Would Breast Augumentation the Second Time Around Be More Painful?

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.

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, replacement of these implants can lead to similar pain like the original augmentation since the breast tissue/muscle will need to be stretched again.

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

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?

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 to dissect.  You should consult with a board certified plastic surgeon and obtain your previous operative reports to help outline the best surgical plan for you.

On a related note, patients who have implants and then want to increase the size of the those implants, usually have a very easy recovery in terms of pain.

Best wishes,

Dr. Bruno

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.

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.

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 secondary surgery.

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 the breast capsule is already stretched out and you don't have to go through that part again.
Dr. Shah

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.