Aesthetic Breast Surgery Recovery Guide

Preparation for Breast Surgery

The below recommendations each have a specific purpose, such as reducing the risk of bleeding (herbal supplements, aspirins, Advil, etc.), blood clots (estrogen hormones, smoking), and wound healing complications (smoking, vaping, nicotine use).

1. Begin a high-protein diet that includes lean chicken, fish, eggs, beans, and protein shakes. Protein enables your body to heal wounds more effectively.
2. NO SMOKING for four weeks before your surgery and four weeks after. There should be NO SMOKING/VAPING/NICOTINE USE by you or anyone who is living with you during this period. Smoking significantly compromises blood flow to incisions and increases the likelihood of complications such as skin death, wound separation, and poor scar outcomes.
3. To reduce the risk of bleeding, avoid aspirin and other over-the-counter anti-inflammatory medications such as Advil or Aleve (you will receive a complete list from the office), alcohol, and herbal supplements for two weeks before and two weeks after surgery.
4. For two weeks before surgery, avoid close contact with people who are ill to reduce the risk of infection.
5. Two weeks before surgery, begin taking the VitaMedica Recovery Support vitamins we provide to aid wound healing and reduce bruising and swelling.
6. Avoid using heating pads or warming blankets on surgical areas to prevent potential burns to the skin near surgical sites. These areas are sensitive to heat and may burn more easily than usual.
7. If you become ill before your scheduled surgery, please notify Dr. Patronella as soon as possible.

Items to Have on Hand Prior to Your Aesthetic Breast Surgery

1. Loose clothing such as sweat pants, zip-up jackets, or loose, button-up shirts – You’ll temporarily be more swollen than usual, so loose clothing will be most comfortable for you
2. Antibacterial soap for your hands, antibacterial body wash, and alcohol-based hand sanitizer – After your surgery, you will need to use an antibacterial body wash when you shower.
3. Laxatives or stool softeners (especially magnesium citrate) – Constipation is a common side effect of pain medication for the first week following your surgery.
4. A big water bottle – You will need to ensure you drink plenty of water to help you stay hydrated. We recommend drinking at least 8 cups of water per day (16 cups if you also had liposuction).
5. Bland, soft foods – Toast, crackers, ginger ale, broth soups, etc., are more easily digested after surgery.
6. Sports bras with NO underwire – If you are having a breast augmentation, you will go home with an ACE bandage around your breasts. After 24 hours, you may take the bandage off to shower and use the sports bra given to you at the clinic or one you purchased. After a breast reduction or breast lift, you will wear a compression garment for approximately two weeks before transitioning to a sports bra.

The Day Before Your Breast Surgery

1. Eat a liquid diet and have a bowel movement. You may need to use a laxative or Fleet enema.
2. To reduce the risk of infection, thoroughly cleanse your body the night before your surgery with the antiseptic soap given to you at the clinic. Do not use this on your face.
3. If you are anxious, take a Xanax (one of the medications that will be prescribed to you) the night before your surgery. Please take it before midnight.
4. Do not eat or drink anything beginning at midnight before your surgery.

On Surgery Day

1. On the night before surgery, have nothing at all to eat or drink after midnight. Do not chew gum.
2. You may brush your teeth in the morning, but do not swallow any water.
3. Do not wear contacts to the surgery center. Please wear your glasses. If you do accidentally wear your contacts, please notify your nurse.
4. If you are menstruating, do not wear tampons on the day of your surgery.
5. The clinic will tell you what time to arrive at the surgery center. Please arrive on time and leave all valuables at home. The only things you will need on the day of surgery will be your filled medications and your clothes. The nurse will verify that you have all the medications you need.
6. Remove all jewelry and leave it at home.

The Evening After Surgery

Most patients who are having breast surgery as the sole procedure will go home one to two hours after surgery. Rest and take it easy.

Days 1–3 After Breast Surgery

1. During surgery, a long-acting, non-narcotic local anesthetic injection (EXPAREL®) may be performed. EXPAREL® will reduce discomfort but not eliminate it completely. You will still need to take your pain medication so that you will be able to get up and around.
2. To reduce the risk of blood clots and help speed recovery, you should get out of bed (with assistance) for 10-15 minutes every two hours during the day. While reclining or lying down, remember to flex and extend the feet at the ankles to activate the calf muscles and pump blood out of the legs.
3. Although discomfort may occur, it is vital to fully expand the lungs with deep breathing exercises throughout each day.
4. You may shower twenty-four hours after your surgery using an antibacterial soap like Dial or Lever 2000. Have someone assist you while showering in case you get dizzy or light-headed. Avoid bathtubs, pools, and hot tubs until Dr. Patronella says it is okay.
5. If Exofin® tape and wound glue are used, do not remove them before showering. The waterproof Exofin® will provide support for your incision’s healing while creating a watertight seal to help prevent infection.
6. Do not apply any soaps, creams, or ointments to the incision(s). After showering, blot these areas dry. The Exofin® tape and glue will stay on between two and four weeks.
7. If Steri-Strips™ are applied by us during surgery, follow the same instructions. Steri-Strips™ may be changed every four to five days. If you experience any allergic reaction at the incision site or anywhere on the body, report it to Dr. Patronella as soon as possible.
8. For incisions not covered with tape and glue or Steri-Strips™, simply clean them with hydrogen peroxide or mild antibacterial soap and water. You may then apply Bacitracin ointment and a sterile dressing.
9. Your diet should consist of foods that are easy to digest and high in protein. Please avoid salty foods, including canned and packaged foods. Low-sodium or sodium-free foods help reduce swelling, and protein improves wound healing.
10. An ACPS-certified home health provider will come to your home or hotel in Houston on the first and possibly second day after your surgery to assist and teach wound care and dressing change.
11. Constipation is very common after surgery. We recommend using a stool softener (Colace® or Dulcolax®) while taking the pain medication. Make sure to drink plenty of water (8-12 cups per day). If constipation persists, use over-the-counter magnesium citrate.
12. If you had ONLY a breast augmentation, begin the Implant Displacement Exercise (IDE).
13. Our caregivers will provide you with instructions on performing the IDE, and you may also watch a video demonstrating it at the QR code link at the end of this guide.

Days 3–5 After Breast Surgery

1. Gradually increasing light activity is recommended. Avoid over-exerting yourself. Lift NO more than 10 pounds during the first two weeks.
2. By now, a family member or caregiver should have been trained to assist with dressing changes once daily. This is usually done after showering.
3. Avoid contact with animals to reduce the risk of infection.
4. Avoid contact with any ill family member, friend, or acquaintance.
5. Eat a low-salt and high-protein diet.
6. Keep biceps close to the body. Avoid hyperextending and overreaching of the arms. Bend at the hips and knees to squat rather than bending over.

Days 5–10 After Breast Surgery

1. You may begin driving five to seven days after surgery if you are comfortable and no longer taking prescription pain medication.
2. Incisions will still be covered with waterproof glue (Exofin®). Please do not apply any ointments and creams until advised. If you have Steri-Strips, they may be removed after one week at your follow-up appointment.
3. Most sutures (stitches) are dissolvable; only a few sutures require removal, usually 7 to 10 days after surgery.
4. You should become progressively more mobile and be able to perform light activities such as walking, sitting, and limited household chores.
5. After seven days, you may resume work with light-duty restrictions (no lifting, stooping, prolonged standing, or strenuous activity).
6. If you had a breast lift WITH a breast augmentation, you may begin the Implant Displacement Exercise at this time. If no implants were used, you do not need to do this exercise.

Days 10–14 After Breast Surgery

Gradually increase walking to half a mile twice a day (about 45 to 60 minutes) to improve your mobility.

Weeks 2–4 After Breast Surgery

Your exercise may now include brisk walking or riding a stationary bicycle for 15-30 minutes. Keep your heart rate below 120 beats per minute. Avoid any straining or heavy lifting.

Weeks 4–6 After Breast Surgery

1. Keep your exercise at about 50-75% of your pre-surgery ability.
2. With a breast augmentation, AVOID ALL chest exercises (dumbbell flies, bench press, etc.).
3. Strengthening the pectoral muscles will alter the appearance of your breast augmentation.
4. Initiating Dr. Patronella’s Scar Therapy Program is recommended at this time. Several products are used to achieve optimal scar appearance. Treatment is usually needed for 6 to 12 months. Consistency of use is essential for the best results.
5. If your breast augmentation includes silicone implants, an ultrasound or MRI of both breasts will be needed every four to five years to ensure implants are still intact.

Weeks 6–12 After Breast Surgery

You may gradually increase the intensity of your exercise to full capacity. Aerobic exercises, jogging, Pilates, and yoga are allowed. Lightweight lifting can be initiated with caution. You will need to AVOID pectoral exercises until cleared by Dr. Patronella.