What Is Flash Recovery Breast Augmentation?
This article has undergone medical accuracy review by Rockville, MD board-certified plastic surgeon, Dr. Adam Tattelbaum on September 15, 2024.
Plastic surgeons have a fondness for trademarks – a phenomenon that has always struck me as odd, especially when it comes to naming and claiming medical treatments. Are there brain surgeons out there patenting elaborate craniotomy techniques? It's hard to envision, but I digress. In the field of aesthetics, branded treatments abound – typically designed to make a procedure seem unparalleled in terms of innovation and simplicity.
Clever (or merely skeptical) patients understand, of course, that incisions can never truly be "scar-free" and even operations with charming names have consequences. Nevertheless, with certain procedures, distinguishing medical facts from marketing hype can be a challenge. Breast augmentation, for instance – the most sought-after cosmetic surgery in America – is often labeled with one of the following synonymous terms: "Flash Recovery," "rapid recovery," "fast-track recovery," or the most precise promise, "24-hour recovery."
It's natural to be skeptical: after all, breast augmentation using 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, we are led to believe that this physical trauma can be overcome faster than, say, the average cold.
The fact is, these rapid-recovery pledges are featured on the websites of some of the most respected breast surgeons worldwide – the very doctors known for opposing unethical marketing. For us, this lends a certain level 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 meticulously planned procedure to what to expect 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 expanded on it and solidified the specifics.) "The 24-hour recovery is a by-product of this process," explains Dr. Adams, referring to the methods he outlined 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 reduce downtime – "it was about minimizing the complications of the surgery and ensuring better results for patients," he states.
In his study of 300 primary augmentation patients, 97% "returned to full normal daily activities, including washing and drying hair, getting dressed, picking up children younger than 3 years old, [and] driving a car," within 24 hours of the surgery. The process was also shown to significantly lower 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 adapted based on 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's an overview.
Before Breast Augmentation Surgery
The 24-hour concept begins at the consultation. "Patient education is the most crucial aspect," according to Dr. Adams, as "the more a patient knows, the better they fare." In his practice, patients have an extensive discussion with a dedicated patient educator to understand the ins and outs of the procedure, including the associated risks, the various types of implants and their defining features, and what to anticipate 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 type of "careful pre-operative assessment is highly significant," remarks Dr. Ashley Gordon, a board-certified plastic surgeon in Austin, Texas. Choosing an implant based on pre-surgery measurements – rather than engaging in the once customary trial-and-error sizing process with patients under anesthesia – keeps everyone on the same page, 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 prolong and intensify the recovery [by causing] excessive stretching of the muscle and the skin," explains Dr. Gordon.
Beyond reducing downtime, "thorough preoperative planning and ensuring the patient is comfortable, fully informed about, and has consented to the planned procedure is also extremely vital in lowering reoperation rates," adds Dr. Umbareen Mahmood, a board-certified plastic surgeon in New York City.
During Breast Augmentation Surgery
Dr. Tebbetts' papers present surgical guidelines regarding general anesthesia and other intraoperative medications; the use of specific tools, such as 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 becomes more efficient, the surgery is shorter [approximately 30 to 60 minutes], and recovery time and complications are reduced," says Dr. Michelle Lee, a board-certified plastic surgeon in Beverly Hills, California.
In Dr. Lee's opinion, the most critical elements of the flash formula – those essential for minimizing setbacks during healing – are "meticulous surgical technique, gentle handling of tissues, 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 might seem intuitive to today's breast surgeons, they are nonetheless indispensable for a successful operation. "It still astonishes me that someone had to publish an article instructing surgeons to be gentle with tissues and 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 immediate recovery issues and long-term complications, such as capsular contracture, which can be triggered by residual blood in the implant pocket.
Like many plastic surgeons, Dr. Gordon bases her breast augmentation approach on published protocols and 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 tissue trauma and reduce inflammation. With less inflammation and muscle spasm, there is less pain and swelling, and the implants settle into position more quickly." (The no-touch technique also helps prevent implant contamination and related problems.)
Excluding general anesthesia, there isn't a unanimously agreed-upon strategy for the administration of medications during surgery, but Dr. Gordon has discovered that administering 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-operative period" – which is another major objective of the Flash Recovery Breast Augmentation.
Related: The Best Bras to Wear After Your Breast Augmentation, According to Ruli Members
After Breast Augmentation Surgery
Aside from addiction risks, "narcotics are not ideal pain medications – all they do is mask the pain," says Dr. Adams. "They make patients feel nauseous and sleepy, which goes against what we're striving to achieve [with the 24-hour recovery]."
In an effort to reduce patients' reliance on narcotics, "many surgeons prescribe a combination of Celebrex [an anti-inflammatory], gabapentin [for nerve pain], and Tylenol," Dr. Mahmood says. (There might also be a muscle relaxant included.) "A rapid recovery [also] means using dissolvable sutures and avoiding 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 perform 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 relaxants in their system.
The only significant post-operative restriction, notes Dr. Mahmood, pertains to exercise: no vigorous physical activity or heavy lifting for three to four weeks. Dr. Gordon instructs 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 quickly as possible, she says. (For the record, doctors have varying opinions on when it's safe to resume strenuous activities.)
Some surgeons provide patients with more precise instructions when they go home. "My patients have approximately eight hours to enter the 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 prevent the pectoralis muscles from getting stiff and sore." Many patients even go shopping or out to dinner on the same day, he adds – but "they can't just go home and lie in bed for a couple of days."
That said, the recovery stages of breast augmentation can vary from person to person. "Some patients simply have a more challenging time, and we never determine the exact reason," says Dr. Gordon. Patients with well-developed pectoralis major muscles might 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, might have a slightly longer recovery.
It's also worth noting that "patients perceive pain differently, even when all other factors are the same," she adds, and some women do rely on narcotics in the days following the surgery.
Is Rapid Recovery Breast Augmentation More Than Marketing?
Truly, yes. While these descriptions are undoubtedly used to attract patients, there is substantial evidence supporting a shortened recovery when doctors (and patients) follow strict blueprints for upfront counseling, best practices in the operating room, and post-operative instructions.
Of course, even established guidelines are subject to interpretation, and "it can be challenging to assess what 'rapid recovery' means from one surgeon to another," notes Dr. Lee.
There's also the risk of patients misunderstanding the terminology or taking catchy claims too literally.
"I refer to our [version] as 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 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 typically recover in about three days.
"What's crucial to remember," adds Dr. Lee, "is that even if you feel great at 24 hours, it doesn't mean you're fully healed and ready to go to the gym the next day." Regardless of the label given to a breast augmentation procedure, complete "recovery after breast augmentation still takes three to four weeks. If a patient resumes full activity too soon, it will actually slow down the recovery process."
When consulting with doctors, ask which aspects of their breast augmentation surgery facilitate a swift recovery. Inquire about the medications used during surgery and prescribed afterwards. Press for a realistic return-to-normal timeline and ensure you understand your role in your recovery. Above all, prioritize the reputation 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 this or not.
