Would Breast Augumentation the Second Time Around Be More Painful?
- Asked by executivemom2007 in Boston
- 5 years ago
If you have had augumentation in the past and had them out. Would having the surgery again to put them back in be as painful. Even if it is done under the muscle again?
Breast Implant Pain the Second Time Around
Thank you for your important question. Generally speaking Breast Implant pain is less when an exchange of Breast Implants is done at the same time, as the pocket does not need to be totally re done.
However since it has been some time since your explantation your surgeon will in essence be starting over again, so you may experience similar discomfort to that of your original procedure.
Second Time Around Much Less Painful
The stretching of the muscle over the implant is most often the part that is most uncomfortable.
Because the pocket had already been created, a second augmentation is usually less painful.
Your question depends on a number of factors. If you are...
Your question depends on a number of factors.
If you are planning on being of similar size, through the same incision and in the same tissue plane (ie below the muscle) and have a relatively small amount of scar tissue then the pain will likely be less than you originally experienced.
If any of the above is changing then you may or may not have pain.
In my practice, we have an effective regimen for managing post-op breast augmentation pain that can include pain medication, muscle relaxers, appropriate post-op garments and pain pumps that greatly reduce post-op discomfort.
Talk to your surgeon about your concerns and find an effective way to minimize your post-op pain!
I hope this helps.
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The pain will most likely be the same as the first operation.
It sounds as if you had a problem with the first breast augmentation, or were just unhappy with the results. Either way, the pocket that was created to place the original implant has healed. If this was under the muscle, your surgeon will need to reopen the pocket to place the new implant. You should anticipate similar discomfort to the first operation. I would recommend an On-Q pain device to help with the pain. This is a small catheter placed at the time of surgery, under the muscle. The catheter from each breast is connected to a small pressure ball that would be located in fanny pack. This would be filled with medication that would automatically provide you with pain medication directly into the breast for 48 hours. We utilize these pumps in our practice and most augmentation patients do not require any pain pills post op.
Depends on the pocket
If you are simply replacing an implant for a new one in the same pocket without much pocket revision, there is virtually no recovery especially when compared to the first time. If your pockets have healed over or if the implants are being placed in a new pocket location, the recovery is the same as the original surgery.
Second Helping of Breast Augmentation
After explantation, there may be some collapse of the space where the implants were originally placed. If this pocket had been located behind the pectoral muscle, re-opening the pocket may not be as painful as the initial Breast Augmentation procedure.
Most of the pain from sub-pectoral Breast Augmentation comes as a result of the surgeon retracting or lifting the muscle in an effort to enlarge the space under the muscle sufficiently to accommodate the implant.
The larger the space created, massaging the implant around the large space post-operatively lessens the risk of encapsulation, which is a benefit. Since this "pain" is mostly due to muscle spasm, I find that my patients get good relief from a combination of muscle relaxers and pain medications.
It is very important to move the implants around the pockets while the space remains large in the first few days after the surgery, which is also when it is the most painful, so I engourage the liberal use of pain medications and muscle relaxants during this time.
In addition, the use of nerve blocks and topical local anesthetics instilled into the breast implant pocket during surgery can also lessen the pain for the patient.
Pain is unpredictable
Usually a subpectoral augmentation is less painful the second time around although if you had the implants out and the muscle pocket needs to be re-dissected, this may not be the case. In general, pain is unpredictable but can be reasonably controlled with local medication infusion and oral narcotics. Expect pain for no more than 24-72 hours in the usual case.
There will probably be some discomfort
Much of the postop discomfort from breast augmentation is due to the stretching of the muscle by the implant. If the muscle is already stretched, this pain will be less. In your case, it is difficult to know how much discomfort you will have, but I would be surprised if it's worse than your first procedure.
The pain involved in submuscular breast augmentation is usually due to stretching of the muscle
If it has been an number of years since your original breast augmentation you may not expect much change from the original pain that you experienced. Pain, however, is a very subjective quality. Typically when I perform a breast augmentation I do several things in an attempt to make the post operative recovery as smooth and painless as possible. I usually give a long acting block to the main nerves that supply the breast. This helps to keep downt the pain for the first 6 - 8 hours. Next I place a long acting local anesthetic in the breast implant pocket along with an anti-inflammatory drug (NSAID). It is also important to get as little blood in the implant pocket as possible, the less the bruising the less it hurts.
May factors are involved in secondary breast augmentation
Many factors are involved in secondary breast augmentation. If you are having the implants switched out, the surgery is less involved than the primary surgery -- since the muscle is already dissected and the pocket is already formed. If I am understanding your question correctly, you have already had the implants removed and now you are considering returning for placement of new implants. In this case, there is a likelihood that the muscle will be scarred down and will have to be dissected again. (This is assuming that your original implants were sub-muscular). If your original implants were sub-glandular and now you are having sub-muscular implants, then the difference between the primary and secondary surgery would be negligible.
I hope this is helpful.
David Shafer, MD
Shafer Plastic Surgery
These answers are for educational purposes and should not be relied upon as a substitute for medical advice you may receive from your physician. If you have a medical emergency, please call 911. These answers do not constitute or initiate a patient/doctor relationship.