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Recovery After Surgery

Recovery After Surgery McAllen

RGV Cosmetic recovery - actual patients exercising
Actual Patients

24-Hour Recovery after Breast Augmentation

    About My 24-Hour Recovery after Breast Augmentation

    For the past thirty years, breast augmentation surgery has been performed using procedures that tear the tissue and bruise the bone, creating excessive bleeding and making it very uncomfortable for the patient after surgery. In order to treat post-surgical pain the patients were given narcotics and instructed to reduce activity for several days, which promoted cramping and stiffness of the muscles and prolonged the healing process.

    My staff and I at RGV Cosmetic Surgery and Vein Care utilize new surgical and post-operative techniques, implemented by Dr. John Tebbetts (author of ‘The Best Breast’) from Dallas, TX and perfected by Dr. Marvin Borsand at the Body Sculpting Center in Scottsdale, AZ. These new techniques minimize “blunt dissection”, or tearing of the tissue, and instead utilize precise dissection techniques. I also ensure that the sheath that provides sensation to the bones, known as the periosteum, is not touched. This minimizes bruising and significantly reduces post-operative discomfort. These new techniques are part of my “zero bleeding” surgical approach, which further reduces post-operative discomfort, since blood acts as an irritant and causes inflammation of the tissue. To further ensure minimal discomfort, I administer long-lasting local anesthesia during surgery. This prevents postoperative discomfort and allows you to perform the stretching exercises that are fundamental to the 24 Hour Breast Augmentation Recovery. As a result of these cutting edge techniques and the extra attention and care that I take during your RGV Breast Augmentation surgery, post-surgical pain is reduced so drastically that any discomfort you feel can be treated with a mild analgesic such as Tylenol or Aleve.

    Taking an active role in your recovery is the most important part of the 24-hour recovery process. You are encouraged to leave the house and go out to dinner the night of your surgery. You will also be required to follow a strict protocol of activities. This will begin with arm stretching exercises immediately after surgery. You should do at least 1 set every 15-minutes while awake the first night of surgery, and then 5 sets every hour while awake for the next 2-3 days. I cannot stress enough how important these stretching exercises are to ensure a successful recovery.

    Patients undergoing inframammary (incision in the fold below the breast) or periareolar (incision hidden in pigment of the areola) breast augmentation are the best candidates for the 24-hour recovery. This is because the implant is placed directly through incisions in the breast and I have direct access to the implant pocket. Although other approaches such as transumbilical (through the belly button) and transaxillary (through the armpit) don’t grant me such direct access to the implant pocket, it is still possible for patients undergoing these procedures to enjoy a 24-hour recovery, except that with the transumbilical and transaxillary procedures, patients may experience minor soreness at the belly button or under the arm for a few days.

    Instructions for the 24-Hour Recovery after Breast Augmentation

    ACTIVITY: After surgery you will take a short (2 hour) nap and then resume normal non-strenuous activities. You may raise your arms above shoulders as needed and perform the arm stretching exercise, doing 1 set every 15 minutes while awake the first night of surgery. Continue performing the arm stretching exercises, at least 5 sets every hour while awake for the next 2-3 days. These stretching exercises are critical for preventing spasms and pain in the chest muscle, similar to stretching the calf when suffering a “Charlie horse” cramp. You must refrain from any vigorous activity for at least the first three weeks. For example, no jogging or running, spinning, or aerobic type exercises. When you do resume this type of activity, you should always wear a sports bra. If you feel up to it, you may do light housework 24 hours after your general anesthesia is administered. You may operate a vehicle a few days after surgery as long as you are not taking any narcotic pain pills. Please be advised that operating a vehicle under the influence of narcotics is illegal.

    POSITION: To help reduce swelling, you should keep yourself propped up on a few pillows while resting. You may sleep in any comfortable position. Beginning the day of surgery lay on your chest every night for 15 minutes until it is no longer uncomfortable to do so.

    POST-OPERATIVE VISITS: 1 to 4 days after the surgery you will come in to the office for a post-operative evaluation. At this time, you will most likely receive a breast stabilizer for the implants, which will be worn 24 hours a day (except for showering) for 14 days. You will receive additional instructions at that time regarding post-operative care. Since all of your sutures are under the skin, no suture removal is required. You may have steri-strips or specialized Hypafix tape on your incisions. This tape should be left in place until 10 days after surgery, at which time you should remove it. Your additional follow-up appointments will be at 6-weeks, 3 months, 6 months, and then every 12 months after your surgery.

    DRESSINGS: The bra and ace wrap serve as the dressing to prevent initial bleeding. Try to keep the ace wrap over the breast like a tube top until the morning after surgery. We want you to wear the bra at all times for one week. After two weeks, you may sleep without the bra, although we recommend that all of our patients with implants sleep in a sports bra every night for the rest of their life to reduce lateral migration of the implants. You should not go braless during the day for two weeks after surgery. Please note that the use of under wire bras is not recommended for at least three months after surgery. During this time, wear only loose fitting sports bras that provide coverage but no support so that the implants can settle properly. It is very important that the sports bra be loose and non restrictive.

    SHOWERING AND BATHING: Most patients can remove the ace wrap in order to shower the morning after surgery. However, the Hypafix tape must be kept in place. No bathing, swimming, or Jacuzzis is allowed for two weeks after surgery and until the incisions fully seal, in order to prevent infection.

    PAIN MEDICATIONS & VITAMINS: You will receive a prescription for narcotic pain medication to be used as needed every 4-6 hours for severe pain as well as a muscle relaxant to help while sleeping overnight when the stretching exercises cannot be performed. If you do not have any allergies, we recommend taking over the counter Aleve the second night after surgery (2 tablets at night and 2 tablets in the morning). We strongly urge you to avoid ibuprofen (Motrin, Advil), especially while taking the Aleve. The Aleve will last 12 hours and will directly treat the muscle soreness and inflammation, which the narcotics will not do. This will help wean you off the narcotics, which tend to cause nausea and constipation, and also impair your ability to drive. In addition to the Aleve, regular strength Tylenol can be used every 4-6 hours as needed for any pain.

    Take vitamin E (400 units) twice a day for 6-8 weeks, starting after 7 days. This will help with the scarring.

    Arnica Montana and Bromelain are natural supplements that have been shown to decrease post-operative bruising and swelling. You may take Bromelain 500mg two weeks prior to and one week after surgery. A 4-day surgical recovery regimen packet of Arnica Montana is available at our office.

    DEODERANT: If you had a transaxillary procedure (through the arm pit,) you should not wear deodorant for 1 week following surgery in order to avoid infection. Use spray perfume instead, which is alcohol based.

    EXPOSURE TO SUNLIGHT: Scars take at least one year to fully heal and fade. During this time, you must protect them from the sun. Even through a bathing suit, sunlight can reach the skin and cause damage. Wear a sunscreen with a sun protection factor (SPF) of at least 15 at all times when in the sunshine. Be extremely careful with areas of your breast that have reduced sensitivity. No tanning nude breasts for 1 year, and no sunbathing or tanning for 2 weeks after surgery in order to prevent severe sun burns resulting from the decreased sensation of the breasts.

    SWELLING: During the first 4 weeks after surgery, your breasts will sit up high and feel hard. The implants will slowly start to settle during this time. In general, swelling lasts for a total of 6 to 8 weeks and the implants will continue to settle into place over the first 3 months. It is for this reason that no under wire bras should be worn for 3 months after surgery.

    LIFTING: No lifting anything over 5 pounds for the first 5 days, over 10 pounds for the first 10 days, and over 15 pounds for the first 15 days.

    EXERCISE: As early as the day of your surgery, you may take gentle walks, go out to dinner, walk around the mall, etc. However, you should not return to any aerobic, running or jumping exercise for 2 weeks. When you do start these activities, you should always wear your sports bra. We recommend that you abstain from any activity that would raise your blood pressure or heart rate for 3 weeks after surgery. (This includes working out, strenuous activities, or lifting more than 15 lbs.) After 2 weeks you can begin walking on a treadmill, but avoid elliptical, stair stepping, or rowing machines until 6 weeks after surgery. Women with implants placed under the muscle should avoid any exercises that engage the chest muscles (such as bench press, push-ups, and pectoral fly exercises) in order to minimize lateral displacement of the implants.

    Beginning the day of surgery, you should lay on your chest every night for 15 minutes until it is no longer uncomfortable to do so. After your first appointment you will receive a breast stabilizer to help the implants settle down, and it must be worn 24 hours a day (except for showering) for 2 weeks. You may also be instructed to perform “nipple placement” exercise by sliding your hand to the bottom of your breast and pulling up the skin. This exercise raises the nipple into correct position as the implant settles downward. Beginning 6 weeks after surgery, breast displacement exercises should be performed 3 times daily by squeezing the bottom of the implant pocket and displacing the implant upwards. Hold for 2 to 3 seconds and repeat 3 times for each breast.

    Specific “As You Heal” Information

    ASYMMETRY: It is quite common for the two breasts to heal differently. One may swell more, feel more uncomfortable, or the shapes may initially look different. After complete healing, they will look similar and natural, but they will never be exactly alike. Patience is required while your breasts fully heal. If you are concerned during the healing process you should speak with your surgeon or the nursing staff.

    HEALING OF SENSORY NERVES: Regeneration of the sensory nerves occurs over 9-12 months after surgery and is accompanied by tingling, burning, or shooting pains. These will disappear with time and are nothing to be alarmed about. To help alleviate this pain, you may exert pressure with the palm of your hand over the area until the pain is gone.

    SENSITIVITY: As the nerves regenerate, the nipples commonly become hypersensitive. This will subside with time. You may find that gentle massaging helps.

    “SLOSHING” SENSATION: You may hear and feel “sloshing” in your breast after surgery. This is not the implant! It is the air that is trapped in the space around the implant and the natural fluid that accumulates after an operation. There is no reason to be concerned with this, as the body will absorb all the air within a few weeks.

    SHINY SKIN The skin of your breasts may become shiny. This is a result of the swelling that occurs after surgery. Within a few weeks, the edema and swelling will subside, and the skin will look more normal.

    Common Breast Augmentation Risks & Complications

    The most common complication resulting from breast augmentation surgery is called capsular contracture. When a breast implant, or any foreign object, is placed under the skin, scar tissue begins to develop around it creating a capsule. In some women, the capsule can tighten and squeeze the breast implant creating a hard shell. If caught in the early stages, capsular contracture can be corrected with a simple non-invasive method of squeezing the breast tissue and with proper medication. If capsular contracture worsens, a surgical procedure is required to remove the encapsulating scar tissue from the breast.

    To help prevent capsular contracture before it happens, the patient is given exercises to perform after her breast augmentation surgery that reduce the risk of capsular contracture. This is why I cannot stress enough the importance of performing the postoperative stretching exercises that you will be given. In the event of capsular contracture, the patient will notice that the breast has hardened and is no longer soft or that one breast is considerably harder than the other.

    Another common complication is deflation or rupturing of the implant. Breast implants deflate when the saline solution leaks either through an unsealed or damaged valve, or through a break in the breast implant shell. The body will safely absorb the saline solution leaked by a deflating or ruptured saline implant. Breast implant deflation can occur immediately or progressively over a period of days and is noticed by loss of size or shape of the breast implant. Ruptureof a silicone implant is more difficult to diagnose, since the implant does not deflate. Special MRI studies are required to identify a ruptured silicone implant, and the FDA recommends an MRI study be performed every 3 years for surveillance after silicone implants. You should also be aware that over time the breast implant might wear out and deflate or rupture. Some implants deflate or rupture in the first few months after being implanted and some breast implants deflate after several years. Deflated and ruptured breast implants require additional surgery to remove and to possibly replace the breast implant. All implants are covered by a manufacturer’s warranty against rupture and deflation.

    The dangers of breast cancer are no greater after breast augmentation surgery, and self-examination of your breast after surgery is still possible and important.

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Recovery after Breast Lift

    For the first 24 to 48 hours after surgery, your stitches will be covered with gauze and a soft wrap with a soft surgical bra will hold the bandages in place. Your breasts may be slightly bruised or swollen, and you may experience some mild discomfort for a couple of days. I will prescribe pain medication strong enough to counteract any pain or discomfort you may feel. If implants are chosen you will be started on the Bandera and nipple redraping exercises, which you will continue for 2 weeks at your first post-operative visit. If drains are placed, they will be removed after 2 to 5 days. You may experience a temporary loss of feeling in your nipples or breasts, which is generally caused by swelling during the initial post-operative period of six to twelve weeks. Normal sensation usually returns after three to six months.

    To ensure proper healing, follow the detailed instructions you will be given at the time of your pre-operative consultation. Most patients may return to normal daily activities within 24 to 48 hours. You may resume non-strenuous work within one week or less following the surgery. You should avoid lifting heavy objects for 3-4 weeks. If implants were used, do not lift anything over 5 pounds for the first five days, anything over 10 pounds for the first 10 days, and anything over 15 pounds for the first 15 days. You may gradually resume strenuous physical exercise after approximately three to four weeks. Women with implants placed under the muscle should avoid any exercises that engage the chest muscles (such as bench press, push-ups, and pectoral fly exercises) for the rest of their lives in order to minimize lateral displacement of the implants over time.

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Recovery after Liposuction

    Your recuperation from Liposuction surgery is relatively easy. Most patients awaken with little or no pain as a result of the tumescent anesthesia and are mobile immediately after liposuction, although an extra day or two of bed rest may be needed when large amounts of fat are removed. Keep in mind that healing is a gradual process. Initially, you may feel somewhat stiff and sore. The day after surgery, you should be up and walking around to promote normal circulation. You should begin normal activity as soon as possible to reduce post-operative complications, but in some cases I may advise to avoid strenuous activity for a few weeks. Light exercise is usually permitted within a few days.

    You should expect some bruising, swelling and pain after your procedure. If you feel like you’ve lost sensations in the areas treated, don’t be alarmed. As your nerves begin to regenerate feeling and sensation should return to normal. Swelling may linger for as long as several months. Pain medication will be prescribed to control any discomfort, however, if you begin to have severe pain, contact us immediately. The swelling tends to resolve most dramatically after the first 4-6 weeks, although the final result and skin tightening after liposuction takes 4-6 months. There will most likely be some bruising after your procedure, and this resolves over the first two weeks. You will wear special elastic compression garments provided to apply pressure, minimize swelling and provide support while healing. These garments also assist in retraction of the skin, and although they may be somewhat hot and uncomfortable, they must be worn continuously for the first 4-6 weeks after surgery, except when showering, in order to maximize your cosmetic outcome. After the first 4-6 weeks, the compression garment can be used for support and comfort as desired, for an additional 3 weeks. You will be sent home in a primary, black colored compression garment that will resist staining from the leaking of the tumescent fluid the first 2-3 days after surgery and which has zippers to make it easier to put on after showering. You will wear this black garment for the first 3-4 days, at which point you will switch to the secondary, skin colored garment once the leaking has stopped and your initial swelling has gone down. This secondary garment has no zippers and is to be worn for the remainder of the 4-6 weeks. The zippers are to be avoided as they can create contour defects along the sides. Compression after liposuction to the arms and chin is different and will be discussed during your consultation.

    You may shower on the second or third day following surgery, but no bathing, swimming, or hot tubs until 4-6 weeks after surgery. Depending on the number of areas treated, you will be ready to return to office work in 3-5 days, and more strenuous activities at 10-14 days. You may increase your activity daily until full activity is resumed at 2-4 weeks. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely; it is easy to get sunburned during recovery because of temporarily diminished sensation.

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Recovery after Tummy Tuck

    You will awaken gently from anesthesia in the recovery room, usually free of nausea or pain. Mild discomfort is usually well controlled with oral pain medication. When you are fully awake, you will be ready to be transfered to your home. You will need a friend or family member to drive you home and stay with you through the first night following your surgery. As part of the “Rapid Recovery Abdominoplasty,” patients are encouraged to get out of bed periodically for short walks in order to promote circulation and to facilitate deep breathing. Although you may not be able to stand up completely straight, it is best that you do not lie in bed or sit for long periods of time during the first several days in order to prevent blood clots in the legs.

    A mild amount of swelling and bruising is normal. You will be sent home with dressings on your incisions, as well as a comfortably fitting compression garment that provides support and helps to minimize swelling. You should wear this garment 24 hours a day for 6 weeks and should remove it only when showering. You will be seen at the practice the morning after surgery to ensure that you are up and walking. I will evaluate you and then you will begin your medication to prevent blood clots.

    You will be restricted to light activities for the first 7 to 10 days after surgery while your body heals. The speed of recovery depends on your physical condition prior to surgery; those with stronger abdominal muscles usually recover faster. Straining, bending, and lifting must be avoided, since these activities might cause increased swelling, bleeding, or disruption of the surgical repair. Allow at least 1 to 2 weeks to recuperate before returning to non-strenuous work; sexual activity should be avoided for at least two weeks. Most patients may resume light to moderate exercise 3 to 4 weeks after surgery. If muscle repair was performed, avoid lifting more than 10 pounds (approximately one gallon of milk) for 6 weeks after surgery. It may take several weeks for all of the swelling to subside to the point that the final results of your improved abdominal contour can be fully appreciated. You may experience prolonged numbness over portions of the abdominal area, which may persist for several months but will ultimately resolve. The incisions may remain red or pink for many months following surgery before they finally begin to fade. I want you to have the best appearing scar possible, and I will give you specific recommendations for scar care after your procedure.

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Recovery after Brazilian Butt Augmentation

    Recovery from a fat transfer into the buttocks depends primarily on the length of time it takes for you to recuperate from the liposuctioned areas. Fortunately, recuperation from Liposuction surgery is relatively easy. Most patients awaken with little or no pain as a result of the tumescent anesthesia and are mobile immediately after liposuction, although an extra day or two of bed rest may be needed when large amounts of fat are removed. Keep in mind that healing is a gradual process. Initially, you may feel somewhat stiff and sore. The day after surgery, you should be up and walking around to promote normal circulation. You should begin normal activity as soon as possible to reduce post-operative complications. Light exercise is usually permitted within a few days.

    You should expect some bruising, swelling, and pain after your procedure. It is also normal if you feel as though you have lost sensation in the areas treated. As your nerves begin to regenerate, feeling and sensation should return to normal. Swelling may linger for as long as several months. Pain medication will be prescribed for any discomfort. However, you should contact us immediately if you begin to have severe pain. The swelling tends to subside most dramatically after the first 4 to 6 weeks, although the final result and skin tightening after liposuction takes 4 to 6 months. There will most likely be some bruising after your procedure, but this tends to go away during the first two weeks. You will wear special elastic compression garments to apply pressure, minimize swelling, and provide support while healing. These garments also assist in the retraction of the skin. These garments can be somewhat hot and uncomfortable, but they must be worn continuously for the first 4 to 6 weeks after surgery, except when showering, in order to maximize your cosmetic outcome. After the first 4 to 6 weeks, the compression garment can be used for support and comfort as desired for an additional 3 weeks.

    You will be sent home in a black colored compression garment that will resist staining from the leaking of the tumescent fluid the first 2 to 3 days after surgery and which has zippers to make it easier to put on after showering. You will wear this black garment for the first 3 to 4 days, after which you will switch to a flesh colored garment once the leaking has stopped and your initial swelling has gone down. This second garment has no zippers and is to be worn for the remaining 4 to 6 weeks. The zippers are to be avoided as they can create contour defects along the sides.

    It is important that you stay off the buttocks as much as possible for the first two weeks because the buttocks is revascularizing the newly implanted fatty tissue. It is best that you sleep on your abdomen or sides and when you sit, sit on the thighs as much as possible to take direct pressure of the buttocks.
    You may shower on the second or third day following surgery, but no bathing, swimming, or hot tubs until 4 to 6 weeks after surgery. Depending on the number of areas treated, you will be ready to return to office work in 3 to 5 days, and more strenuous activities at 10 to 14 days. You may increase your activity daily until full activity is resumed at 2 to 4 weeks. Avoid the sun until all bruising has subsided. A sunscreen should be used routinely. Patients should note that it is easy to get sunburned during recovery because of temporarily diminished sensation.

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Frequently Asked Questions about Recovery after Cosmetic Surgery

    Can I sleep on my side after surgery?
    Yes, patients can position themselves with pillows to take pressure off surgical areas.

    How long do I have to wear the bandera/breast stabilizer?
    2 weeks for most patients. If the breasts have not dropped into the bottom of the pocket, continue to wear the bandera until dropped.

    When can I go swimming or take a bath?
    No submersing in water until drains are out and all incisions are fully closed without scabs.

    When can I work out, ride motorcycles, dance, etc?
    Working out should be avoided for at least 2 weeks, except for moderate walking. A good rule of thumb is “if it hurts, don’t do it.”

    Is this bleeding/leaking normal after liposuction?
    Yes, the drainage should look like red Kool-Aide and last for about 24 hours at most liposuction exit sites, longer from the small of the back and knee areas because of gravity.

    Can I remove the saturated pads from inside the compression garment?
    Yes, if they are in a place you can remove them without removing the garment. The drainage will then run out of the garment unchecked. So if at all possible, leave the pads in until your fist follow-up appointment.

    Can I remove my garment and take a shower?
    Some patients may remove the garment and take a shower 2 days after surgery. It is on an individual basis; they should follow their individual instructions. The first time you remove your garment and take a shower, have someone with you for safety reasons. From a sitting position, unzip the garment and wait 5 minutes. Unhook the hooks and wait 5 minutes, then remove the garment. Finally, wait another 5 minutes before getting into the shower as your blood pressure will drop and you may become dizzy and pass out.

    How long do I have to wear the compression garment?
    For 6 weeks or longer. The head strap is worn for 7-10 days after chin liposuction.

    Is the sloshing noise normal?
    Yes, you are the only one who can hear it.

    Is there anything stronger for pain?
    No. Percocet is the strongest narcotic pain prescription. I may allow some patients to start taking over the counter Aleve as an anti-inflammatory sooner rather than later, which greatly helps minimize the pain and wean off the narcotics.

    When can I drink water and eat?
    Plain water is discouraged for 24 hours following anesthesia and food is encouraged as soon as possible according to patient taste and preference, starting with light foods. Dark colas, non-diet are the preferred beverage the day of surgery as they help the pain medication work better and help prevent and/or treat nausea.

    My drain is falling out.
    The drains are occasionally sutured to the skin, and occasionally the suture comes out and the drain may slip out. Just leave the drain alone. Do not pull or push the drain back in if it is working itself out. We will evaluate in the morning or on Monday if over the weekend and remove the drain if indicated. Usually if the drain has yielded less than 20mL in 8 hours, it is removed.

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