Marta Montenegro: How to Exercise After Breast Plastic Surgery

(Andrew Meade Photography)

After a lot of thinking, researching and seeing several doctors, you decided to go for a breast augmentation. You can’t wait to go shopping for a new fitness-sports bra to look your best in the gym or for your run with your running team. However, your post-surgery guidelines say you are forbidden to exercise for awhile. Suddenly, the idea of losing all what you have accomplished at the gym kicks in.

Eugene Elliot, cosmetic and reconstructive surgeon at Orange Coast Memorial Medical Center in Fountain Valley, CA, says that “in general terms, after complete recovery from breast augmentation the patient will not have any exercise restrictions.”

However, before you think that you can hit the gym the following days after the procedure, you need to beware that there is a timeframe for each activity type – low impact vs. high impact, upper body vs. lower body moves.

Fitness savvy

For Elliot, it’s important that the patient gets up and walks frequently to avoid any blood clots, deep venous thrombosis and pulmonary embolism, but this activity should not be vigorous.

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“At three weeks after surgery mild stretching except the upper torso is acceptable but not vigorous yoga positions. At six weeks after surgery I tell my patients to begin non-impact aerobic exercise, as in stationary bike for the first week then gradually over the following three weeks they can resume impact aerobic exercise,” advises Elliot.

In this regard, Michael Niccole, M.D, medical director and founder of CosmetiCare in Newport Beach, CA, suggests to his “patients to begin 25 percent of their workout after 4 weeks, 50 percent after 5 weeks, 75 percent after 6 weeks and 100 percent by 7 to 8 weeks.”

If you love running and/or lifting weights, these are the two most sensitive types of activity to consider when resuming your sports-fitness programs. Overall, experts advise a period of six weeks to start doing weights, very light and being extremely careful with exercises that strains the pec and the surrounding muscles such as push-ups, pull-ups and planks.

Tips to come back

In my practice, I helped many women resuming their fitness and sports workouts after a breast augmentation surgery. I always found a way to have them being active and working according to their physicians’ clearance and input. This way, they managed the pain better, recovered faster and did not lose all the effort that they had put in the gym before the procedure.

Overall this is what you can do with your doctor’s approval:

a) Never exercise without a well supported bra. Ask your doctor which one he or she recommends.

b) Low-impact activity such as light walking, elliptical – but don’t move the arms, hold them in the console grip for slight support. Embrace other muscles such as the core and you won’t need to hold onto anything, and biking – but not the Spinning type, at least not hill quest simulation.

c) Gently stretch the muscles of the pectoral and the back. Movement is what keeps the joints flexible and will also help getting rid of the byproducts of the surgery faster. For every stretch move for the pectoralis muscle, you must perform one for the back. It’s important that you keep balance between these two muscles to avoid tightness and other aches such as back pain. Likewise, the neck muscles usually get really tight as a consequence of the overall surgery trauma. Some of the moves that you can gradually do to maintain flexibility in this area – allow sometime to recovery full range of motion. Don’t force any stretch.Take your time.

1. Chest & shoulders: Stand next to a tall support with one leg in front of another and the outside hand on your waist. Bend your inside arm at a right angle and raise it to shoulder level. Press gently against the support. Hold the stretch for 20 to 30 seconds and the other arm. – Delavier’s Stretching Anatomy

2. Trapezius, rear shoulders, rhomboids, triceps and back: Stand upright inside a doorway while facing the doorjam in line with the right shoulder. Bring the left arm across the body toward the right shoulder. Pointing the thumb down, grab hold of the doorjam at shoulder level. Rotate the trunk inward until you feel the stretch in the posterior left shoulder. Hold for 20 to 30 seconds and do the other arm. – Arnol G. Nelson and Jouko Kokkonen, Stretching Anatomy

3. Side neck stretch: Sit on a chair, back straight and chest up. Support your hands on the chair. Keep the shoulders down. Gradually tilt your neck to one side and hold the stretch for 20 to 30 seconds and do the other side. Avoid this exercise if you have any cervical spine issues.

d) Start weight training by doing legs. Look for lower body machines that don’t put pressure on the upper body at the beginning such as leg extension, seated hamstring curl, leg press and adductor/abductor seated machine, step up with no weights. Vary the reps and sets so you can go one day for strength (8 to 10 rep) and one day for endurance (15 to 20 reps). Leave one day in between.

e) Once you can work on your upper body same principle that applies to stretching moves does when weightlifting. To avoid developing a round shoulder misalignment posture, it’s necessary to strengthen both the back and chest muscles. Typically, for each push exercise (pec move) select one pull exercise (back move). Some exercises that you can do after the period suggested for recovery are:

1. Dumbbell/cable row: Make sure that you fully contract the scapula together when pulling the weight in and keep the shoulders down and chest up.

2. Incline dumbbell chest press: When doing incline chest press you’ll emphasize the shoulders as well. This will be a good move to start gradually into other chest moves that stress the pectoralis muscle more. At the same time, dumbbells will allow you to control the range of motion better than barbells or machines. Go down gradually to 90 degrees. Don’t expect full range of motion in the beginning.

f) When doing arms moves, you won’t have difficulty performing biceps curl but you’ll do when doing triceps push-down because of the tension that you’ll put in the pec. So, begin with dumbbells tricep kick backs. Lean your body forward slightly. Keep the elbows tucked to your body and extend the dumbbells straight back towards your rear.

g) Avoid, at the beginning, overhead exercises until you recover the full range of motion of the arms. In this case, you’ll find easier to do lateral shoulder raises than overhead shoulder press. Same way, frontal shoulder raises will be difficult to perform because they involve the chest muscles more than the lateral raises. One way to add these moves back to your routine is doing one arm at a time.

h) As per moves to work the abdominals. Stay with the seated abdominal machines until you can move to the physioball to do some crunches.

i) To start bringing back the push-ups, do so in an inclined position. The more upright you are the less body weight that you have to lift up, thus the less pressure that you put in the pec muscles. Gradually, you can lower the bar until you can do push-ups as usual.

As difficult as it sounds, you’ll see that time flies if this is what you really want for yourself. Perhaps, this can be a great time to give your muscles and mind some rest to come back stronger to your fitness-sports habits. In any case, Elliot affirms that “the good news is once healing is complete (breasts are soft and not tender) patients will be able to resume all activities they performed prior to surgery. Nevertheless, if something doesn’t feel right – as in pain, pulling or stretching- don’t do it until it feels OK.”

Marta Montenegro is an exercise physiologist, certified strength and conditioning, coach and master trainer who is an adjunct professor at Florida International University. Marta has developed her own system of exercises used by professional athletes. Her personal website martamontenegro.com, combines fitness, nutrition and health tips, exercise routines, recipes and the latest news to help you change your life but not your lifestyle. She was the founder of nationally awarded SOBeFiT magazine and the fitness DVD series Montenegro Method.