For the past few years, I have been using a rapid recovery program, or "24 hour Recovery Program", for breast augmentation. This program has stimulated a great deal of interest because patients looking for breast augmentation are in a very active stage of their lives and no one wants the down time anymore. But the most common question is: How is it possible?
The answer is that Yes, it is possible, and it's really just a situation in which a lot of small changes can add up to one big change. The big change is the recovery time, and it is based on a time-motion study of breast augmentation by a plastic surgery group in Texas. Since that study, plastic surgeons have added their own modifications, and I have personalized my approach as well, although the principles remain the same.
The main sources of pain after breast augmentation are trauma to the ribs and muscles, bleeding, and external pressure. In my current protocol, I use muscle relaxants during surgery to reduce the strain on the chest muscles and I protect the ribs from any trauma. I also take extra time to minimize bleeding and I have eliminated restrictive bandages in favor of a comfortable bra to avoid pressure on the breast implant. By introducing these changes, all of the main sources of pain have all been addressed.
After surgery, this attention to detail is continued. Much of the post-operative pain is inflammatory, and so anti-inflammatory medications (ibuprofen) are used as the first line of pain control, ahead of narcotics. The other source of post-operative pain is muscle spasm, and so muscle relaxants (I think Valium is the best) are continued.
This approach has eliminated the need for narcotics in over 90% of patients. No narcotics means no drowsy, "doped-up" feeling and no nausea, which are the two most common side effects. In other words, you get to feel like yourself again very quickly. The only restrictions are no heavy lifting or strenuous exercise for two weeks. Other than that you can do anything you feel up to. This includes going out to dinner or shopping the night after you surgery. The same guidelines are used for silicone gel breast implants and saline breast implants.
Does everyone get back to work and play in 24 hours? Not everyone, but the majority of patients do, and the rest just take another day or two. Once in a while someone might take a little longer to bounce back, but that has been the exception, not the rule. No one approach works for everyone, but my "24 Hour Recovery Program" has reduced the average recovery time after breast augmentation in my practice from 7-10 days to 24-48 hours. Now that's progress.