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Would Breast Augumentation the Second Time Around Be More Painful?

asked 3 years ago by executivemom2007 in Boston
Latest answer by Naveen Setty, MD
Question viewed 5,749 times
Tags: explant, pain

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?

26 answers to Would Breast Augumentation the Second Time Around Be More Painful?

+2

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.
Paul C. Zwiebel, MD

Denver Plastic Surgeon

www.pzwiebel.com

+2

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,... more
Steven H. Williams, MD

San Francisco Plastic Surgeon
+2

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. ... more
David A. Dreyfuss, MD

Chicago Plastic Surgeon
+2

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.
Richard P. Rand, MD, FACS

Seattle Plastic Surgeon
+2

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,... more
Athleo Louis Cambre, MD

Los Angeles Plastic Surgeon
+2

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.
Robin T.W. Yuan, MD

Beverly Hills Plastic Surgeon
+2

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.
Shahram Salemy, MD

Seattle Plastic Surgeon
+2

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... more
Jeffrey Zwiren, MD

Atlanta Plastic Surgeon
+2

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... more
David Shafer, MD

New York Plastic Surgeon
+1

Pain after revision breast augmentation

Pain after revisional breast augmentation often is less than the original surgery.  Of course, this depends on many factors.  If the implants are placed in the same location as the original implants all in one procedure, there can often be minimal pain.  However, if implants are changed to a new location, there can be an increase in pain (probably still less than the original surgery).  Finally, if implants are removed and left out for a several months to years,... more
Naveen Setty, MD

Plano Plastic Surgeon
+1

Pain after Revision Breast Augmentation

Hello Executive Mom in Boston- In my experience, revision breast surgery is typically not as painful as the first time around....however, this obviously depends on what exactly the reasons involved are and the surgical plan your surgeon has for you.  Great question to ask your surgeon as he or she can give you a heads up...important for post-operative planning of lifestyle, help at home, recovery expectations! Hope this helps and good luck! Dr. C
John Philip Connors III, MD

Atlanta Plastic Surgeon
+1

Breast augmentation revision and pain

Pain after breast implant revision depends upon many factors including: the degree of capsule surgery that you need, placement of the implants, and incision location. If the reaugmentation is simply an exchange of implants (either larger or smaller) in the same place then the discomfort associated with surgery is typically less than the original operation. When changing the position of the implants, performing extensive surgery on the implant capsule, or even changing the incision the... more
David Bogue, MD

Boca Raton Plastic Surgeon

www.drbogue.com

+1

If the original scar tissue capsule remains the recovery from second surgery can be relatively painless.

Replacing implants in the same plane, such as under the muscle, after they have been removed for some time may be quite easy if the original scar tissue capsule remains. There is a natural production of scar tissue around all implants that completely encircles the implant. If this capsule is still there when your surgeon goes to reinsert your implants the procedure can go quite easily and the recovery much less painful then the first time. This is because the surgeon does not have to... more
David A. Ross, MD

Chicago Plastic Surgeon
+1

Revision breast augmentation should not be too painful

Pain is a very subjective thing, and so it is hard to make any promises. If your muscle has already been stretched, I would anticipate that your surgery would be a bit less painful the second time around.
Adam David Lowenstein, MD

Santa Barbara Plastic Surgeon
+1

Revision breast augmentation is minimally painful

Breast augmentation is the most common cosmetic surgery in the United States because it provides a consistent way for a woman to change the shape, position and size of her breasts. The discomfort from implant comes from lifting the pectoralis muscle off the chest and placing implant underneath. As your body becomes used to this implant, the discomfort will fade. Now that you have had a breast augmentation you've already done the hard work. A revision surgery or an implant exchange... more
B. Pat Pazmino, MD

Miami Plastic Surgeon
+1

Revisional breast surgery usually not as painful as primary operation.

Most of the time revisional surgery is not as painful as the original operation particularly submuscular placement.  However, if you have had your implants taken out for some time and now choose to have new ones placed below the muscle, this comment probably doesn't apply to you.  The pain will probably be similar.  I wonder why you had the first ones removed?
Vincent N. Zubowicz, MD

Atlanta Plastic Surgeon
+1

Pain associaed with a second breast augmentation

If you previously had subpectoral (under the muscle) breast augmentation, had them removed, now want implants under the muscle again, it may be just as painful as your initial surgery.  If the new implants are placed subglandular (in front of the muscle) the recovery would be much easier for you.  It's difficult to say for sure because there may be some scar tissue from your first surgery surrounding your pectoral muscle making that subpectoral pocket technically difficult... more
William Bruno, MD

Beverly Hills Plastic Surgeon
+1

Less pain with breast implants the second time around (remove and replace only)

In my experience, the vast majority of pain with a revision breast augmentation is a fraction of the intiial procedure and I would estimate probably less than 30% (based on pain medication use). This is true for straightforward breast implant removal and replacement and does not include lifts, revisions, capsulorrrhapy, capsulopexy, capsulotomy, size change, etc. see video
Otto Joseph Placik, MD

Chicago Plastic Surgeon
+1

Breast implant secondary surgery

Usually, secondary breast implant surgery is not as painful as the first surgery. However, in your case where the implants were removed, it may hurt a bit more than say a person who had an exchange. It also may hurt a bit more if you are going in a submuscular pocket but had subglandular before.
Steven Wallach, MD

Manhattan Plastic Surgeon
+1

Secondary surgery usually hurts less

Hello, The fact that you have had your implants removed and are now having them replaced may throw a monkey wrench into this however. The question is how tight are your tissues and will they stretch with the implants quickly. Is there any scar in there? What does your surgeon say? I would say it will still likely hurt less unless you are having much larger implants placed.
John P. Di Saia, MD

Orange Plastic Surgeon
+1

Breast Augmentation and Pain: Revisional Surgery

Breast augmentation is performed under general anesthesia in a sterile surgery center. Postoperatively, patients complain of pain along the incision site and heavines along their chest. Patients typically feel more pain with a submuscular implant vs. a subglandular implants. Revisional breast augmentation surgery is less painful as the implant pocket is already dissected and well formed. In some cases, patients will need a capsulotomy or capsulectomy, which will cause more pain after surgery. more
Raffy Karamanoukian, MD

Los Angeles Plastic Surgeon
+1

No pain, no gain?

Postoperative pain is a very hot topic these days and a strong focus of many medical device and pharmaceutical manufacturers. Several intraoperative techniques, insertable and topical devices and newer generation medications are now available that were not available in the not so distant past. So, even though the implant reinsertion would cause the same pain, there are effective means of alleviating it. Breast augmentations in my practice are relatively pain free today. Good luck! more
Kenneth R. Francis, MD

Manhattan Plastic Surgeon

www.francisnyplasticsurgery.com

+1

Second surgery usually not more painful than first surgery

In my practice, 95% of the patients for breast implants do not take their prescription pain medicine at all. The 5% that elect to take the medicine usually regret it, as the medicine can cause nausea, constipation and make you light headed. Instead, I recommend only extra strength Tylenol, occasionally with Valium. At the end of the surgery, the area is filled with long acting local anesthesia allowing the patients to be free from discomfort. This is true of primary as well as possible... more
Darrick E. Antell, MD

Manhattan Plastic Surgeon
+1

A second breast augmentation would probably be more painful

You describe the situation of the patient who has decided to remove their implants for some reason or another. Once the old implants are out the pockets will typically close down. The pectoralis muscles will tighten up to their preimplant size. Redoing the augmentation with reopen the pocket and restretch the muscles leading to a similar amout of postop pain typically. If you were just switching out old implants most patients will agree that it is much easier the second time around because... more
Manish H. Shah, MD

Denver Plastic Surgeon
+1

It depends how long it has been since the first operation

I f the implants have been out for several months and the pocket is closed, then it will be painful. But, if the pocket is still open, then it won´t be as painful. Also, generally, if you are getting larger implants than you had before, they will hurt more.
Usha Rajagopal, MD

San Francisco Plastic Surgeon

www.sfcosmeticsurgery.com

+1

Probably less painful

Since the implant pocket has been created before, repeat surgery is often less painful. But don't make the decision because of this. Breast augmentation in general is not very painful.
George J. Beraka, MD

Manhattan Plastic Surgeon

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