Breast augmentation: preparing for a safe recovery

If you are considering breast augmentation with implants, the part worth preparing for is the recovery. The decision about size and shape is made in a consulting room over a couple of appointments. The recovery is several weeks of your life, and how well you prepare for it affects both your comfort and your result.

Surgical warning: Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.

Before you get to recovery

Since 1 July 2023, breast augmentation in Australia requires a referral from your GP or another appropriate practitioner, screening for underlying psychological conditions including body dysmorphic disorder, at least two consultations before booking (one may be by video), and a cooling-off period of at least seven days for adults. Under-18s require three months and an independent psychological assessment.

Use the consultations to settle the things that determine your recovery: implant type and size, placement above or below the muscle, incision site, and where the surgery will be performed.

Implants

Implants differ in shell surface, gel cohesiveness, profile and shape. Me Clinic uses Motiva implants. Round implants give more upper-pole fullness; ergonomic and shaped implants are chosen where a more tapered contour is wanted. Your surgeon matches the implant to your chest width, existing tissue and what you want, which is why a size chosen from a photograph often is not the size you end up with.

Two things to be clear about before you sign:

• Implants are not lifetime devices. Most people will need further surgery at some stage - for rupture, capsular contracture, change in position, or personal preference. Plan for that, financially and practically.
• Ask for your implant card after surgery, and keep it. It records make, model, size and batch numbers, and you will want it years later. All implants used in Australia must be included in the Australian Register of Therapeutic Goods, and your details are recorded in the Australian Breast Device Registry unless you opt out.

Ask your surgeon about the specific risks of implants, including capsular contracture, rupture, rippling, malposition, altered nipple sensation, effects on breastfeeding and mammography, and the rare but recognised conditions associated with breast implants - BIA-ALCL and breast implant illness. These are discussed properly at consultation and should be in your written consent.

Preparing at home

• Arrange an adult to drive you home and stay the first night - this is mandatory, and surgery will not proceed without it
• Book time off: usually one to two weeks for desk work, four to six weeks before lifting or gym
• Arrange help with children, pets, driving and shopping
• Move everything you use daily to waist height - reaching overhead will be uncomfortable
• Buy front-fastening tops; you will not want to pull things over your head
• Cook and freeze meals
• Set up somewhere to sleep propped up - several pillows or a recliner
• Stop smoking and vaping well beforehand; nicotine constricts small blood vessels and increases the risk of wound problems
• Tell your surgeon about every medication and supplement - several increase bleeding

The first week

Expect tightness and pressure across the chest rather than sharp pain, usually worst on days two and three. Swelling and bruising increase for 48 to 72 hours before settling. You may feel breathless with deep breaths at first because of the tightness. Sleeping propped up is uncomfortable but necessary.

You will be given a support garment or surgical bra and told how long to wear it, typically several weeks including at night. Wear it as instructed - it supports position while tissues settle.

Short, frequent walks from day one reduce clot risk. No lifting, pushing, pulling or overhead reaching.

Weeks two to six

Most people return to desk work in the second week. Bruising fades; swelling continues to reduce. Implants sit high and firm at first and gradually settle into position over roughly two to three months - the shape at two weeks is not your result.

Sharp shooting sensations and areas of numbness are common as nerves recover, and can take months to settle. Gym, running and anything that bounces or strains the chest waits until your surgeon clears you, usually around six weeks.

Scars

Every incision leaves a permanent scar. It will look flat and pink at first, become raised, firm and red at around six to eight weeks, then flatten and fade over twelve to eighteen months. Keep it out of the sun or under high-SPF sunscreen for at least a year. Silicone gel or sheeting from the time the wound is fully closed is the best-evidenced scar treatment.

When to call, and when to call 000

Contact the clinic promptly for fever, spreading redness, increasing pain after day three, discharge with odour, a wound edge opening, or sudden swelling or asymmetry on one side.

Call 000 for chest pain, shortness of breath, or calf pain with swelling - these can indicate a clot in the lung or leg.

Longer term, see your surgeon or GP about any new lump, change in shape, persistent pain, or sudden swelling of one breast, however many years later.

Follow-up

Reviews are typically at one week, six weeks, three months and twelve months, with the practitioner who operated, and further visits as needed. Breast screening still applies to you - tell the radiographer you have implants, as different views are used.

Related reading: recovery after breast augmentation, choosing implant size, risks and complications, the total cost.

Me Clinic has worked in cosmetic surgery in Melbourne since the early 1980s. 4 Burke Road, Malvern East VIC 3145. Phone 1300 852 050 or (03) 9569 3511. Specialist Plastic Surgeon consultation $350, including GST, as at September 2024.

Individual results may vary. Any surgical or invasive procedure carries risks. Before proceeding you should seek a second opinion from an appropriately qualified health practitioner.