Case #1404 · Pacific Palisades, CA
Breast Augmentation
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This 38-year-old patient from Pacific Palisades, CA desired fuller breasts after having two children. Dr. Cassileth performed a bilateral submuscular breast augmentation with 397cc silicone implants.
Continued care
Recommended aftercare, skincare, and MedSpa services for Breast Augmentation.
- Compression bra continuously for 4 weeks, daytime for 8 weeks
- No lifting above 10 lb for the first 3 weeks
- Walking encouraged from day 1; cardio at week 4, full chest workouts at week 6
- Scar management protocol at 3 weeks
- Hyperbaric Oxygen Therapy to support healing when recommended
- Medical-grade silicone sheeting on incisions starting week 3
- SkinCeuticals C E Ferulic for scar healing
- SPF 50+ on incision sites for 12 months
- Laser or microneedling for scar refinement after 3 months
- LED light therapy to reduce post-op swelling
- Indiba radiofrequency for tissue recovery
- Aftercare
Extended hyperbaric oxygen course (10–15 sessions) to support bilateral healing.
Bilateral procedures heal more reliably with sustained HBOT.
- Coordination
Recovery medications calibrated to nursing status; hormone panel rechecked if symptoms warrant.
Post-pregnancy hormonal shifts influence healing and skin behavior.
- Skincare
Sun avoidance and SPF protocol extended through month 12 to minimize scar hyperpigmentation.
Younger skin pigments scars more reliably under sun exposure.
Why this approach
The decisions that shaped this surgical plan.
- Pregnancy-related anatomy informs the plan: rectus separation, skin laxity, and breast tissue volume change all factor in.
- Bilateral breast augmentation performed in one operative session so symmetry, tissue handling, and final shape track between both sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Stop NSAIDs, aspirin, and high-dose fish oil two weeks before surgery; the surgical team provides a full medication list at the pre-op visit.
- Nicotine in any form, cigarettes, vapes, patches, gum, paused six weeks before and six weeks after surgery. Nicotine narrows blood vessels and slows wound healing.
- No overhead clothing for 3 weeks. Stock front-zip tops, supportive sports bras (post-clearance), and the drain pouches we provide.
- Confirm a driver for surgery day and a companion who can stay through the first night.
- Hormonal stability and lab values confirmed before surgery. Nursing-friendly scheduling and meds are coordinated when relevant.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
First week is the strictest activity window. Bilateral cases benefit most from staying ahead of swelling with consistent icing and rest.
- Week 2
Walking distance doubles. Showering rules relax. Compression garments transition to the long-wear schedule.
- Week 4
Return to most low-impact activity. Scar massage, compression, and skincare protocols pick up.
- Week 6
Most physical restrictions lift. Return to strength training, full-impact cardio, and overhead lifting.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
