Exercise After Breast Reconstruction: No Extreme Workouts

I recently saw a patient who was almost 4 years post-double mastectomy and cancer reconstruction. She had participated in a Pilates session that utilized spring-based equipment – a new workout regimen for her. She decided she wanted to kick her workout routine up a notch. This gal is strong, has worked out regularly her entire adult life and was a college athlete. 
Yet, during this workout, she over-stretched her pectoral muscles, which caused her implant to bulge out on one breast. All it took was this one workout to over-exert her tissues. And, she felt no pain from it.
This unfortunate incident is going to result in the need for an additional surgery to strengthen her breast tissues, using a mesh substance. The lesson here? Ladies, when you have cancer reconstruction surgery, you have less tissue to start with than the woman who undergoes a routine breast augmentation. Therefore, you need to be careful when working out – and not just in the short-term after surgery. My advice to this patient going forward was to not perform any exercises that directly expand and contract her pectoral muscles. 
In general, that means no planks, no downward dogs, no pec flies or other pec weight-bearing exercises and no push-ups. And, definitely no Pilates workouts that require using your arms and pecs to lift or pull your body weight. Other upper body exercises that work the biceps, triceps and shoulders are generally ok.
When in doubt, ask your plastic surgeon what your own body tissue will allow – and what you are able to do – before you embark on a workout routine. And please, no extreme workouts.