After I finish my pre operative consent discussion, the most common additional question I get is on return to activity and exercise. As an accidental long distance runner myself, I understand how addictive exercise can be. It is very important to walk as frequently as possible after an operation to minimize chances of venous thromboembolism and pneumonia. On the other hand, too much early post operative activity- work, exercise, or travel- may put you at higher risk for complications such as bleeding, wound breakdown, seroma, and infection.
Resuming full activities of daily living at 2 weeks, aerobic exercise at 4 weeks, and heavy lifting at 6 weeks is usually safe. Patients with specific breast implant positioning issues or those with post operative healing problems may have further restrictions.
One advice conflict I see at times is post mastectomy exercise. After a mastectomy with or without axillary dissection, it is good to start range of motion and strength exercises as soon a tolerable. I recently got a call from the local coordinator for Livestrong exercise program to do a webinar for their therapists. I was happy to hear that the organization offered programs through the YMCA for patient recovering from mastectomies. Here is an example of what they advise. https://www.livestrong.com/article/28314-post-mastectomy-exercises/ I would encourage you to investigate the local program if you have the need.
Early aggressive motion, however, can make fluid collections (seromas) for frequent. Seromas, while usually benign, can be bothersome to the patient and require prolonged treatment with decreased activity. I advise limiting therapy until after drains are removed and there is no evidence of seroma. You have to go slow early to go fast later. In fact, I have a patient who just ran in the New York Marathon after recovering from her mastectomy and expander placement and before her implant exchange and nipple reconstruction. With the right combination of pacing and motivation, it is amazing what patients can do.
Plastic Surgery for Boise, Meridian, and the greater Southeastern Idaho Region
