Case #1434
Breast Augmentation
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This 23-year-old patient desired a feminine chest while transitioning from a man to a woman. Dr. Cassileth performed bilateral breast augmentation using 350cc saline 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.
- Skincare
SPF 50+ on incisions daily for the first year; younger skin pigments scars more reliably under UV.
Younger skin pigments scars more reliably under sun exposure.
Why this approach
The decisions that shaped this surgical plan.
- Bilateral approach chosen to keep the planning, the tissue response, and the aesthetic outcome consistent between sides.
Pre-op preparation
What to do before surgery. Specific to this case.
- Discontinue blood thinners (NSAIDs, aspirin, fish oil, vitamin E) two weeks out. Acetaminophen remains safe; the full list is reviewed at pre-op.
- 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.
- Front-closing clothing only for 3 weeks. Drain holders and supportive surgical bras are issued at discharge.
- Confirm a driver for surgery day and a companion who can stay through the first night.
Recovery timeline
Milestones specific to this case. Individual recovery varies.
- Day 1–7
Both sides healing in parallel means the early phase is quieter, short walks, full rest periods, and no driving until off pain medication.
- Week 2
Patients off prescription pain medication, walking 1–2 miles daily, and back to most light household activity.
- Week 4
Most patients back to gym cardio at 50 percent intensity. Scar massage protocol begins. Driving restored if not already.
- Week 6
Standard clearance milestone. Patients return to most exercise, gym work, and sleeping in any position.
- Month 3
Most patients consider this the "final result emerges" milestone. The remaining 10 percent of refinement plays out through month 6.
