For women undergoing breast augmentation, returning to exercise one week after surgery does not increase the risk of complications—but does lead to increased patient satisfaction, reports a clinical trial in the January issue of Plastic and Reconstructive Surgery, the official medical journal of the American Society of Plastic Surgeons (ASPS).

The findings question the recommendation made by some plastic surgeons to avoid exercise for several weeks after breast augmentation, according to the study by Filipe V. Basile, MD, and Thais S. Oliveira, MD, plastic surgeons in private practice in Ribeirão Preto, Brazil. They write, “These findings are in line with a broader tendency recently seen in other surgical fields in which early exercise was shown to be safe without increasing complication rates.”

For women interested in breast augmentation, early exercise has ‘obvious appeal’

Plastic surgeons have differing opinions as to how long patients should wait to resume exercise after breast augmentation, with recommendations ranging from a few weeks to a few months after surgery. “This recommendation is based on the belief that exercise could increase the complication rate, diminish scar quality and jeopardize surgical results,” according to the authors.

Toward providing evidence to guide these policies, Drs. Basile and Oliveira designed a study in which patients undergoing breast augmentation were randomly assigned to early exercise versus standard restrictions. One week after their procedure, women in the exercise group began a supervised exercise program—either aerobic exercise or strength training, three times weekly for 12 weeks. Patients assigned to the control group were advised to avoid exercise for 12 weeks after surgery.

At one-year follow-up, complication rates and scar quality were compared between groups. In addition, patient satisfaction with their breast augmentation results was assessed using the validated BREAST-Q questionnaire. Seventy-five patients in each group completed the study.

The results supported the safety of early exercise. Overall complication rate was 6.9 percent in the exercise groups and 7.5 percent in the non-exercise group. Complications were generally minor; none of the patients needed revision surgery during the 12-month follow-up period. Scar quality was also similar between groups.

Unexpectedly, patient satisfaction scores were higher for women assigned to early exercise. Average satisfaction score on the 100-point BREAST-Q was 83 in the early exercise groups versus 66 in the non-exercise control group. Outcomes were similar for women assigned to aerobic exercise versus strength training.

That may seem counterintuitive to surgeons who recommend that their patients avoid physical activity while recovering after surgery. However, Drs. Basile and Oliveira note that the findings are consistent with previous studies showing that early postoperative exercise is beneficial and does not increase complication rates after several types of surgery, including cardiac surgery.

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