. At this stage, with diligent aftercare the scar should start to become flatter and paler in colour.

What kind of tape should I use?

We recommend a flexible paper tape such as Micropore. You will receive a complimentary role of Micropore and a tube of Vitamin E cream at your six-week post-operative appointment to begin your scar management regime. Micropore tape is inexpensive and additional supplies can easily be purchased at your local chemist.

Can I shower with the tape on?

Yes! Unlike the dressings used in the immediate post-operative period, you are able to shower with the tape in place and can perform scar massage in the shower over top of the tape. This tape is quick drying and does not require blow-drying after showering.

Will it hurt to remove the tape?

While the incision may feel sensitive, it should not be painful to remove and replace a gentle paper tape. After one week in place, the tape should begin to peel up at the edges by itself. If required, you can use an oil-based product like Vitamin E or medical grade Universal Adhesive Remover to help slide the tape right off.

Have another question about minimising your plastic surgery scars?

If you have a question about taping your scar after surgery or would like more advise on minimising your plastic surgery scars, please do not hesitate to call one of our friendly team on 4920 7700. Many of our team members have undergone plastic surgery themselves and are experts in all things scar management!