How Painful Was Your Breast Augmentation with Under the Muscle Placement?

On a scale from 1-10, how would most women rate the pain of gummy bear Breast Implants with sub-muscular placement? I will be doing this with stomach and thigh PAL Liposuction.

Doctor Answers (13)

How Painful is breast augmentation surgery?

The most important aspect of postoperative pain control following subpectoral breast augmentation is the surgical technique.  Local anesthetic infiltration prior to incision and meticulous, gentle, minimally traumatic surgical technique, in combination with highly effective non-narcotic, anti-inflammatory pain medications - both preoperatively and postoperatively - will allow many patients to have a 24-hour return to routine, non-strenuous activities of daily living without any need for postoperative narcotic pain medications like Vicodin and Percocet.
Postoperative local anesthetic administration is also effective in reducing postop discomfort and speeding the return to routine activities of daily living, and some plastic surgeons have incorporated this into the care of breast augmentation patients.  For many years I used the On-Q ‘pain buster’ which is a closed system that delivers a long-acting local anesthetic medication through catheters placed into the implant pockets during the breast augmentation surgery.  The On-Q (and others like it such as the GoPump etc) allows continuous infusion of bupivacaine (Marcaine) into the breast implant pockets for 2-3 days postop, and makes the recovery narcotic-free for most patients. The major downside of the On-Q and other similar devices is the balloon reservoir and catheter system that patients would have to manage (i.e. carry around in a pouch and attempt to conceal under clothing) for the first two to three days.
A sustained-release form of bupivacaine called Exparel has recently been developed (FDA approved in 2011) which eliminates the need for pain pumps following breast augmentation.   Exparel is injected around the base of the breast prior to implant placement, and provides about 48 hours of local anesthesia following surgery.  Not only are the catheters and reservoirs eliminated, but also the effectiveness of bupivacaine appears to be higher when infiltrated directly into the periphery of the breast (where sensory nerves pass through) compared to infusion of bupivacaine into the implant pocket around the implant through a catheter system.  Which makes sense, as it’s not the breast implants that need the local anesthetic, it’s the surrounding breast tissue.
With this approach to postoperative pain control, patients are usually pain-free in the recovery room, and report a sensation of pressure or ‘tightness’ over their sternum.  When I call patients in the evening later that day, they in most cases are not in pain and have enjoyed a normal dinner.  Arm range-of-motion exercises can begin immediately, including locking the fingers of both hands together with arms extended fully overhead, and with arms extended fully behind the back.  Patients usually report some soreness but no severe pain when seen in the office two or three days after surgery. The goal truly is a 24-hour return to non-strenuous activities of daily living.
This kind of outcome is achievable in some patients without the administration of Exparel intraoperatively, but it is impossible to identify who those patients are preoperatively.  So our practice is to administer Exparel to all breast augmentation and augmentation mastopexy patients to ensure the highest possible level of postoperative pain control and the lowest likelihood of need for oral narcotic pain medication at home.  

Raleigh-Durham Plastic Surgeon
4.5 out of 5 stars 41 reviews

Pain with Breast Augmentation


The VAST majority of women having Breast Augmentation in our practice tolerate it extremely well and resume near full normal activities (gym and heavy lifting excluded) in 2 days or so.

It has been demonstrated that the degree of post-surgical pain is related to surgical technique (minimizing pulling of tissues bluntly, avoiding contact with ribs and cartilage and controlling bleeding precisely). It is also related to the age of the patient (women who had children do better than those who have not) and educating the patient on what to expect after surgery.

To read learn everything you need to know about BREAST IMPLANTS and BREAST AUGMENTATION, follow the link below -

Dr. P. Aldea

Peter A. Aldea, MD
Memphis Plastic Surgeon
5.0 out of 5 stars 62 reviews

Depends on your pain tolerance

The pain from sub muscular breast augmentation moderate, and can be easily controlled with postoperative pain medicine.  Most patients feel well within the first week.  Some are well within a day!

Gary Lawton, MD
San Antonio Plastic Surgeon
4.5 out of 5 stars 11 reviews

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Post operative pain

Pain varies from patient to patient and with size of implant. You will be uncomfortable for a few days, but it's nothing you can't handle. Best of luck.

Grant Stevens, MD
Los Angeles Plastic Surgeon
4.5 out of 5 stars 67 reviews

Less pain with Breast Implant surgery


A breakthrough medication, Exparel, is now being used for Breast Implant surgery.  This medication is placed at the time of surgery and provides for 3-4 days of pain relief.  Recovery is now quicker and time back to work is shorter!

David Finkle, MD
Omaha Plastic Surgeon
5.0 out of 5 stars 45 reviews

Post-operative pain after breast augmentation


Most patients have mild discomfort for 1-2 days after submuscular breast augmentation. I agree with Dr. Aldea that it is really dependent upon the surgical technique used. If we as surgeons are gentle with your tissues during surgery, you should have no more than minor discomfort and be back to regular activity within several days. Traditionally patients were told that submuscular augmentation was much more painful than subglandular, but that is not necessarily the case. Good luck, /nsn.

Nina S. Naidu, MD, FACS
New York Plastic Surgeon
4.0 out of 5 stars 5 reviews

Postoperative pain following Breast Augmentation with Implants


The varying pain response to this operation is truly amazing to me despite the use of identical techniques and implants.

Some of my patients require nothing more than Tylenol while others have necessitated the use oxycontin for up to 6 weeks.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
5.0 out of 5 stars 44 reviews

Breast Augmentation and Pain


It really doesnt depend on the type of implant but the size. Also, it depends on the patient and how meticulous the dissection is. To minimize the post op pain and medication requirement, the dissection needs to be meticulous.

Having said that some patients have more pain than others. In general most of my patients take pain medications for 1-2 days.

Hope that helps.

Farbod Esmailian, MD
Orange County Plastic Surgeon
5.0 out of 5 stars 39 reviews

Pain associated with submuscular breast implants


I always counsel my patients that submuscular BAM is one of the most painful procedures I do. That said, the perception of pain is very subjective so not everyone has the same experience. Most people complain of tightness or "an elephant" sitting on the chest.

Your past experience with pain will be a good indicator. The type of implant does not matter.

Scott E. Kasden, MD
Dallas Plastic Surgeon
4.5 out of 5 stars 47 reviews

Pain after submuscular breast augmentation


For the most part post-op pain varies with the individual. Using the same technique some will have pain and some will say it was no pain at all. Younger women with tight chest skin will likely have more pain than older women who generally have less tight skin.

Saying that the pain is technique dependent is a good marketing message but all board certified Plastic Surgeons should use good technique; and even if you use a good technique, if a patient has post-op bleeding, it will hurt more than one that does not have any bleeding.

Walter D. Gracia, MD
Arlington Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.