Nashville Plastic Surgeon
Dr. Jacob G. Unger

Below you will find the list of resources provided by Dr. Unger for your associated surgery. If you have any questions or need clarification, please don’t hesitate to reach out for more information. 

• Dr. Unger’s Pre-Op Instructions
• Dr. Unger’s Breast Augmentation Instructions
• Dr. Unger’s Breast Reduction and Lift Instructions
• Dr. Unger’s Tissue Expander Instructions
• Dr. Unger’s Tissue Expander-Exchange Instructions
• Dr. Unger’s Breast Reconstruction/Revision Instructions
• Dr. Unger’s Liposuction Instructions

If you had multiple procedures performed at the same time, as a general rule of thumb, follow the more conservative instructions first. For example, if one procedure’s instructions indicate resuming cardiovascular activity at 2 weeks and the other you had performed indicates resuming at 4 weeks, you should resume at 4 weeks unless otherwise specified by Dr. Unger. 

Regardless of the type of breast surgery you had performed, Dr. Unger’s post-op instructions encourage walking shortly after the operation. Walking increases blood flow and decreases risk of blood clots.  In the first 2 weeks, Dr. Unger advises keeping your heart rate under 100 beats per minute with activities. If you have a fit bit, smart watch or a stop watch you can monitor your heart rate more accurately. When using a stop watch, count the number of heart beats you feel through either your carotid pulse (easily felt in your neck next to your windpipe) or your radial pulse (on the inside of your wrist on the thumb side of your arm) for 30 seconds and double that number. Or you can count the number of beats for an entire minute for a more accurate measurement. Dr. Unger allows return to light cardiovascular activity gradually after 2 weeks and full activity can be resumed at 6 weeks. 

Dr. Unger advises all of his patients to not lift anything heavier than 10 pounds for 4 weeks. 

As always, listen to your body and use proper form as shown in the videos. If anything feels strange or painful, stop and seek guidance to ensure your overall safety. Your progress may be faster than someone else’s so it’s critical that you listen to your body as well as get clarification from Dr. Unger if you are able to proceed sooner than the typical guidelines. 

When to Call the Office:

• If you have increased swelling and bruising of one breast significantly more than the other. (Remove the bra to make this determination. This may represent a hematoma {collection of blood} or a seroma {collection of clear fluid}.)
• If you have increasing swelling or redness around the incision.
• If you have severe pain not relieved by pain medication.
• If you have any side effects from the medication: rash, nausea, headache, vomiting.
• If you have fever over 101 degrees.
• If you have yellow or greenish drainage from an incision or notice a foul odor.
• If you notice some vaginal burning and itching as a result of the antibiotics used during and after surgery.
• If a drain was placed and the output is less than 30cc for 24 hours. (This is typically when Dr. Unger will arrange to remove the drains.)

Below you will find the Upper Body Movement Videos. Dr. Unger recommends beginning the upper body ROM video for range of motion during week two, 7-10 days post-op and continue daily to maintain full range of motion of your arms. These movements are gradual and you should never force a motion. The idea is to gradually return/regain your full range of motion. The timeline is only a suggestion and you should always allow your body and pain tolerance be your guide.

Below you will find Dr. Unger’s general guidelines. If he has told you otherwise, please follow his guidelines above all else. 

• Begin Upper Body ROM prior to surgery to ensure full range before your surgery date, as well as beginning around day 7 post-operative up to day 14. It is not advised to raise your arms above 90 degrees (the T motion) during the 1-14 days following surgery, but PRIOR to surgery is fine to ensure full range of motion before surgery. 
• Begin Upper Body Level 1 at day 15 and continue until full range of motion is gradually achieved with comfort. 
• Begin Upper Body Level 2 at week five. (Dr. Unger advises no heavy lifting/stretching (Yoga) until after week 6. You can perform this video safely without using the resistance tubing for the tricep kickbacks or the bicep curls until week 6.) At week six, perform this same video adding the resistance tubing. 
• Begin Upper Body Level 3 at week seven. 
• Begin Upper Body Level 4 at week eight. 

As always, listen to your body and use proper form as shown in the videos. If anything feels strange or painful, stop and seek guidance to ensure your overall safety.