Successful surgery is only the first step; optimal recovery is paramount to achieving the best possible long-term results. Dr. Khout provides detailed, tailored post-operative care plans to ensure a safe, efficient, and comfortable healing process for all patients.

Immediate Post-Surgical Phase (Days 1–7)

The first week is critical for minimizing complications and managing initial discomfort.

1. Pain Management

• Protocol: A multi-modal approach is used, combining non-opioid medications (acetaminophen, NSAIDs) with targeted nerve blocks administered during surgery. Opioid medication is prescribed sparingly and only for breakthrough pain.
• Goal: To keep pain at a manageable level, allowing for early mobilization, which is vital for preventing blood clots.

2. Drains and Dressings

• Surgical Drains: For major procedures like reconstruction (especially flap surgeries like DIEP) or large reductions, surgical drains may be placed to collect excess fluid. Patients receive comprehensive training on managing and measuring drain output at home. 
• Dressings: Dressings are typically waterproof and left intact until the first post-operative visit. They must be kept clean and dry. Patients are instructed on recognizing signs that dressings may need immediate attention (e.g., saturation, displacement).

3. Activity and Positioning

• Rest and Elevation: Strict limits on lifting, pushing, or pulling anything heavier than 5 pounds. For most breast surgeries, sleeping in a semi-reclined position is recommended to reduce swelling and tension on the incisions.
• Mobility: Gentle walking is encouraged from day one to stimulate circulation and aid recovery. Arm movement is restricted based on the procedure (e.g., no reaching above the shoulder after a latissimus flap or a mastopexy).

Short-Term Recovery (Weeks 2–6)

During this phase, the focus shifts to scar maturation and gradual return to normal activity.

4. Incision and Scar Management

• Suture Removal: Non-dissolvable sutures or staples are usually removed during the first two weeks.
• Scar Care Initiation:Once the incisions are fully closed, Dr. Khout recommends starting a personalized scar management program, which may include:
  • Silicone sheeting or topical gels.
  • Gentle massage to soften the scar tissue.
  • Strict sun protection (SPF 30+) to prevent hyperpigmentation.

5. Return to Activity

• Driving: Typically allowed once the patient is off all narcotic pain medication and can comfortably operate the vehicle without significant pain or reduced range of motion, usually around 2–3 weeks.
• Exercise: Light aerobic activity (walking, stationary bike) can usually resume around 3 weeks. Resistance training and high-impact activities are avoided until cleared by the surgical team (usually 6–8 weeks).

Long-Term Healing and Follow-Up

Recovery extends far beyond the initial weeks, requiring continued monitoring.

6. Managing Swelling and Sensation

• Swelling (Edema): Swelling will gradually subside, but it may take several months (6–12) for the final contour to stabilize. Compression garments are essential during this period.
• Sensation Changes: Numbness, tingling, or hypersensitivity is common post-surgery. Sensation usually returns or improves over the course of the first year, though full sensation may not always return.

7. Continuous Follow-Up

Regular follow-up appointments are scheduled to monitor healing, assess symmetry, and address any long-term concerns. These appointments are crucial for ensuring the final outcome is optimized.