I am scheduled to have breast augmentation and a mastopexy. I have a high tolerance to pain medication due to chronic muscle pain and I am nervous that they will not prescribe a strong medication after my surgery. What should I do?
Strong Pain Medication Prescription After Breast Augmentation and Lift
Doctor Answers 9
Pain Medication for Breast Augmentation
It has and continues to surprise me that patients don't really complain about much pain following augmentation and/or mastopexy. The reason is that the breasts aren't as sensitive as other areas of the body. And the pain is usually described more as a soreness than actual "pain."
I typically prescribe both Percocet and Vicodin because most patient don't know which will work better with the least amount of side effects. In addition I prescribe Valium because it relaxes the pectoralis muscle spasm that occurs after placing the implants.
A vast majority of my patients take the Valium and or the narcotic pain meds for only a day or two. If stronger pain medication is needed Dilaudid or even oral morphine is possible but in these cases I think evaluation by a pain specialist is important.
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Breast Augmentation, breast lifting
Pain with any surgery can be controlled by a variety of techniques. The most important steps are 1) pre-operative dosing of pain meds along with a medication to dull the nerves, 2) long acting freezing for the tissues during surgery, 3) post operative mobilization, and 4) good early post operative pain control.
You can discuss this with your surgeon.
With Warm Regards,
Trevor M Born MD
Pain relief and management after Breast Augmentation
There is no answer to this other than trial and error. Use of meticulous technique and perhaps the use of bipolar cautery has been claimed to lessen pain but the latter has not been my personal experience. Use of a pain pump is controversial but may provide relief as well. Some anesthesiologists specializing in precise nerve blocks can provide a regional thoracic block to limit perioperative pain. Use of muscle relaxants may also supplement the pain relievers. The use of motrin may be controversial due to its potential for bleeding. Alternatively some physicians utilize celebrex as an antiinflammatory and analgesic.
Of course there are many narcotic analgesics as well and many other options to consider. IF you have extremely low thresholds, you may want to see a pain specialist pre-operatively to prepare you and have them available in the post-operative period.
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Pain control for breast aug with lift with high toleramce to narcotics
If you have a significant chronic pain issue, most patients are under the care of a pain specialist. This doctor usually is in charge of all pain medicine for that patient. The pain specialist can work together with the plastic surgeon to help manage post operative pain.
There are some techniques such as instillation of numbing medicine at time of surgery. Temporary pain pumps that drizzle numbing medicine into the pocket after surgery can be helpful as well.
Make sure your plastic surgeon is aware of this early on so that he may best help to manage this issue.
History of tolerance to pain medication and upcoming surgery
Please discuss your concerns with your plastic surgeon. We want our patients to be as comfortable and pain-free as possible after surgery. If your surgeon knows ahead of time, that you have a tolerance for certain medicines appropriate adjustments can be made.
If you are under the care of a "pain management specialist" , they can be involved as well to help you.
Need for strong pain medications after breast augmentation and lift
I believe that pain management after breast augmentation surgery has to be based upon individual needs. I start with a long acting local anesthetic such as Marcaine 0.25% instilled in the sub-muscular space at the time of surgery. I also use Valium as a muscle relaxer in the post-op period. Both of these measures have reduced the need for oral narcotics in most of my patients. In your case you may require stronger oral pain medications such as Demerol or Diluadid in the early post op period. It is difficult to predict the amount of discomfort ahead of time and it is a matter of trying one method and then switching to another method if the first method doesn't work.
I have used the anesthetic pump post op but I have found it to be more trouble than its worth. I usually have my patients get on NSAIDs such as Ibuprofen or Naprosin as soon as possible because there is an inflammatory component to the post op pain as well.
I hope this helps, but make sure that you express your concerns to your plastic surgeon.
Pain medication post breast surgery
Pain medication requirements are tailored to the individual. This is a topic you should talk with your surgeon about. Some patients only need Tylenol while others require stronger meds like Vicodan/Percocet.
Pain After Breast Augmentation
You need to discuss pain management with your plastic surgeon. Both you and he need to be comfortable with how your pain will be managed. After the procedure is not the time to figure out the pain management, especially since you have recognized that this could be an issue.