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Breast Augmentation

How much pain can you expect after a breast augmentation surgery?

QuebecViv
4 months ago

I've been thinking about getting my breasts enlarged for a while now, but I'm worried about the pain after recovery. All the stuff I see on the news about the opioid crisis makes me nervous about taking strong painkillers. Is the pain something I could manage with some Advil or will I need something stronger?


Josef Hadeed, MD, FACS Beverly Hills, CA
4 months ago
SURGEON PROFILE PROFILE

Hello QuebecViv,

Thank you for your question. You can expect to have some degree of pain after breast augmentation surgery. In general, the average number of days that you may reasonably expect to be in pain is several days after breast augmentation. Some women do well on extra-strength ibuprofen after the procedure, while others may need something stronger. During your consultation with your plastic surgery be sure to bring up your concerns about taking opiods after surgery. Please remember to seek a consultation with a board-certified plastic surgeon who is board-certified by the American Board of Plastic Surgery and a member of the American Society of Plastic Surgeons. Best wishes moving forward!

Josef Hadeed, MD, FACS

Shashidhar Kusuma, MD Plantation, FL
4 months ago
SURGEON PROFILE PROFILE

Hello,

Breast augmentation pain depends on the placement of the implant; sub muscular or sub glandular. Generally sub muscular is more painful than sub glandular placement. Also the size of the implant and atraumatic dissection has an impact on pain. In addition managing pain before incisions are made proactively, during the surgery, and also at the end of surgery, to stay ahead of pain helps a lot. Long acting local anesthetics help manage this well. It is important to stay ahead of the pain. As soon as surgery is done, it is important to maintain consistent dosing of non narcotic meds such as ibuprofen, Tylenol and icing to manage pain. In other cases, some short term narcotics help. We have also found that using muscle relaxers for a couple of day helps especially in sub muscular placements. But in most cases, patients do very well after about 3 to 4 days.

Thomas Fiala, MD, MBA, CPE Altamonte Springs, FL
4 months ago
SURGEON PROFILE PROFILE

Hi.

Most of our patients use a high dose Ibuprofen and a muscle relaxer ("Flexeril") after their breast augmentation surgery. With this combo, they rarely need narcotic pain medications - and even the patients that do use them, don't need them longer than a day or two. And this is with implants placed using the dual-plane technique.

But there is a certain way to do the surgery - premedications, lots of local anesthetic, careful & precise pocket dissection, etc. Find a surgeon who is familiar with the "rapid recovery" methods.

Debra Johnson, MD Sacramento, CA
4 months ago
SURGEON PROFILE PROFILE

No pain, no gain! But, really, it’s not too bad. Feels like you did 100 push-ups the first day, 50 push-ups the second, and 25 the third day. Usually by 4-5 days you’re feeling pretty good, able to drive if you’re off pain med. I suggest one week off work and two weeks without vigorous exercise. Talk to an ASPS surgeon for more definitive. And personalized info!

Rick Rosen, MD Norwalk, CT
4 months ago

Thank you for your question. I have found that using Exparel has done a great job at reducing the level of pain and makes it much easier with less narcotic used in the first three days. With an appropriate sized implant, most women now inform me that it is very tolerable. I have found that most people are able to return to work in 5-7 days and be off narcotics after 3-4 days. I would recommend you look for a board certified plastic surgeon in your area and start with a consultation.

Jon Ver Halen, MD Colleyville, TX
4 months ago
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Hello and thank you for your excellent question. Congratulations on your decision to have a breast augmentation! Our patients are very happy with this decision.

In general, we all try to minimize narcotic use postoperatively. We try to prevent pain during the surgery using local anesthetic nerve blocks, and postoperatively with the use of anti-inflammatory medications like ibuprofen or celebrex, and non-narcotic pain relievers like neurontin or tramadol. This way, narcotic use can be minimized.

It is essential that you have an in-person consultation to develop a treatment plan that specifically addresses your personal surgical goals, and your body’s anatomy. Be sure to have all of your questions answered during a face-to-face meeting with your surgeon, and review before and after pictures of similar patients whom have had this procedure. If you have any questions, call our office for assistance. Good luck!

Best,

Jon Ver Halen, MD FACS

Austin Hayes, MD Hillsboro, OR
4 months ago
SURGEON PROFILE PROFILE

Thank you for your question. It's common to wonder about pain after breast augmentation surgery. Most of my patients will only take ibuprofen, but I also provide them with stronger pain medicine to use as needed. I find that women who are very motivated to avoid the stronger pain medicine will use only ibuprofen without 90% of the time. Speak with your board-certified plastic surgeon about the types of pain medicine that their patients require after breast augmentation surgery. Good luck with the process!

Thank you for your question. Breast augmentation is a very rewarding procedure and if done correctly by an experienced surgeon, you should have a very straightforward recovery. Of course it is still surgery so there will be SOME degree of pain, but I find that my breast augmentation patients do very well after surgery and really don't have pain as a major complaint. Most patients describe a sense of fullness & pressure immediately after surgery that subsides fairly quickly. In fact, I often have to remind my patients not to overexert themselves right after surgery because they are feeling so good. Most patients will take some prescription pain killers for a day or two after surgery and then switch to either ibuprofen or acetaminophen. Even if you need the prescription pain medications, it would be extremely rare for you to have any issues or complications from the meds as long as you take them as directed. Best wishes to you!

That is a very common concern of patients considering breast augmentation. Several years ago we started using Exparel during breast augmentation surgery. Placing this medication directly into the breast pocket during the procedure has significantly decreased our patients’ post-operative pain and need for oral medication. We also prescribe a muscle relaxer to help decrease feelings of breast tightness. Most of our patients report discomfort similar to doing a lot of push ups for approximately three days post-op. We recommend that our patients avoid medications like ibuprophen, because this may lead to increased bruising and bleeding post-operatively. The benefits and patient satisfaction following breast augmentation far outweigh the few days of discomfort. Thank you so much for your question and good luck to you!

Moneer Jaibaji, MD Coronado, CA
4 months ago
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Thank you for the question. Pain after breast augmentation is very variable. Most patient will end up needing some opioid for the first few day after surgery. This should not cause an addiction issue. Some patients can get relief Wirth simply using Tylenol. I do not recommend using Advil after surgery because of the bleeding risk. Your plastic surgeon will advise you on pain control after surgery. Bes

Keith Blechman, MD New York, NY
4 months ago

It's a very common question. Fortunately, the pain is manageable with mild medications and over the counter pain killers. In fact, I have not prescribed an opioid for an outpatient breast surgery in over a year! Good luck with your procedure and be sure to always see a plastic surgeon certified by the American Board of Plastic Surgery.

Steven Wallach, MD New York, NY
4 months ago
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Most of the time patience tolerate a breast augmentation very well. When placing it in a dual plane, there certainly is a little bit more pain than a sub glandular pocket placement. This is because to place it in a dual plane, the muscle is divided along it’s inferomedial attachments. On a scale of 0 to 10 most patients That have breast augmentation Feel that the pain is about a six out of 10 but usually within a few days they feel much better.

Katerina Gallus, MD San Diego, CA
4 months ago
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Hello and thank you for your question! The pain after augmentation is dependent on the patient and the surgical technique. In general, you can expect to have discomfort for 1-2 weeks that is managed with NSAIDs or other over the counter medications and sometimes narcotic pain medication. I use pre-operative medications and Exparel (a long-acting local anesthetic) during surgery to minimize discomfort after surgery. There are different protocols available for a non-narcotic recovery after surgery so if that is something you are interested in, seek out a board-certified plastic surgeon who can work with you to provide the recovery you desire.

Best of luck!

Dr. Katerina Gallus MD FACS

Trent Douglas, MD San Diego, CA
4 months ago
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Thanks for your question and doing your research to find a qualified board-certified plastic surgeon. Recovery will depend on the individual patient as well as the technique used. Postoperative discomfort is managed in our practice with NSAIDs and a muscle relaxant. We use the long-acting local anesthetic, Exparel, to get up to 72 hours of extended postoperative pain relief. Patients tend to experience tightness and discomfort over the first few days but rapidly recover and are on to their usual activities within a few weeks. Minimal or no-opiod recovery protocols are being established to help combat the opiod crisis so please see a surgeon in your area who can work with your goals for both surgical outcome and recovery. Best wishes on a speedy recovery and great result!

David Berman, MD Sterling, VA
4 months ago
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Everyone is different. However, I have my patients start stretching immediately and I believe that helps a great deal. Almost all of my patients return to work in 4-5 days. Of course, they are given medication at the time of surgery, which will be helpful.

see a board certified PS and you will be in good hands.

Great question. My patients are typically off all narcotic pain medicines within 2-3 days after surgery. I use Marcaine in the pocket at the end of the procedure and preoperative and postoperative muscle relaxants and anti inflammatory medicine. Most patients stay on these two for 4-6 days after augmentation. For the pain 25 years, I have also used, MLD (manual lymphatic drainage) postoperatively to rapidly decrease the swelling, which also decreases the pain. The key is that you are getting informed through the best source of information, that is from Plastic Surgeons who are certified by the American Board of Plastic Surgery and who are members of ASPS. Good luck.

Eugenio Aguilar, III, MD Houston, TX
4 months ago

I’ve found that we do not use narcotics at al in our post-op pain medicine regimen. We use anti inflammatory medications that work very well. We inject anesthetic into the pocket as we are closing the incisions and that gives a full day of relief. Exparel is a great tool to use as well. Please don’t be afraid we have come a long way in pain management for breast augmentation.

Michael Kulick, MD San Francisco, CA
4 months ago
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There are two factors that determine one's "pain" after a procedure. One is the actual procedure and most would agree if the implants are put below the muscle vs. on top of the muscle, the former is more painful. How one processes the painful stimuli is another important factor. Some patients have a lower pain threshold. However, your consultation with a Board Certified plastic surgeon will determine the correct implant placement and post operative pain management.

Regarding the opioid crisis, this usually is referring to doctors that provide opioids for financial gain vs. following a surgical procedure. If you need to use narcotic, that's the right thing to do.

Hope this helps.

Sachin Shridharani, MD New York, NY
4 months ago

Breast augmentation surgery is the most commonly sought after cosmetic surgery procedure in the United States. Like any surgical procedure, there is some discomfort involved with having an incision on your body. One of the biggest factors in having breast augmentation is implant placement. Many surgeons opt for placing the implant "below the muscle," which often entails more pain. Nonetheless, patients liken the pain the first few days to having performed "a lot" of push-ups and then progressively less pain as the week continues. A good regimen of anti-inflammatory medications with long acting local anesthetics paired with good surgical technique leads most patients to be off narcotic pain medication by 2-3 days after surgery.

Javier Jesus Vera Cucchiaro, MD Salta - Argentina
4 months ago

The pain varies according to the plane of placement: sub glandular, sub fascial o sub muscular. If an intercostal and pectoral nerve block is used, it helps a lot in the postoperative pain.

Hello. Thank you for your question. After a breast augmentation, pain can vary depending on the patient's pain tolerance and the placement of the implant. If you've had children, expect to experience pressure in the chest area similar to being engorged or feeling urge to pump (like during breast feeding). If you've never had children, you may experience a heaviness like carrying a backpack on your chest.

While pain medicine may be prescribed by your surgeon, many patients only take Tylenol or Tylenol extra strength instead to help manage pain. Advil or similar NSAIDS are generally (but not always) avoided as they thin your blood and may increase risk of post surgical bleeding. I hope this helps!

Dr. Ghaderi

Hello Ms Quebec,

The discomfort after breast augmentation varies between persons and surgeons. My patients do great with a long weekend off to rest and ice. The discomfort can be treated with nonopiod medications and if you are hesitant to have the procedure there are alternatives. In addition try to find a surgeon who takes time to handle your tissues with gentle care as well as makes time to place numbing in your pocket and tissues. You should not need strong pain medication after one week and most patients use it for the first few days so if you need it fill it and use it then throw out what is left once your recovered. Opiod is usually an issue with chronic pain but not an issue with breast augmentation. Always share your concern with your surgeon. Best of luck!

Steve Vu, MD, FACS Huntington Beach, CA
4 months ago
SURGEON PROFILE PROFILE

Very fair question to ask. "How much pain am I willing to endure to improve my looks?" The emotional component to the answer is dependent on your motivation level, your ability to handle anxiety/stress and your innate ability to handle physical pain/discomfort. Those are things that only you would know. As far as the real physical sensation, pain level will likely range between 4 - 8/10. Opioids and muscle relaxers are commonly used post-operatively. I would be concerned about using NSAID's because of the anti-coagulation effect of some medicine. There are alternatives to opioids but they may not be as effective. Nerve blocks would help in the first several hours after surgery. I'm not too concerned about addiction complication since my patients aren't taking high enough doses and aren't taken them long enough to build dependency or tolerance, assuming that they are not chronically taking narcotics already. Most patients are able to wean themselves off pain meds in 1 -2 weeks

Michael Law, MD Raleigh, NC
one month ago
SURGEON PROFILE PROFILE

Most women have little to no pain following breast augmentation surgery

Our protocol includes the following measures that have a synergistic effect that result in the major reduction of, or complete elimination of, postoperative pain:

Pre-op administration of three non-narcotic oral medications that have been shown in randomized, blinded clinical trials to reduce the need for postop narcotic pain medications

Pre-incision injection of all incision sites with a combination of local anesthetics

Minimally-traumatic surgical technique, using low-power electrocautery for surgical dissection and hemostasis

Injection of an extra-long-lasting local anesthetic (Exparel) into the inferior margins of the pectoralis major muscles (in the area where they have been divided using electrocautery)

As most of our breast augmentation patients never require postop narcotic pain medication, we do not routinely prescribe it for this surgery




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