Breast Reduction Recovery: What to Expect Week by Week

Introduction

Breast reduction is a plastic surgery procedure that is consistently reported by patients to be something that they are extremely glad to have undergone. This is because it addresses the functional problems that their large and heavy breasts were causing, as well as the aesthetic and psychological issues. The breast reduction recovery process is as important as the surgery itself and this blog will explain what to expect should you be planning breast reduction surgery (reduction mammaplasty).

Marc Pacifico MD FRCS(Plast) is an internationally renowned plastic surgeon with a vast experience in breast reduction surgery. His approach is both personal and bespoke, and he is not only meticulous in undertaking the surgery, but the aftercare he and his team provides is second to none.

What to Expect Immediately After Breast Reduction Surgery

A breast reduction operation is performed under a general anaesthetic, with you asleep, normally as a day case procedure (meaning you will go home on the same day as your surgery). Marc Pacifico normally undertakes breast reduction surgery at Purity Bridge in Tunbridge Wells in the bespoke operating room that is designed for exactly this type of procedure.

Waking up from anaesthesia, you will have tapes over the incisions (scars) and you will already be in your post-surgery bra. You will not be in large bandages, and you will be able to see most of your breasts, including your nipples.

There will be no surgical drainage tubes as Marc does not use these, and therefore no concerns about the discomfort these can cause, or the worry about having to have them removed.

There will be some discomfort afterwards, although this will be kept to a minimum with a combination of pain killers and local anaesthetic injections that are put in at the end of the surgery. Swelling will increase over the first few days after surgery before gradually dissipating. Feelings of tightness are common, but most patients do not describe breast reduction surgery as painful.

Week-by-Week Recovery Timeline

Week 1: Rest & Initial Healing

You will go home on the day of surgery, and we normally suggest sleeping slightly propped up on pillows to allow the swelling to settle. Sometimes the swelling actually accumulates below the breast before disappearing. Gentle arm movements are encouraged, and the first day after a breast reduction is when we recommend you gently wash your hair. This both makes you feel much fresher and ensures you move your shoulders. You should take regular painkillers for the first few days after surgery, but most patients are onto paracetamol only after a few days.

You will have a check-up appointment at Purity Bridge with the nurses who will review your breasts, your nipples and want to understand how you are doing. 

Week 2–3: Resuming Light Activity

You will have a further appointment with the nurses at Purity Bridge at 2-weeks – this is an important appointment as the surgical tapes will be removed and any exposed stitch knots will be trimmed. Surgical tapes will be reapplied to offer further scar support, which is very beneficial early after surgery. You should be able to drive two weeks after surgery and return to desk work. Manual jobs will need to be postponed for longer to allow the wounds to heal further. 

Week 4–6: Back to Normal Activities

At around 4-weeks you will have a check-up appointment with Mr Pacifico. At this appointment the scar tapes would normally be removed and he will discuss on-going scar care. This is normally in the form of a combination of wearing silicone tape and performing scar massage. A good routine that we recommend is to massage the scars using a cream or oil, such as vitamin E cream, in the morning. After massage, have a shower, which ensures the cream or oil has been removed from the skin. The silicone tape can then be applied. The silicone tape can last for some time, so instead of throwing it away after removing it, hang it off the edge of a shelf and re-apply it after your shower. You can continue to do this until it loses its stickiness. Another tip, is that the tape from the roll is quite wide, and wiser than is needed. It is possible to cut the tape lengthways in half, and this means a roll of tape will go further.

At 4-weeks you can start gentle exercise, such as gentle sessions on an exercise bike, with a view to gradually building up over the next few weeks.

Week 6+: Long-Term Healing

By 6-weeks, the biology of wound healing means that your scars will be very robust and you can increase your exercise, and start to lift heavier weights. The shape of your breasts will have changed over the last 6-weeks, and in actual fact, will continue to evolve over the next 6-12 months. What tends to happen is that the nipple position remains in place, but the rest of the breast “bottoms out”, meaning that the breast expands in the lower pole, so if the nipples looked a little low straight after surgery, they will look in a better position over time.

Tips to Support Your Recovery

As part of your pre-operative journey, we will supply you with a supportive surgical bra. This should be worn for 6-weeks after surgery (day and night) and we would in fact recommend that you continue wearing it at night after that (or at least something similar). Initially, sleeping on your back ensures that there is no pressure on your healing breasts, however, during the recovery process (normally by week 4) you can start to sleep on your side.

As mentioned earlier, try to avoid heavy lifting for 6-weeks. Even though you may be pain-free and feel back to normal much sooner, the biology of wound healing cannot be rushed, and should be allowed the time needed. This is a concept often referred to as conscious recovery – reminding yourself to take it easy, even when you feel well enough to do more.

It goes without saying that you ought to keep well hydrated during the recovery process, and eat a balanced healthy diet. We recommend Skinade as a nutritional supplement that can really improve wound healing and recovery.

Signs to Watch For & When to Contact Your Surgeon

Active monitoring of your breasts after surgery is crucial. This is particularly in relation to the blood supply to the nipples. The nipples should be warm and have capillary refill after surgery – this means that when you press on the nipple, the colour will fade, and on release of your finger, the colour will return as blood re-enters the skin of the areola. Nipple and areola colour varies between different people, and of course, between ethnicities, but the same principles apply.

Any marked increase in swelling, particularly if it is on one side is something that would mean we need to rule out any bleeding in the breast. If there is an increase in pain and redness, particularly if this coincides with you feeling poorly might suggest an infection is starting.

We pride ourselves on our excellent aftercare, and would want to be contacted by you at the earliest opportunity should you have any concerns. You will have an emergency out of hours number to call, so you should never feel help is not close by. We would far rather be able to reassure someone that all is ok if they called, than the reverse – discover that someone did not want to bother us and left a concern too long.

How Long Does Full Recovery Take?

Full recovery after breast reduction takes around 3-months – however, it takes 1-2 years for the scars to fade to their full extent. Scar care is therefore important in the medium-term to ensure you develop the best scars possible. 

Sexual intercourse should be avoided for 3-4 weeks after surgery, and even then, should be started cautiously. No handling of the breasts by a partner should occur until at least 6-weeks after surgery. Remember that after any surgery the sensation will be different, and if your breasts are numb, you will not feel if they are being squeezed or held too firmly. 

Listen to your body – when you start exercise and sexual intercourse, if anything hurts, aches, or does not feel right, stop doing that activity and allow some further recovery before trying again.

Mr Pacifico normally suggests not travelling for 4-weeks after surgery – this is principally so that if a patient has a concern, it is easy for them to get to Purity Bridge to be reviewed speedily. That said, we would normally advise a minimum of two weeks before travel after surgery (and in particular long haul travel due to the risk of blood clots, DVTs).

Dr. Pacifico’s Recovery Philosophy

Many patients come to see Dr Pacifico based on his reputation – whether through direct word of mouth, or from the multitude of positive on-line reviews his patients have written about him. One theme that you will see repeated over and over again is his high levels of personal care, the aftercare he and his team provide and his emphasis on patient safety as well as surgical results.

Dr Pacifico’s philosophy is very much a holistic approach. He appreciates that whilst a patient might see him regarding concerns with her breasts, the bigger picture is also that these concerns intrude on her life in different ways. To be able to give someone the freedom to be rid of these concerns, to improve their self-esteem and body confidence is one of the most rewarding aspects of his approach. 

Getting the best aesthetic outcome within the margins of safety is at the core of all he does. He will not compromise on safety, and his outcome aims to provide a natural appearing result. What does he mean by natural? Something that could have conceivably been produced by nature, without a surgeon’s hand; something that is aesthetically pleasing without the stigmata of being operated on, and a result that is proportionate to the individual.

FAQs

• How painful is breast reduction recovery?

Breast reduction surgery tends to be described as uncomfortable and achy, rather than painful. Sometimes if a lot of internal shaping stitches have been required, it can be sore along the breast crease in particular, but this usually settles down 24-48 hours after surgery.

• When can I sleep on my side after breast reduction surgery?

Sleeping on your side can normally be done at around 4-weeks after surgery – ensuring that you wear your surgical bra in bed.

• Can I shower after breast reduction surgery?

The tapes that we apply are shower proof, but not bath proof. Therefore we encourage our patients to shower the day after surgery. Our advice is to have your back to the shower so the shower hose does not spray water directly on the tapes, and to ensure the tapes are bone dry after showering, often using a hair dryer on a cold setting.

• When can I wear underwire bras again?

Underwired bras can normally be worn 6-weeks after surgery – the advice might change depending on your individual circumstance.

Conclusion

Breast reduction surgery is incredibly rewarding surgery – it can truly be life changing. The improvement in back pain, shoulder pain, neck pain, bra strap grooving and soreness under the breasts can be addressed in addition to the aesthetic and psychological benefits. Interestingly, the comments most women get after a breast reduction is people asking if they have lost weight – this is because their proportions have changed, and others really seldom notice it is their breasts that have changed. 

With the right guidance, for the right person, breast reduction surgery is normally a smooth process and patients enjoy a successful journey.

If you think breast reduction surgery might be right for you, please get in contact with Marc Pacifico’s team at Purity Bridge on 01892 536 960, or email info@pacifico.co.uk