Ever have thoughts about getting breast enhancements? Have large breasts that are killing your back and wishing for a reduction?? C’mon now…. we know, here in Phoenix, this is one of the #1 presents for females graduating from high school….no really, it’s true! Do we have your attention now??
October is a month to recognize those who are fighting, surviving, or are supporting someone going through breast cancer. And oftentimes, we are asked, “What is your opinion on getting the breasts replaced? Are there any possible issues or complications from a physical point of view? Thus, we decided, this topic needs to be addressed, not only for breast cancer survivors, but also for the general population; whether it’s a female who is interested in enhancements, an individual interested in their spouse getting them, or a loved one purchasing them for you. Here’s the down and dirty!
Many women we have talked to have said, their surgeon never recommended PT after their surgery, or that it’s not necessary, or there’s nothing they can do to help….that’s crazy! We are here to educate you differently!
For the technical stuff: The location for implant placement can either be subglandular (in breast tissue) or submuscular (below chest muscles). Both locations have their pros and cons and will need different approaches to rehabilitation. Needless to say, subglandular recovery will be faster than submuscular because the chest muscles need to remain immobilized allowing for tissue growth to lay over the incision ends.
Many people don’t realize the impact that augmentation has on tissue healing and muscular and structural demands, as well that the augmentation is not a one size fits all. It is a very specific procedure that depends on the type of mastectomy and desires of augmentation. There are many different types of implants, but their surgical placement and size are most relevant to this blog.
As we grow older, women’s breast tissue was meant to start to sag (great mental image, I know), but that is to help off-set the weight that is being held up high, pulling on your back, neck, shoulders, etc, also causing headaches. When you have very large breasts, or you get large implants, over time, they will start to cause those issues. They pull the top of your chest downwards, increasing poor posture, and thus leading to shoulder injuries, neck pain, back pain, and awful headaches. Thus, it is imperative that you maintain a lifelong strengthening program to help minimize these symptoms.
It is interesting to note that with these types of aesthetic procedures, the weight of these implants influence neutral posture of those who undergo the procedure. From the research and clinical evidence, augmentation procedures have been shown to change cervical (neck) as well as lumbar (low back) curvature. Understanding that augmentation literally adds mass to a patient’s chest in front of their center of gravity, it is evident that the muscles supporting the neck and low back have not been accustomed to the excess load they now have to support.
Is it too late? NO! If you already have some of these issues, it’s not too late! Here’s where PT can help.
Physical therapists can gain significant knowledge about the patient and their history, whether it was a medically necessary surgical intervention or elective surgery, which will greatly help decipher the best route to treat the patient. We can help initiate a lengthening program for the front side, which is likely shortened, causing the forward pull; initiate a strengthening program for the back side to help offset gravity; and then initiate a mobility program for the shoulders and neck to help minimize the pain. This can be done within weeks of the surgical intervention, or years after.
So back to October…..
Unfortunately, the results of any mastectomy can result in complicated healing and deformation of the breast tissue and overlaying skin. Breast augmentation procedures can help to address the emotional, physical and psychological issues that arise because of the invasiveness of the mastectomy. Oftentimes, spacers are used, which again pulls at the tissue causing discomfort. Let PT help! We are here to help minimize the abnormal pulling of tissue, whether it is from a mastectomy alone, a replacement procedure, or an enhancement.
Overall, whether the augmentation procedure was done post-mastectomy or for general aesthetics, there are some healing guidelines when returning to normal arm ranges of motion. Following a protocol, ensures protection of the site during proper tissue healing, as well as functional training to increase strength of muscles that will support the augmented breasts and arms. Coming up next week, we will discuss some general exercises for rehabilitation from a mastectomy, breast augmentation or being well-endowed.