Injection into Breast Pocket for Pain

I've read that many surgeons inject a long-lasting anesthetic into the breast pocket during augmentation to reduce pain. I am VERY anxious about having pain & when I asked my surgeon about the possibility of having the breast pockets treated w/ an anesthetic, he said he never does injections & acted annoyed that I would even ask. My surgery is 2 weeks away & I am so anxious & upset by his response & the possibility of pain that I am in tears! Is there anything I can do?

Doctor Answers 16

Pain after Breast Augmentation-To Numb the Pocket or Not to Numb?

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Numbing of the breast pocket is not necessary and its effecitveness is controversial. If your surgeon is gentle with your breast tissue, then you should not need anything like that.

What is important is that your surgeon limits bleeding, bruising, and trauma to your chest wall and breast tissue. There are quick recovery techniques that do this and it is all up to the surgeon you choose. You should not need any strong narcotic pain pills, just Motrin or ibuprofen. There should be no drain or compression wraps used with quick reovery techniques.

You can see the link below for more information on the quick reovery breast augmentation techniques and conroversies.

best of luck and hope all goes well for you.

Beverly Hills Plastic Surgeon
4.1 out of 5 stars 105 reviews

Pain Pump Makes a Big Difference

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Fortunately, the use of a pain pump can make a big diffeence in your post-op comfort. Ask your surgeon if he can provide this for you.

It sounds like your not comfortable with communication with your current surgeon: better to find out pre-op and find someone who will better address your needs.

Paul C. Zwiebel, MD
Denver Plastic Surgeon
4.7 out of 5 stars 46 reviews

Longer acting local can reduce breast augmentation pain

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There are longer acting local medications which we use in the breast pocket after breast augmentation to smooth the transition to oral pain medication. The medication we use is called marcaine and your surgeon is certainly familiar with it. It should give good pain relief for up to six hours after your procedure. The red flag  is that your surgeon seems annoyed with your questions, and perhaps this is sign that your should look for other opinions.

Best of luck,


Peter E. Johnson, MD
Chicago Plastic Surgeon
4.0 out of 5 stars 44 reviews

Pain reduction

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I almost always instil a long acting local anesthetic in the pocket to minimize the discomfort for about the first 12 hours. It really works and I always want to make my patients as comfortable as possible. Watch my videos!

Edward J. Domanskis, MD
Newport Beach Plastic Surgeon
4.5 out of 5 stars 28 reviews

Pain After Breast Augmentation Varies With Each Patient

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With a breast augmentation, the level of pain and discomfort is different for everyone.  Some people come in the next day and have almost no pain.  Others come in and look miserable.  I generally inject a long acting anesthetic right beforethe implant goes in to the pocket, but in reality, it only lasts about 4-5 hours, then the pain kicks in. Even the pain pumps afterwards do not take the pain away to any significant level.  I would not get too nervous about it.  All surgeons are different, and al use varying techniques.  Know that no matter who you are, generally within 72 hours you are doing well and well on your way to recovery.  I hope this helps.

Reducing post op pain after augmentation/annoyed MD

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Hi Lard in Houston,

My first impression is that if a surgeon acts annoyed when you asked a question, you should find another surgeon.  There are plenty of compassionate, patient plastic surgeons in Houston.  If you need a recommendation, feel free to call my office.  As for pain after breast augmentation, if you are having the implant under the muscle it will be a little more uncomfortable than if it is on top of the muscle.  For all my patients I use Methocarbamol, which is a muscle relaxor, pre and post op.  This helps reduce the muscle spasm which contributes to post op pain.  It is VERY effective.  I also use Marcaine which is a long lasting local anesthetic in the pocket.  This helps as well but the Methocarbamol is the most important.  Anxiety will also increase post op discomfort.  If a patient is anxious I also use Valium for a few days.  Good luck and consider finding another surgeon.  If you are not in a good environment and feeling supported by your surgeon and his staff, this will not be a good experience.

Tracy M. Pfeifer, MD, MS

Tracy Pfeifer, MD
Manhattan Plastic Surgeon
4.8 out of 5 stars 29 reviews

Post-operative pain relief following breast augmentation

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I typically perform injections of bupivicaine into the implant pocket at the conclusion of the operation. While this may diminish the early post-operative pain, it is relatively short lived. Pain pumps are available for longer term relief but I have not been impressed with the degree of pain relief.

Otto Joseph Placik, MD
Chicago Plastic Surgeon
4.9 out of 5 stars 86 reviews

Breast augmentation pain

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I will on occassion inject the operative site with marcaine ( a long acting local anesthetic).  I, too, believe you should be weary if you are having a difficulty communicating with your surgeon PRIOR to surgery.  You need to be able to get along, and have faith in your doctor in the unlikely event that things do not go well.

David A. Lickstein, MD
Palm Beach Gardens Plastic Surgeon
5.0 out of 5 stars 9 reviews

Anesthetic for breast augmentation

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You should discuss this further with your surgeon. Some surgeons use pain pumps( I do not), but I usually inject the pockets with a long acting anesthetic to ease the post-op discomfort.

Steven Wallach, MD
New York Plastic Surgeon
4.2 out of 5 stars 30 reviews

Injections and other options for pain control after augmentation

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I and many other surgeons routinely inject a long-acting numbing anesthetic to help with discomfort after breast augmentation. However, at most it only lasts 6-8 hours. Another option is an On-Q "pain pump" which slowly infuses numbing medication into the pocket through a tiny catheter. This lasts for about 3 days, at which time you should be doing well-enough to get by.

Some surgeons make an issue of having patients return to routine activities early because they use gentle surgical techniques, and so they feel that the numbing meds aren't necessary. I think all of us use similar gentle techniques but every patient is different and you should feel very comfortable that your surgeon is paying attention to your needs.

Richard Baxter, MD
Seattle Plastic Surgeon
4.9 out of 5 stars 59 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.