Breast augmentation is one of the most common cosmetic surgeries performed in the United States every year. Women typically desire this procedure to improve their breast size and shape. 

What is breast augmentation?

There is a lot to understand about the type of breast implants (silicone or saline), where they are placed (above or under the muscle), placement of scars.

Additionally, a breast augmentation can be combined with a breast lift or mastopexy. This surgery changes the shape of your breasts, but it doesn’t alter the size.

How to find a surgeon

The most important part of considering breast augmentation is choosing the right surgeon. Make sure you see a board-certified plastic surgeon. 

Ask questions about your procedure and make sure you feel comfortable with your surgeon of choice 

Surgeons website to find a board-certified plastic surgeon near you.

And while preoperative planning is important to optimize your surgery, recovery is just as essential to ensure an excellent outcome. 

How long is a full recovery?

In general, full recovery from a breast augmentation can take on average 6 weeks. Each person is different, so for specifics make sure you talk to your board-certified plastic surgeon. 

Let’s break down the recovery into a few stages so you can better understand how to prepare.

Acute Recovery:

This period is usually immediately post-operation. 

Your breast will be wrapped and you will be transported to the recovery room, where you will likely feel groggy and sore. 

At this point, your surgeon may elect to give you a local numbing pain block to improve any discomfort you are experiencing and reduce narcotic use. This typically lasts around 12 hours. 

Because you have just woken up from anesthesia, you will need someone to drive you home and stay with you overnight.

The first 3 to 5 days

The first few days after surgery are the most uncomfortable.  

Your surgeon will recommend instructions on how often to take antibiotics and muscle relaxants or pain medications for the first few days after your procedure.

Ideally, any strong narcotic medications should be discontinued within the first few days since they cause constipation and prolonged use can lead to a longer recovery.  

While some patients report pain, most patients experience tightness or muscle aching at this time. 

This can be in the breasts, shoulders, neck, and back. These symptoms are best controlled with a muscle relaxant such as Valium. For most women, this sensation resolves over the next 3 to 5 days.

You will also have instructions on how to care for your incision and what bra or garments to wear.

Bruising, swelling, and minor bleeding from the site is all normal. If something does not feel right, call your doctor.

1 week

By this time, you should have minimal discomfort that can be managed with over-the-counter medications.  

You should be seen by your surgeon within this time frame, and most women are able to resume light daily activities. Women who work at desk jobs are usually fine to return to work and drive. Many physicians encourage a few short walks 1-2 times a day. 

Next few weeks

During this time, you will start to feel like yourself again and get back into your routine. 

It’s important to note that your wound heals approximately 10% per week and so most doctors do not recommend resuming an exercise routine, especially upper extremity focused workouts, until about 4-6 weeks after surgery. 

Additionally, patients with labor-intensive jobs may have to wait 3-4 weeks after their procedure before returning.

If you have a physically demanding job, you’ll need to be out of work for 3 weeks or more. You’ll also need to avoid heavy lifting and intense physical activities, like running.

2 months

After about 2 months, your physician should assess your healing and clear you for all normal activities. 

It's vital to follow your doctor's care instructions closely so that your breast implants heal properly and there are no complications.

Possible complications  

Breast augmentation is a surgical procedure, and every procedure has potential risks. Complications can include

• Unsightly scars

• infections

• bleeding problems, like blood loss. 

• Asymmetries between your breasts

• Implant malposition

• Breast and nipple pain or numbness

• Poor cosmetic result 

• breast cellulitis

• breasts appear to merge (symmastia)

• skin dimpling or visibility of the implant 

• scarring around the implant 

• implant leak or break

• breastfeeding problems

• breast implant-associated anaplastic large cell lymphoma  

• breast implant illness 

Tips for recovery

There are things you can do in order to avoid complications and enhance your recovery experience. 

Make sure you discuss all concerns with your physician before the surgery. 

Follow instructions regarding medication frequency and duration, wear your surgical garments as instructed, and avoid activities that your physician discourages. 

Ask friends and family to help. Prepare healthy meals ahead of time and take the rest you need to heal well. 

It’s 2020, and lip augmentation is now all the rage. Luckily, many women are doing their research and asking important questions before undergoing treatment. 

Unlike getting your hair highlighted or a massage, lip augmentation is a medical procedure and can have long-lasting issues if done incorrectly. The goal of course, is a natural result that highlights your beauty.

What happens to our lips as we age:

Time and gravity take their toll on all parts of our bodies. For our lips, we naturally lose collagen and dermal elasticity. 

As a result, our lips thin, shorten, and fold into our mouths. Our cupids bow is no longer as prominent and we lose the appearance of a full lip.

The goal of a lip filler or surgical procedure is to reshape the lips and replace lost collagen and hyaluronic acid. 

How can I rejuvenate my lips?

There are different ways to augment lips. Dermal fillers are currently the most popular way, as the procedure is minimally invasive with little discomfort and downtime. These hyaluronic acid fillers are temporary and resorbed by your body over time.

For women who want a more permanent look, fat may be suctioned from an area of the body and injected into the lips in a small surgical procedure.

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And to reshape your lips, a lip lift or bullhorn lift is a great surgical option.

Tell me more about lip fillers:

Lip fillers are currently the most popular way to increase lip size. 

There are a variety of different filler products on the market that are used to augment the lips. 

You may have heard of Juvederm or Restalyne, and within these brands, there are different products that range in their consistency (think honey vs. whip cream) depending on your anatomy and desired result. 

Ask your physician about her philosophy on choosing a specific filler for you and what the alternatives are in order to make an informed decision. 

How can I prepare for my appointment?

I often recommend bringing a few photos of lips to understand the look you want, and to discuss whether the desired outcome is feasible given your individual anatomy. Just like any other part of the body, everyone’s lips are slightly different.

Additionally, discuss with your doctor how much volume you desire. I prefer filling lips to give a natural, subtle enhancement and often recommend underfilling as opposed to overfilling on a first visit. Ask questions about the type of filler, amount of filler to be injected initially, and its side effects in order to make an informed decision.

It’s important to avoid blood thinners such as aspirin, Motrin, Aleve, and alcohol, herbal supplements or multivitamins several days before and after the procedure to reduce bruising

How long does lip filler last?

Your body absorbs the filler over time. Fillers last approximately 6-12 months. 

Is the injection painful?

Filler injections may be mildly uncomfortable, and for patients who are apprehensive, we recommend coming a few minutes early to have some local numbing cream applied to the area. 

The injectable also has a local numbing agent that is introduced along with the filler, so patients are comfortable post-procedure. 

Can fillers be removed?

Most likely. Ask your physician what they are injecting and if it is dissolvable or permanent. Most on-label lip fillers are dissolvable and can be removed by injecting an enzyme called hyaluronidase to break up the particles and cause the filler to break down. This can be performed in the office.  

What should I expect in terms of aftercare?

Expect a moderate amount of swelling 1-3 days after the procedure that may initially distort the shape of your lips. Monitor your progress, and I recommend you follow up with your physician within 2 weeks to address any ongoing issues. 

By 2 weeks. The lips usually have had enough time to adjust to their increased volume and you can visualize a final result.

Are there risks?

Although fillers are a straightforward procedure when performed by an experienced board-certified physician, minimal side effects such as swelling and bruising have the potential to occur. 

Additionally, this potentially invasive procedure can rarely cause vascular occlusion and result in a wound on your lip (tissue necrosis) requiring wound care and lip reconstruction. 

How do I find the right physician?

You should only see a board-certified professional, such as a plastic surgeon or dermatologist who is highly experienced in this specific procedure. 

Ask to see before and after pictures and ask questions to make sure you are comfortable with the procedure and its effects. 

Recovery is different for everyone

You’ve met your board-certified plastic surgeon. You’ve selected your date for your surgery and have all your preparations in order. But what about recovery time?

A tummy tuck, or abdominoplasty, is a very common plastic surgery procedure. However, your length of recuperation and the overall postoperative course will depend on several factors including your overall health and compliance with your physicians’ instructions. Understanding this recovery process and timeline will make your surgical transformation much easier.

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Let's talk timeline

It’s natural to want to bounce back to normal after your surgery, but it’s important that you give your body time to heal. 

Instead of rushing to get back to your baseline level of activity, spend some time organizing your recovery so you have ample time to heal and can take a break to avoid stressing your body. Talk to family and friends to make the proper arrangements and be fully prepared for your recovery period.

Patients in my practice are encouraged to spend a night in the hospital to monitor fluid intake and output, drain output, and overall pain control. 

Most men and women are back to light daily activities by 5-7 days. Most can return to work at about 2 weeks. No heavy lifting or gym until 4-6 weeks. Full strength activities can usually be resumed by 6 weeks. 

What should I expect immediately after surgery?

• how to care for incisions and drain tubes

• what to be aware of in terms of infection or overall health

• what to avoid in terms of physical activity that affects your incision line for six weeks

• when you need to see your plastic surgeon again

• how long to wear the abdominal pressure garment

• how much to rest

• what you can eat

The day after surgery you will be placed in a surgical compression garment which you will wear for an additional 6-12 weeks. This helps to avoid fluid buildup and helps to support your abdomen.

After staying in the hospital overnight, you’ll need a family or friend who can drive you home from the hospital and help take care of you for at least the first few days after your surgery. 

You should avoid alcohol, tobacco, and marijuana / CBD / vape products as they can hinder the healing process and result in open wounds.

Drains are usually left in place for upwards of a week after surgery. You’ll be shown how to take care of and empty the drains. You’ll also need to take an antibiotic and an anticoagulant to prevent blood clots while your drains are in place.

It is important to have documentation on your recovery process. Ask your surgeon for specific instructions that should include:

• Caring for your drains

• Specific concerns to be aware of 

• Medication dosage and administration

• Activity limitations

Additionally, ask your surgeon specific questions about your individual recovery period and how long until you can resume normal daily activities. 

Possible physical side effects

Most patients say the first 1-3 days after the procedure are the most difficult in terms of managing pain and mobilizing around the home. 

A small amount of swelling is normal and the use of the compression garment can help improve that.  

Numbness around your abdomen is normal and may take months or years to improve. 

Bruising around the area is also normal. 

Scars will be red and raised several weeks after surgery but will eventually settle with time and scar massage. 

Is there anything I can do to optimize my recovery?

Remaining healthy before, during, and after the surgical period is very important in overall recovery.

Eating fruits, vegetables, and other items high in protein will provide the body the nutrition it needs to heal. Avoid alcohol, tobacco and marijuana / CBD / Vape products. 

Drink plenty of fluids and take a stool softener as needed, especially if prescribed narcotics (even if only short-term). 

A raised toilet seat and removable shower head are helpful bathroom additions. 

In terms of sleeping, some patients prefer a recliner for comfort for the first few nights.

You’ll want to drink plenty of water to flush your body of toxins and reduce swelling. Keep your diet as healthy as possible. Include as many fresh fruits and vegetables as possible.

A final message:

Congratulations! You’ve made a decision that will most certainly be life-changing. Recovery may feel daunting but for most patients, it is easily manageable as long as you plan and comply with your doctor’s instructions. 

While it initially feels slow, focus on your recovery day-by-day and before you know it you will be back to your new, improved baseline. 

Be sure to connect your surgical team for clarification or if you have any questions or concerns. Ask about how to clean your belly button as well as pearls for showering with and without drains and how to care for your incision site.

And lastly, for best results, see a plastic surgeon who is board certified by the American Society of Plastic Surgeons. 

One of the most common topics of conversation regarding breast implants is their shelf life, or “how long they last.” 

For women considering a removal and possible implant replacement, there are several important things to understand in order to make an informed decision.

What is the average duration of implants?

Breast implants are one of the most studied medical devices in history. Over the past fifty years, there have been concerns about implant safety and so much so that they have been taken on and off the market in order to conduct thorough medical research. 

The first medical-grade silicone gel implants consisted of a thin shell and gooey gel, and patients were concerned that high rates of rupture and leaking implant material were leading to silicone infiltrating the bloodstream and lymph nodes and contributing to connective tissue diseases and autoimmune conditions. 

 So, in 1992, the Food and Drug Administration (FDA) pulled silicone gel implants off the market, amid a sea of concerns about their safety. 

After 14 years of research in cooperation with the American Society of Plastic Surgeons, silicone implants were reintroduced to the market in 2006 and the FDA issued a warning that breast implants are not life-long devices and may require removal and replacement. Additionally, In the case of silicone implants, the FDA recommends having an MRI every three years or so, but not many women do that because it is often an out-of-pocket expense and not covered by your insurance.

However, there is no allotted amount of time (i.e. 20 years) that we as plastic surgeons recommend removal and replacement of implants. Rather, we recommend proper self-breast exams and consultation with your physician should you feel a change in your breasts.  On average, most breast implants last anywhere from 10 – 20 years. 

How do I know if my implants need to be removed or replaced?

The following issues may necessitate evaluation and possible breast implant removal.

Hardening (Capsular Contracture):

Some women may experience tightness and hardening of the scar, or breast capsule, around their implant. This may cause the breast to migrate up and toward the armpit and be uncomfortable.  

Capsular contracture can occur almost immediately after surgery, or it can develop years and years later. The condition can occur on just one or on both breasts.

Implant Rupture: 

In women with saline implants, an implant leak would result in the deflation of the implant as the body absorbs the saline, or saltwater, in approximately 24-48hours after deflation. The breast will look dramatically different. 

Women with silicone gel implant rupture may not recognize a change in their breasts. The silicone gel in implants today is much thicker than it had previously been and has a consistency similar to taffy or a gummy bear. These cohesive gels make it difficult to detect a rupture because they tend to stay in place within the breast capsule. Additionally, most women do not experience symptoms with a silent rupture. 

However, symptoms that you may have a leak include: 

• change in breast size and/or shape

• pain or tenderness

• swelling

• changes in the sensation of the breast. 

Change in Position:

The effects of time and gravity, as well as fluctuations in weight, may cause stretching and sagging of the breasts. 

If you’re bothered by these changes, getting a revision with a mastopexy (breast lift) or breast augmentation replacement may help return your breasts to their previous appearance.

Rippling or Palpability:

Rippling occurs when the implant develops wrinkles or ripples. This is more common with saline implants and may worsen with time.

Palpability refers to the ability to feel the ripples when you touch your breast. 

If you see or feel wrinkling in your implant, you may want to consider replacing or removing it.

What about Breast Implant Illness? Breast-Implant Associated Anaplastic Large Cell Lymphoma (BIA-ALCL)? Can implants make you ill?

Breast Implant Illness (BII) is a combination of various systemic symptoms that women have been reporting and believe to be related to their breast implants. 

To date, these symptoms have been reported in women with saline, silicone, smooth and textured implants. 

I have recently written an article all about BIA-ALCL and encourage you to learn more.

Deciding to remove your implants:

If you are experiencing changes in your breasts or simply desire to have your implants removed, make sure to see a board-certified plastic surgeon in consultation to discuss your surgical options.

It is important to talk to your doctor about what your breast may look like after implant removal. Some women may experience deflation, sagging, or asymmetries of their breast

Because of this, your doctor may recommend a breast revision by replacing your implants with a different type of implant, different size or shape, or in combination with a breast lift. 

Additionally, the scar tissue, or breast capsule, may be removed in addition to the removal of your breast implants.

What are the surgery and recovery like?

Most patients have this surgery performed and go home the same day. Recovery time will be dependent on the extent of surgery that is being performed. 

Most women are back to light activities 3-5 days after surgery and the gym at about 1 month. 

The Bottom Line

Implants are some of the most studied medical devices on the market. At this time, research has continued to argue for their safety. 

However, implants are not life-long devices and you may need to have them removed or replaced for a variety of reasons.

The best way to ensure the best cosmetic outcome is to consult with a board-certified plastic surgeon and follow all postoperative instructions.