Swelling after Breast Augmentation Surgery

As with every surgery, swelling should be expected after a breast augmentation procedure as well. However, patients can reduce the amount of swelling after the surgery if they follow the doctor’s instructions on the list of medications that should be avoided before the surgery. Doctors recommend this because certain medications can increase bleeding after surgery, which contributes to bruising and swelling.  You are strongly advised to take this list of medications very seriously.  It includes many over-the counter vitamins and herbal products that most people believe are harmless and have no idea that they can affect surgery. If one or more of these medications have been prescribed for your health by your primary care physician (pcp), you need to inform your plastic surgeon of this so the two physicians can discuss possible temporary discontinuation of the drugs around the time of surgery.

Swelling from surgery occurs because of the trauma of the procedure to the tissues in addition to some blood which will naturally accumulate after surgery.  Blood accumulation in the tissues results in more swelling than just tissue injury from the surgery itself.

Swelling Prevention

Once fluid has accumulated after surgery, there is not much that can be done to eliminate it faster than what the body normally would get rid of it.  Therefore, it is better to try and reduce it by utilizing preventative measures.  In addition to avoiding the above mentioned list of medications, sitting upright in a reclining chair position rather than laying flat for the first few days after can help reduce swelling.  Many patients also find that using ice packs on the upper aspect of the breasts can not only keep swelling down, but can also help to relieve pain after surgery.

Most of this ‘swelling’ is, in reality, a displacement of the gel or saline fluid in the implant to the upper pole of the breast due to the tightness of the lower chest muscle. As this muscle stretches and relaxes in the weeks to months after surgery, the breast implant material flows more to the bottom of the breast, where it is supposed to be. Hence, a majority of the ‘swelling’ is more of a perception than a reality.

Volume Changes

In the first few weeks after surgery, the volume of the breast consists of the natural breast tissue, the implant and excess fluid which exists as a result of the trauma of surgery.  Not only does the fluid gradually go away, but also the pressure from the implant results in a change of the volume of natural breast tissue.  The fatty tissue in the breast does not tolerate pressure very well.  As a result, this tissue becomes somewhat compressed resulting is some loss of overall breast volume.  Most patients mistake this slight decrease in size as swelling going away when, if fact, it is tissue compression.  This goes away when implants are removed, however it takes several weeks for the tissue to re-expand.  It remains as long as the implants are in place and the degree of compression cannot be determined before surgery; every patient is different.

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