Recovery: What to Expect While Healing after Breast Reduction Surgery

Initial Breast Reduction Surgery Recovery: Anesthesia

After you are awakened and brought into the recovery room following your breast reduction surgery, the recovery nurse will monitor your vital stats until you are ready to be released. This is dependent upon the individual but may take up to two hours or more. You will feel quite tender and possibly confused as the anesthesia wears off. If you feel any discomfort you may want to ask for a pain reliever, which you will more than likely have been asked to bring with you. You may even feel emotional or upset, depending on body's reaction to anesthesia. You may also experience rigors or shivering. This may feel uncontrollable and is usually from the medications, more than likely epinephrine that is used as a vasoconstrictor, and the cold saline, which was introduced into your system over the last few hours.

The fact that the operating room is usually very chilly surely does not help matters. The recovery nurse usually has wrapped you in a warm blanket, but if not, request one. It certainly makes things more tolerable. You may even be lucky enough to have heating lamps!

Some patients feel nothing different than waking up from a good night's rest, although if you have had general you may feel a little sick; hopefully your surgeon gave you something to lessen this. Your prescribed medication should alleviate any pain or discomfort. However, if you believe your pain to be out of the ordinary once you get home, call your surgeon or the on call staff immediately.

Drains

A drain may be inserted to allow the fluids an exit from the incision sites or from the bottom most portion of the treatment area. You will be swollen and bruised and will more than likely be wearing a type of compression garment or surgical bra with elastic bandages binding your breasts to your body. This may cause you some discomfort, but it is very important not to touch or mess with it unless you are instructed to empty the collection grenades.

Your drains will more than likely be removed at your first follow-up appointment, which may be within a few days of surgery. Patients have described this experience as either pain-free and nothing to worry about to odd-feeling. There may be a little irritation around the wound edges.

Incision Care

Please keep your incisions/suture line dry. Your surgeon may have placed Steri-Strips on top of your incision line and sutures, or you may have internal sutures and tissue glue externally to bind your incision edges. Either way your surgeon will give you specific care instructions at your preoperative appointment or send them home with you the day of your surgery. It is best to learn beforehand so that your spouse, friend or caretaker will understand and assist you instead of having to learn the routine at the last minute. Also take care in not getting creams, lotions or topical Arnica into the incision, as these can cause inflammation.

Suture Removal

You will have your incision sites checked and your stitches removed in approximately 10 days. Suture removal may be painful, especially if the wound edges are snipped with the surgical scissors accidentally. It is generally a quick process and nothing to worry about, although know that there may be some discomfort associated with the removal process. It may feel like a tugging sensation or slight stinging.

Breast Reduction After Care

Monitor Your Temperature

While you are healing from breast reduction, take your temperature regularly. An elevated temperature could mean an infection. Take those antibiotics on time and don't forget that some antibiotics can interfere with birth control pills, so use another form of protection as backup.

Soreness & Pain Factor

Pain tolerances depend upon the individual, but you will feel tender, stiff and sore for a few days and will more than likely not want to move too much. This will subside. Be sure to take your required medications and follow the precise instructions provided to you by your surgeon. Common pain medications may be Vicodin, Vicodin ES, Percocet, etc. There is no reason to suffer, so please take your medications regularly instead of waiting to feel pain before taking a pain reliever. The less pain you have, the better your overall experience and the faster your recovery time.

Some patients are given a pain pump. Pain pumps deliver pain medications directly to the area of treatment and effectively relieve discomfort without the common grogginess of oral pain relievers. The use of this machine will generally run you about $150 to $200 more on your total bill. Not all surgeons offer this option, so be sure to ask first.

Swelling (Edema)

As with all surgeries, swelling will be an issue. Swelling is a normal reaction to an injury and is categorized as a natural inflammatory action. Fluids high in white blood cells and hemoglobin will accumulate at the treatment site to treat the injury. Swelling is not necessarily a bad thing, but severe swelling can be a problem.

You may be swollen for up to 3 to 4 months, although this could be very slight and only noticed by you. Your breasts, of course, will be smaller than they were before and higher, so you may not notice swelling too much, perhaps just soreness.

Treatment for prolonged edema include increasing your fluid intake (preferably water), normal to low sodium intake, movement such as light walking and, in some cases, prescription prednisone. Diuretics, including natural diuretics, are not advised and should be avoided unless specifically instructed.

Bruising

Bruises may or may not be present after your surgery. This depends entirely on the patient, the technique and the effectiveness of the epinephrine. One thing is for sure, bruises will usually get better. Perhaps you can ask your surgeon about Arnica Montana or Bromelain or even Vitamin A and C to reduce swelling and discolorations and improve healing. Warm, gentle compresses starting several days post-op can assist in bruise removal by dilating the superficial blood vessels to help the body remove blood and damaged tissue away from the treatment area.

Permanent bruising is a risk but very rare. If this is the case and you have discolorations several months post-op, you may wish to seek Intense Pulsed Light treatments. These treatments target the hemoglobin in the blood, which carries oxygen from the lungs to the tissues of the body. A highly advanced computer regulates the light pulse to a specific wavelength range, which in turn heats the visible, targeted blood vessel(s), damaging or destroying the targeted lesion while sparing the surrounding healthy or normal tissue. The penetration depth and degree of heat is highly controlled so that most complications contributed to these specific factors are not an issue with Pulsed Light Therapy.

Many surgeons offer their patients a prescription of Ativan or Valium to ease pre- and postoperative jitters, sore muscles and help put you to sleep. I personally found Valium very helpful in falling, and staying, asleep. My back was a little sore due to sleeping upright for two weeks, and the Valium eased this as well.

Be sure that you do get some sleep because your body can heal itself better while it is at rest. Besides, sleeping is a good way to past the time during recovery. Just be sure to have someone wake you up to take your meds, eat some healthy meals and drink fluids.

Bathing

You will have to sponge bathe until your incisions are completely closed and your sutures are no longer in. You should wash your hair beforehand and either braid it or keep it back in a ponytail if it is long enough. This will keep your hair clean and out of the way when you are eating and taking medications, or if you get sick. You may not be able to wash your hair for a while since you'll be unable to raise your hands over your head to do so. If you must wash your hair, please get a friend to assist you in the sink or with a hand held showerhead. Or if you wish, have your hairstylist wash your hair for you.

Activity

Even though you may not feel like it, your surgeon will more than likely advise you to walk and move around as soon as you are able. If you do not and lie around you may develop clots and or retain fluid (swelling, edema) a lot longer.

You will be instructed not to exercise or engage in strenuous activities for at least 3 to 4 weeks. Raising your blood pressure can cause bleeding, and you don't want that. Don't lift anything over 5 pounds and try not to raise anything over your head until your surgeon releases you for activity. Take your time in healing so that you give yourself the best healing environment possible.

Please print out our Complication Symptoms and Preparation Info Sheet.

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Breast Reduction Scars and Keloid Prevention

For help with keloid prevention and scar flattening, some surgeons suggest silicone gel sheeting. Some products, such as those from BioDermis, are manufactured into shapes generally used for breast reduction and breast lift.

For further scar fading for scarless breast reduction (lipo-assisted), you may consider using silicone sheeting, which comes in patches or squares so that you can cut to size. Gels like Mederma and Xeragel usually aren't as beneficial to scars that will be rubbed by clothing or other types of friction as they can rub off and offer no pressure, which is beneficial in flattening. However, you can ask your surgeon about using a combination of silicone gel to keep it soft and moisturized and then place a piece of tacky silicone sheeting over it. Again, check with your surgeon beforehand.

Please see our Scar Treatment Section for more information.

Numbness & Loss of Sensitivity

There may be some loss of sensation in the nipple or general breast area. This usually will subside within a few weeks, but be aware that in rare cases loss of sensation may be permanent. You may also experience sharp pains, burning sensations, heat, tingling, prickling, etc. This is from nerve damage and the sensations of the returning function of the nerves will result in the physical descriptions above.

Nipple Over-sensitivity

Many women complain of very erect and sensitive nipples. They feel very sensitive when even your clothing rubs up against them. You may try using those round Band-Aids, corn pads or nursing pads to cover your nipples. These pads will protect your overly-sensitive nipples from the abrasiveness of your clothing as well as shield your erect nipples from the wandering eyes of the public.

What Will My Breasts Look and Feel Like After Breast Reduction Surgery?

Your breasts may be flat, high and strange-looking. They will drop and they will soften up as the swelling subsides and your skin relaxes. The firmness is from the swelling, which is essentially fluid retention in your tissues. This is a natural reaction to a wound of any sort and is your body's way of repairing it self. Cold compresses will significantly lessen the swelling and bruising in the first 48 hours, as will keeping your torso elevated. Switch to warm (not hot) compresses after 48 hours, which will improve circulation. However, always ask you surgeon before doing any of the above.

As far as what they will first look like... Your breasts may be, for lack of a better explanation, odd looking. This is because of the obvious suture lines (if applicable), the volume loss, bruising and swelling. You may think they are still too big, maybe too small, too square, too itchy, too high, too low, too ugly, too sensitive, too this and too that. This will pass. Remember, your final results are a ways off. Don't jump to conclusions just yet. Please be patient.

Visit our Breast Reduction Message Board for support.

What to Look For & Do In the Event of a Complication

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Please contact your surgeon or the on-call physician immediately if you notice any of the following:

• bleeding from your suture lines

• pus or cloudy discharge from your incision areas, nipples or elsewhere

• a foul odor from your incision areas, nipples or elsewhere

• uncontrollable pain

• temperature over 100.5º F

• inability to pass waste (both liquid and solid)

• numbness of the legs (unless you had lipo as well)

• uncontrollable dizziness not related to the pain relievers

• deflation

Please contact your surgeon or the on-call physician and go to the emergency room as soon as possible if you notice any of the following:

• passing blood through urine, feces or spitting up blood

• abrupt and severe swelling and discoloration (aside from normal swelling)

• blackening of the skin (which is clearly NOT a bruise)

• uncontrollable vomiting

• loss of consciousness not related to sedatives

• temperature over 105º F

• convulsions

What to do in case of a complication:

• #1 STAY CALM

• Have your emergency numbers handy and contact, or have your caretaker contact, your surgeon or the on-call physician to let them know of your problem as soon as you can.

• If you are going to the emergency room, don't forget to tell your surgeon which hospital you are going to.

• Bring all of your medications with you to the hospital.

• It may be precautionary to pack an overnight bag ahead of time "just in case".

• If you are able, keep a written journal (and if possible photos) of your symptoms and complaints.

Emergency Numbers:

Surgeon: ____________________________

Emergency On-call Physician: __________

Hospital: ___________________________

Pharmacy: _________________________

Parents: __________________________

Friend: ___________________________

Other: ___________________________