I had a bilateral mastectomy with immediate reconstruction. They put temporary implants called spacers at that time. Your plastic surgeon then gradually puts saline or air in the implants on a routine schedule until you reach the size both you and the surgeon find acceptable. Once that is done, they exchange the spacers with permanent implants. Everyone is different with recovery, but I found it easier than I thought. The saline or air filling is painless. It does ache a few hours later, but not uncomfortable in 24 hours. I had no pain when they exchanged implants. You really have very little feeling in the breast area. You will have drains which will stay in 1-3 weeks. Not painful, but they are annoying. Once my drains were removed (3 weeks), I was released to resume working out with limited weighs, and chest work. While not a picnic, much easier than expected. Best of luck.