Sleep is one of the most important elements of recovery after any surgery, including breast surgery. Having experienced multiple breast surgeries in the past 14 months, I wanted to capture a few elements of my post-breast-surgery sleep routine. My strategy is based on what I've discovered works for me, advice from friends and ideas from the experts.

After all three recent breast surgeries—a bilateral mastectomy with immediate reconstruction in July 2023, an explant of my right implant in August 2023, and an explant of my left implant and reconstruction with two new implants in September 2024—I have taken a similar approach to sleeping.

I have greatly benefited from the kindness of a friend who leant me a wedge pillow that she used after recovering from her own breast surgery. Sleeping on one's back on an incline following breast surgery is recommended by many plastic surgeons. Several said that sleeping on one's back keeps the breasts in an optimal position for healing. The length of time to sleep on one's back varied from a minimum of 4 weeks to as many as 8-12 weeks. For my part, I returned to sleeping on my sides 7 weeks after my August 2023 surgery. I expect that I will be able to sleep on my sides 6 weeks after my latest surgery, given how quickly and smoothly my recovery is going.

For this round of healing, I have placed a pillow under my knees when I sleep. The experts say this helps to support the lower back. More importantly for me, it appears to reduce strain on my knees. Last summer, after spending 7 weeks sleeping on my back, I found that my knees were stiff and sore. I have yet to experience that this year, and I attribute that to sleeping with a pillow under my knees. Also to support my lower back, I have added a peanut-shaped pillow, which I place in the small of my back at the base of my wedge pillow.

In addition to a pillow propped against the wedge pillow for softness and support, I sleep with a second peanut-shaped pillow behind my neck. This small pillow fills the gap between my head and the pillow and gives me something to rest my head on if it falls to one side or the other. Both peanut pillows were gifts from a friend.

My surgeons and other experts whose online content I read recommended wearing a comfortable but supportive bra, both during the day and while sleeping. I have not found this difficult, as I feel more secure knowing that my breasts and the implants are well supported at all times.

Though the following strategy is not unique to my recovery period, it is helpful for calming my mind and enabling me to quickly drift off to sleep: I listen to vocabulary in languages I'm trying to learn. In fact, I've created a Spotify playlist that includes 35 hours of vocabulary in English-Portuguese, English-French, English-Italian and French-Portuguese.

Despite all the things I'm doing right—the above techniques plus consuming no caffeine or alcohol, wearing a sleep mask to block out any light, and sleeping in a cool room, in comfortable bedding, in light clothing (usually little more than a t-shirt and undergarments)—I still struggle to follow some of the best advice for getting a good night's sleep. I go to bed at inconsistent times. I haven't adopted a 30-minute wind-down period before turning out the lights. I use electronics (laptop or cell phone) right up to the moment I try to go to sleep.

Nevertheless, I find it helpful to acknowledge what I'm doing right, while gently reminding myself of the improvements I can continue to make to get a rejuvenating and healing night's sleep.

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