Patients ask me all the time how long they have to wear the “compression bra.” “Never,” I answer. There is a postop bra, but it should not actually be compressive.
For most plastic surgery procedures, especially on the body, compression is key. The tissues are often moved and loose, with large areas of dead space under the skin flaps. Often, fluid accumulates both from the dead space itself, and sometimes from liposuction. The procedure also creates inflammation, which then leads to swelling. All in all, the situation becomes a swollen, wet, loose mess.
Compression garments, when properly fit and worn correctly, can be extremely helpful during the first phases of healing. They hold things down and in place, they push the fluid away and sometimes into drains, and they prevent excessive swelling from taking place. They can also support the shapes that were made during the surgery by continuing to form the contours that they create.
When it comes to the breast, support is the answer rather than compression. A compressive bra will similarly contain swelling in the breast, but it will also flatten it and make it boxy. The pressure on the nipple decreases blood flow to the area, which is never ideal in the postop breast. The pressure also focuses on the midline of the breast, which is often where multiple incisions meet, limiting the blood flow to both the skin flap and the incision, and possibly leading to wound healing issues. All in all, it is essentially less than optimal.
For my breast surgery patients, I much prefer a smooth supportive bra that gently holds the breast up, while allowing the round and teardrop shape to establish itself. Since most of my breast procedures involve extensive sculpting and shaping, the last thing that I want is for that beautiful shape that I saw in the operating room to get squished and turn out looking like a paddle. In fact, I make it a point to check how each bra fits each patient, and how it evolves over the first few postoperative days, to ensure that the shape is optimized, and my work properly preserved.
This concern goes beyond the bra itself, and must also be taken into account when evaluating full bodysuit garments after belly procedures. If the belly ends up very small, then the garment ends up very small. Depending on how the garment is designed, the breast cups may then be too small for that patient, creating total flattening secondarily to the belly support. Yes, this gets complicated! But it is manageable with a little attention and effort.
Keeping in mind that plastic surgery is all about tailoring, then it should come as no surprise that the fit of the postop garment is a major factor in the ultimate outcome of the case. As they say, if it’s not part of the solution, it’s part of the problem.
