Unable to take Rx pain meds due to allergies, what should I expect with pain following surgery?

Question

Hi! Im a 42 year old woman. 5’4” and 125 pounds. I have opted for a conservative submusclar saline implants. I am unable to take Rx pain meds due to allergies. Pain management will be with over the counter Tylenol/Advil. My surgeon feels I can manage my pain with OTC meds. What should I expect with pain following surgery?

Martin Jugenburg, MD · Answer

Hello, thank you for your question. The first 3 day after a breast augmentation are the usually the most of the pain. The submuscular plain can be more sore and tender. You may do well with just over the counter medications however hopefully your plastic surgeon can give a long acting local anesthetic to help reduce the initial pain as you are healing. For more about pain and breast augmentation stories from other patients feel free to check out our website.

Fernando Ovalle Jr., MD · Answer

Hello and thank you for your question. I would review the allergy and reaction you had with the pain medicine with your surgeon. Some patients may report an allergy but in reality this may be an "intolerance/sensitivity" to a medication (nausea, flushing, upset stomach, drowsiness, constipation which are all common side effects of narcotics) rather than a true allergy (hives/rash, wheezing, anaphylaxis). In many cases, there may be another narcotic which is slightly different in its chemical makeup that you may do ok with even though they are in the same class of medication. That said, it is possible to entirely avoid narcotics after breast augmentation. This varies by patient, but a multi-modal pain regimen of tyleno, advil, gabapentin, long acting local anesthesia and possibly muscle relaxers (since you are doing submuscular) should keep you fairly comfortable without the need for narcotics.

Brian K. Reedy, MD · Answer

Thanks for your question! The discomfort for this surgery is usually quite tolerable, although, I wouldn't have my patients using Advil or nsaids early post-op. I would see if Exparel is an option for you as that will also help with post-op recovery. Good luck!

Ted Eisenberg, DO, FACOS, FAACS · Answer

The first three days after surgery, women who have had children commonly say they feel like they did when their breasts were fully engorged with milk after childbirth. Women who have not had children describe the feeling as some tightness, burning or pressure.  The discomfort usually starts to ease up on the fourth day after surgery. More than 90 percent of the patients are back to work in an office setting on the fifth day.
Three-quarters of our patients report no nausea and vomiting from the day of surgery on; the rest report minimal symptoms.
You can take a shower the day after surgery.
By the third day, many women are able to comfortably lift their children. Dr. Ted Eisenberg, Board Certified Plastic Surgeon and Author. RealSelf Distinguished Hall of Fame Inductee. Philadelphia, Pa., USA

Daniel Barrett, MD · Answer

Dear Neat388031,
I understand your concern. It is best that you consult your plastic surgeon regarding post operative care and management (i.e including massage techniques and timing) specific to your case. Your surgeon knows your condition well and has preferences on when and what to use for faster healing and recovery. Post operative care and management depends on the type of surgery performed and the technique used during surgery among other factors.It is best, however, that you follow your plastic surgeon's advice on post operative care management for a smooth and faster healing and recovery.
Daniel Barrett, MD
Certified, American Board of Plastic Surgery
Member, American Society of Plastic Surgery
Member, American Society of Aesthetic Plastic Surgery

Nelson Castillo, MD · Answer

Thank you for sharing your question. It may be possible to handle the discomfort with only Tylenol and OTC medications.  There are other non-narcotic pain medications that can also be used, talk to your surgeon further about these options.

John Reilly, MD, FACS · Answer

Hi, Pain after surgery is variable but overall, submuscular placement tends to be well tolerated. I place long acting numbing medication in the area during surgery. When I have patients who have had allergies to certain medications I give them one pill of an alternative narcotic sometime before surgery as a "test dose" and most often they tolerate it well. This way you know what narcotic works in case you need other surgery din the future. Good luck.

Connie Hiers, MD, FACS · Answer

I would avoid Advil because of the blood thinning properties. Your surgeon could prescribe a nonnarcotic like Tordol or Gabapentin and a muscle relaxer.

Camille Cash, MD · Answer

Recovery is unique to each person.  Typically patients that use prescription pain medications are able to begin switching to over the counter medications after 3-5 days.  You may want to inquire about Exparel which is a pain medication that can be injected during surgery and lasts for 2 or 3 days.

Douglas Taranow, DO, FACOS · Answer

Dear Neat,
What medications specifically are you allergic too?  There are many narcotic and non-narcotic options to choose from.  Has your surgeon discussed Ultracet/Tramadol (a different type of Opioid) or other options outside of Tylenol and Advil (the latter which may cause bleeding and not be taken for 48 hours post-op).
Dr. Taranow

Unable to take Rx pain meds due to allergies, what should I expect with pain following surgery?

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