Strong Pain Medication Prescription After Breast Augmentation and Lift

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?

Doctor Answers 11

Breast Augmentation, breast lifting

Dear Candis

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

Toronto Plastic Surgeon
4.9 out of 5 stars 115 reviews

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.

Christopher L. Hess, MD
Fairfax Plastic Surgeon
4.4 out of 5 stars 33 reviews

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.

Joel B. Singer, MD
New York Plastic Surgeon
3.4 out of 5 stars 34 reviews

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.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 81 reviews

Managing breast pain after augmentation

Thank you for your question. There are many things that can make your post-operative pain tolerable:
1) Injectable numbing done at the time of surgery (some can last for several days)
2) Muscle relaxants so your muscle is not as tense
3) Narcotics to help address pain. Usually more effective if you stay ahead of it
4) Non-narcotic medications (e.g. anti-inflammatories such as Advil)
You often find that discomfort does correlate with size of the implant and the degree of stretching of the soft tissue of the breast.

Young R. Cho, MD, PhD
Houston Plastic Surgeon
4.8 out of 5 stars 37 reviews

Pain management varies patient to patient.

Pain tolerance varies from patient to patient and, for this reason, pain management needs to be individualized.It’s not unusual for patients to have pain following breast augmentation surgery.Some patients describe this pain as minimal while others describe it as severe.In many cases, the quality of the patient’s surgical experience is related to post-operative pain management.
In the immediate post-operative period, patients are given narcotic pain relievers.They are switched to nonnarcotic pain relievers as soon as possible.This usually takes about 7 to 10 days following surgery.
If you’re concerned about pain management, you should discuss the issue with your plastic surgeon.Your surgeon can make adjustments that will hopefully, make your experience a comfortable one.

Richard J. Bruneteau, MD
Omaha Plastic Surgeon
4.9 out of 5 stars 194 reviews

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.

Jeffrey J. Roth, MD, FACS
Las Vegas Plastic Surgeon
4.6 out of 5 stars 17 reviews

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.

John E. Gross, MD
Los Angeles Plastic Surgeon
5.0 out of 5 stars 2 reviews

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.

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 29 reviews

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.

John P. Stratis, MD
Harrisburg Plastic Surgeon
4.5 out of 5 stars 34 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.