This article has been medically reviewed for accuracy by Rockville, MD board-certified plastic surgeon, Dr. Adam Tattelbaum on September 15, 2024.
Plastic surgeons have a propensity for trademarks—which has always struck me as peculiar, this naming and claiming of medical treatments. Are there brain surgeons out there, patenting fancy craniotomy techniques? It’s hard to envision, but I digress. In the realm of aesthetics, branded treatments are omnipresent—and typically designed to make a procedure seem unrivaled, in both innovation and simplicity.
Savvy (or merely skeptical) patients realize, of course, that incisions can never truly be “scarless” and even operations with charming names have implications. Still, with certain procedures, differentiating medical fact from marketing hyperbole can be arduous. Breast augmentation, for instance—the most popular cosmetic surgery in America—is commonly labeled with one of the following synonymous descriptors: “Flash Recovery,” “rapid recovery,” “fast-track recovery,’ or the most precise of pledges, “24-hour recovery.”
It’s natural to be skeptical: after all, breast augmentation with silicone or saline implants is a general-anesthesia operation that involves cutting through skin, fat, and muscle, stretching and separating tissues, to insert a pair of foreign objects. Yet this physical trauma, we are to believe, can be overcome quicker than, say, the average head cold.
The thing is, these swift-recovery assurances appear on the websites of some of the most respected breast surgeons in the world—the very doctors known to protest against unethical marketing. For us, this fact lends a certain degree of credibility to the claims—enough to warrant further exploration. Ahead, everything you need to know about rapid recovery breast augmentation—from the evidence supporting the carefully planned procedure to what you can anticipate in the hours following.
What is Flash Recovery Breast Augmentation?
These promotional names are actually grounded in science. Between 2002 and 2008, two board-certified Dallas plastic surgeons, Dr. John Tebbetts and Dr. William P. Adams Jr., published a series of papers detailing the steps surgeons should take—before, during, and after surgery—to standardize and refine breast augmentation for more predictable outcomes. (Dr. Tebbetts’ two-part study, here and here, laid the foundation; Dr. Adams built upon it and solidified the particulars.) “The 24-hour recovery is a by-product of this process,” explains Dr. Adams, referring to the methods he delineated in his 2008 paper, “The Process of Breast Augmentation: Four Sequential Steps for Optimizing Outcomes for Patients.” Initially, however, the aim of his work wasn’t necessarily to shorten downtime—“it was about reducing the complications of the surgery and having better outcomes for patients,” he says.
In his study of 300 primary augmentation patients, 97% “returned to full normal activities of daily living, including washing and drying hair, getting dressed, picking up children younger than 3 years old, [and] driving a car,” within 24 hours of surgery. The process was also shown to significantly reduce reoperation rates.
Over the past decade and more, the rituals of the 24-hour recovery have come to represent a gold-standard benchmark for breast augmentation—one that most contemporary board-certified plastic surgeons have adopted and developed according to their own direct experiences.
The rules of rapid recovery extend beyond the operating room, influencing every stage of care, and require a strong partnership between patients and doctors. Here, an overview.
Before breast augmentation surgery
The 24-hour concept commences at the consultation. “Patient education is the most crucial thing,” according to Dr. Adams, since “the more a patient knows, the better they fare.” In his practice, patients have an extensive discussion with a dedicated patient educator in order to learn the ins and outs of the procedure, including the risks involved, the various types of implants and their defining features, and what’s to be expected post-surgery. They later meet with Dr. Adams, who systematically analyzes and measures the breasts and “selects an implant that suits their tissues.”
In other words, objective breast measurements guide patients to implants that are appropriate for their anatomy. This kind of “careful pre-operative assessment is highly significant,” says Dr. Ashley Gordon, a board-certified plastic surgeon in Austin, Texas. Selecting an implant based on measurements before surgery—rather than engaging in the once customary trial-and-error sizing process with patients under anesthesia—keeps everyone in sync, saves time in the operating room, and contributes to a swifter recovery by ensuring a proper fit.
“Using an implant that’s too large for the patient’s tissues could make the recovery longer and more painful [by causing] excessive stretching of the muscle and the skin,” Dr. Gordon explains.
Beyond minimizing downtime, “thorough preoperative planning and ensuring the patient is comfortable, [is] fully informed about, and [has] consented [to] the planned procedure is also extremely vital in reducing reoperation rates,” adds Dr. Umbareen Mahmood, a board-certified plastic surgeon in New York City.
During breast augmentation surgery
Dr. Tebbetts’ papers outline surgical guidelines regarding general anesthesia and other intraoperative drugs; the use of specific tools, like electrocautery, to minimize tissue damage; and strict techniques, to control bleeding during dissection (blood leads to inflammation and pain) and avoid touching sensitive structures, like ribs, when placing the implants. “By standardizing every minute movement, the procedure is more efficient, the surgery is shorter [roughly 30 to 60 minutes], and recovery time and complications are decreased,” says Dr. Michelle Lee, a board-certified plastic surgeon in Beverly Hills, California.
In Dr. Lee’s estimation, the most critical elements of the flash formula—those integral to minimizing setbacks during healing—are “meticulous surgical technique, gentle tissue handling, and placing an implant that is proportionate to the body and doesn’t stress the tissue,” she says.
While certain core principles of the 24-hour recovery may seem intuitive to today’s breast surgeons, they are nonetheless essential to a successful operation. “It still astonishes me that someone had to publish an article telling surgeons to be gentle with tissues and to minimize bleeding,” says Dr. Gordon (though apparently “blunt dissection”—tearing through breast tissue with fingers—was common in the past). Still, Dr. Gordon adds, “the points about bloodless dissection and not touching the ribs with retractors, as it leads to unnecessary pain, are valid and important”—for reducing both the immediate recovery and long-term issues, like capsular contracture, which can be triggered by residual blood in the implant pocket.
Like many plastic surgeons, Dr. Gordon centers her breast augmentation approach around published protocols, then customizes it based on the latest research and her own expertise. “For me, the key components of a rapid recovery breast augmentation include full muscle relaxation during dissection, dissection under direct vision, meticulous hemostasis [to prevent bleeding], and placement of the implant using a no-touch technique with a Keller funnel,” she says. “All of these minimize trauma to the tissues and reduce inflammation. With less inflammation and muscle spasm, there’s less pain and swelling, and the implants settle into position more rapidly.” (The no-touch trick also helps prevent implant contamination and related issues.)
Barring general anesthesia, there isn’t a unanimously agreed-upon strategy for the administration of meds during surgery, but Dr. Gordon has discovered that giving IV ketamine and injecting the breast pocket with a long-lasting local anesthetic before placing the implants can “reduce the need for narcotics in the recovery room and in the post-op period”—which is another major objective of the Flash Recovery Breast Augmentation.
Related: The Best Bras to Wear After Your Breast Augmentation, According to RealSelf Members
After breast augmentation surgery
Apart from addiction risks, “narcotics are not excellent pain meds—all they do is disguise the pain,” says Dr. Adams. “They make patients nauseous and drowsy, which goes against what we’re trying to achieve [with the 24-hour recovery].”
In an effort to curtail patients’ reliance on narcotics, “many surgeons prescribe a regimen of Celebrex [an anti-inflammatory], gabapentin [for nerve pain], and Tylenol,” Dr. Mahmood says. (There may also be a muscle relaxer included.) “A rapid recovery [also] means dissolvable sutures and no unnecessary drains, bandages, or surgical straps. Patients are permitted and encouraged to shower the next day as well as resume all their daily activities and practice range-of-motion exercises with their arms and shoulders.” They can typically drive the day after surgery, as long as they don’t have narcotics or muscle relaxers in their system.
The only genuine post-op restriction, notes Dr. Mahmood, relates to exercise: no vigorous physical activity or heavy lifting for three to four weeks. Dr. Gordon tells patients to avoid lifting anything over 10 pounds for at least a couple of weeks, to prevent any bleeding in the pocket and to encourage the pectoral muscles to relax as promptly as possible, she says. (For the record, doctors have varying opinions about when it’s safe to resume strenuous activities.)
Some surgeons send patients home with more precise instructions. “My patients have about eight hours to enter fast-track recovery,” Dr. Adams explains. “They go home, take a nap, take a hot shower. We give them gentle arm raises to do, to keep the soft tissues moving and the pectoralis muscles from getting stiff and sore.” Many patients even go shopping or out to dinner the same day, he adds—but “they can’t just go home and lie in bed for a couple of days.”
That said, breast augmentation recovery phases can vary from individual to individual. “Some patients simply have a more challenging time, and we never determine why,” says Dr. Gordon. Patients with well-developed pectoralis major muscles may experience more muscle spasms and discomfort, she notes. Those with tuberous breasts or otherwise tight breast envelopes, whose tissues require more stretching and manipulation during surgery, may have a slightly longer recovery.
It’s also worth noting that “patients perceive pain differently, even if all other factors are the same,” she adds, and some women do rely on narcotics in the days following surgery.
Is rapid recovery breast augmentation more than marketing?
Truthfully, yes. While these descriptions are, undoubtedly, used to attract patients, there’s strong evidence supporting a shortened recovery when doctors (and patients) follow strict blueprints for upfront counseling, best practices in the operating room, and post-op instructions.
Of course, even recognized guidelines are subject to interpretation, and “it can be challenging to assess what ‘rapid recovery’ means to one surgeon compared to another,” notes Dr. Lee.
There’s also the risk of patients misunderstanding the jargon or taking catchy claims too literally.
“I call our [version] the ‘rapid recovery protocol,’ because I don’t think it’s realistic that every woman will feel back to normal in 24 hours and I don’t want to set that expectation. I still prefer for them to take a few days off work, just in case,” says Dr. Gordon, who finds that, with the exception of exercise and heavy lifting, patients usually recover in about three days.
“What’s crucial to remember,” adds Dr. Lee, “is that even if you do feel great at 24 hours, it doesn’t mean you’re fully healed and able to go to the gym the next day.” Regardless of the label given to a breast augmentation, complete “recovery after breast augmentation still takes three to four weeks. If a patient returns to full activity too soon, it will actually slow down recovery.”
When consulting with doctors, ask which aspects of their breast augmentation surgery facilitate an expedited recovery. Inquire about medications used during surgery and prescribed afterward. Press for a realistic return-to-activity timeline and ensure you understand your role in your recovery. Above all, prioritize the name of your surgeon over the name of the surgery.
Ultimately, “the goal of most board-certified plastic surgeons is for their patients to have the easiest, fastest, and safest recovery,” says Dr. Gordon—whether they advertise that fact or not.
