Thursday, October 27, 2011

Exercise after Breast Augmentation

Exercise after Breast Augmentation

There has been several athletic women who undergo breast augmentation, and one of the important questions they typically ask is "when can I go back to the gym and exercise?"  One of the key elements is that one must not exercise immediately after any type of procedure, including breast augmentation.  


To understand why one would be careful when it comes to working out a few weeks after surgery, one should understand how the body would heal after surgery.


Photograph Courtesy of breastexercises.com




Fast Facts about Wound Healing & Breast Augmentation
  • Maximum tensile strength of a wound is achieved after approximately 3 months.
  • Around 3 months, the strength of the wound is approximately 90-95% of the original strength of the wound.
Pectoralis Muscle (Chest wall muscle) Strength after a Breast Implant
    • For implants placed underneath the muscle, especially total submuscular placement such as found in breast reconstruction for breast cancer patients, it was found that there was a decrease in torque strength of the pectoralis muscle by 20.1% after surgery.



Exercise Recommendations

3rd Week
  • Stationary bike is appropriate, except for the Spinning Stationary bike.
  • Minimize any activities that would involve bouncing. 
4th Week
  • Stair stepper would be appropriate since there's minimal "bouncing" involved.
  • I don't recommend an elliptical machine at this time since some athletic women could be aggressive with this exercise.
  • One can start leg, thigh and buttock exercises.
  • For the first 8 weeks, no upper body weight lifting at all.  I recommend to only work out the lower extremity.
  • Working out should be every other day if you're an avid athlete to avoid injury and fatigue.
6th Week
  • The tensile strength of the wound is approximately 60%. 
    8th Week
    • At this time, the tensile strength of the wound from surgery would be approximately 70 to 80%.
    • I would continue using the stair stepper and still avoid running aggressively that would involve a lot of bouncing.  
    • The elliptical machine can be started as long as there's minimal "bouncing" action.  I would stress a forward gliding motion on the elliptical instead of vertical bouncing (more resistance can aid with this).   If one start having pain over the chest, I recommend to stop doing this particular exercise. 
    • After eight weeks you can start biceps and triceps exercises with light weights and low repetitions (slowly incorporating these into the workout so as to not injure the weak and healing area.)
    12th Week
    • The tensile strength of the wound is approximately 90-95% at this time.
    • You can slowly start running on the threadmill.
    • At 12 weeks you can start a regular workout routine, BUT TAKE IT SLOW.   We recommend 35-50% of the weight and reps you were using for upper extremity prior to surgery.
    •  


      Signs that You Have Workout Too Much
      • According to some of my athletic patients who have worked out beyond their limits after surgery, one of the signs that you have "worked out too much" is the "feeling of soreness & hardness above the incision." 
      • Pain or soreness over the breast/chest area
      • Worst scenario:  wound breakdown and implant extrusion.
      Potential Consequences if One Works Out Beyond Their Limits after a Breast Augmentation
      • Bottoming out and sagging of the augmented breast.
      • Early wound complications, such as wound breakdown (can occur during the first several days after surgery.)
      • Implant extrusion (implant exposure) which is a surgical indication to remove the implant and replace it with a new one.
      • Re-do surgery may need to be done.  Without a cosmetic insurance, this can be very costly!
      Resuming exercise after breast augmentation can be particularly challenging.  One should ask your plastic surgeon for any advice regarding their exercise protocol after a breast enhancement procedure.  If one experiences pain after a particular exercise activity, I recommend to stop performing that certain activity and resume 1-2 weeks later. 

      Emmanuel De La Cruz MD, PLLC
      Houston Breast Augmentation

      Brooke Dickinson, DC
      Former College Football Exercise Trainer


      References:
      Anglin C, Wyss UP. Arm motion and load analysis of sit-to-stand, stand-to-sit, cane walking and lifting. Clin Biomech (Bristol, Avon). 2000 Jul;15(6):441-8.
      de Haan A, Toor A, Hage JJ, et al. Function of the pectoralis major muscle after combined skin-sparing mastectomy and immediate reconstruction by subpectoral implantation of a prosthesis. Ann Plast Surg. 2007 Dec;59(6):605-10.


      Monaco JL, Lawrence WT. Acute wound healing: an overview. Clin Plast Surg. 2003;30:1-12.

      Wednesday, October 19, 2011

      Saturday, October 15, 2011

      Mesotherapy and Liposuction

      Mesotherapy versus Liposuction

      What is Mesotherapy?
      • Mesotherapy involves the injection of medications into the skin and is used as an alternative to liposuction.
      • Currently, mesotherapy is NOT an effective alternative to liposuction when it comes to reduction of fat in the body.
      • Mesotherapy is NOT approved by the US Food & Drug Administration (FDA)
      • In mesotherapy, a variety of medications are injected into the skin mesoderm, which is the layer of fat and connective tissue underneath the skin.
      • The most common medications injected utilized for lipolysis are phosphatidylcholine and isoproterenol.
      • Currently, there are no clinical reports demonstrating the effectiveness of mesotherapy in body contouring.
      Emmanuel De La Cruz MD, PLLC

      References:
      Park et al.  Effectiveness of mesotherapy on body contouring. Plastic Reconstructive Surgery. 2008 April; 121(4):179e-185 e
      US Food & Drug Administration (FDA)
      Before and after liposuction

      Wednesday, October 5, 2011

      Pippa Butt Lift

      Pippa Butt Lift


      Emmanuel De La Cruz MD, PLLC
      Houston Brazilian Butt Lift

      Silicone Gel Breast Implant or Saline Breast Implant?