American Society of Plastic Surgeons
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Jannie
one year ago
Answered

Pain killers

Hello, my 16 yr old daughter wants to get a breast reduction and we have several consultations scheduled but I’d like to get as many opinions as possible. I am worried about her being prescribed an opioid as a pain killer. Is there a non-addictive pain reliever she can take even if it isn’t quite as effective?

Procedure: Breast Reduction
Type: Question

Replies 7

Rahul Vemula
ASPS Surgeon
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Thanks for huge question. I usually use a long acting medicine called experel which is injected into the tissues at the time of the breast reduction. This should last anywhere from 24-72 hours to provide pain relief. Afterwards I did prescribe my patients a low dose opioid such as Tylenol # 3. However most patients don’t even end up taking this and are able to manage their pain with Motrin and Tylenol.

Best wishes!

Rahul Vemula, MD - Plastic Surgery of the Face and Body

Diplomate of The American Board of Plastic Surgery

Diplomate of The American Board of Surgery

Active Member, ASPS

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Mark Boschert
ASPS Surgeon

Breast reduction surgery is not actually that painful. You may be able to get away with ibuprofen or Tylenol alone. If not the Tylenol with codeine may offer her just enough. The other thing is we can limit the dosing and only give out a small quantity with no refills. It would be extremely rare to get addicted on such a small quantity. Best of luck! Dr. Boschert

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Debra Johnson
ASPS Surgeon
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Unless your daughter has had issues with drugs in the past, the small amount of pain medication given for breast reduction shouldn't cause her any problems. You can certainly control the dosing and interval between pills. She might have enough discomfort for something more than plain acetaminophen for the first couple of days.

There are things to consider in a 16 year old. You want to make sure she has completed her breast development. The breasts usually stop growing about two years after the period starts, but some girls will gain breast tissue into their early 20s. Her weight should be stable. If she is overweight, she should try to get her BMI 25 or below prior to surgery.

Lastly, breast reduction may limit her ability to breastfeed. Ideally, women wait until completing childbearing before undergoing reduction. If your daughter can't wait that long, make sure she understands that implication.

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Curtis Wong
ASPS Surgeon

Your concerns about narcotics are appreciated but a small prescription will not make her an addict. However, you can talk to her surgeon about alternatives to narcotics (there are many), especially if her pain tolerances are on the higher side. The nice thing is breast reduction surgery is not known to be one of the painful ones...

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Daniel Allan
ASPS Surgeon

The appropriate use of narcotics, that is, for 24-48 hours will not produce addiction, and is reasonable. After that, one Tylenol and two Advil should give adequate relief. That combination has been shown to be as effective as Tylenol#3.

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Edward Domanskis

Actually, I have found that patients after a breast reduction do not need opiods and can get by with just tylenol and iprofen. I think they are so relieved that the heaviness is gone.

Dr. Edward Jonas Domanskis is Certified by the American Board of Plastic Surgery

Newport Beach, San Francisco,Miami, EU, Anguilla

Assistant Clinical Professor of SurgeryWOS-Plastic,University of California (Irvine)

Orange County’s Physician of Excellence/America’s Top Physicians/Top Doctors

Plastic Surgery- 2005-2018

President,American Society of Bariatric Plastic Surgeons

Organoderm Skin care/ScaRxTape

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Jennifer Greer
ASPS Surgeon
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Breast reduction is one of the most common procedures I perform, and I have had several patients manage postoperative pain without narcotics. I perform intercostal nerve blocks to help the first night, and start my patients on Celebrex the day before. So this is certainly an achievable goal. What is your daughter's opinion of having surgery without narcotics? At age 16 she is certainly old enough to be involved in the discussion.

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