Pain After Breast Lift and Augmentation - Is This Normal?
Doctor Answers 36
Pain and Recovery After Breast Aumentation
It is unusual to still be taking narcotic pain medication throughout the day two weeks after breast augmentation. The acute muscle pain that is expected after subpectoral breast augmentation should begin to be relieved after only a few days. I expect my patients to be taking no more than a few pain pills a day, if that, by one week after surgery. The searing, burning pain that you describe sounds more like neuropathic pain than muscle pain, especially since it is present on only one side. This can occur after breast augmentation. With creation of the implant pocket during surgery, nerve branches that provide sensation to the breast and nipple may be damaged or irritated from stretching or from cutting with sharp instruments or electrical cautery. Complete loss of sensation may be permanent. Pain and sensitivity is usually temporary. The first thing that you should do is to let your surgeon know about the problem that you are having and follow his/her instructions. If the pain is neuropathic in nature, then treatment other than narcotic medications could include ice, anti-inflammatories, B vitamins, topical anesthetics and nerve blocks. If a neuroma is diagnosed, it is possible that surgical exploration and excision would be indicated and could result in relief of symptoms.3. Among all women who desire improvement in the size and shape of their breasts due to changes from aging, weight loss and/or pregnancies, only a small percentage will achieve a satisfactory result with implant placement alone. This will depend upon the size of implant used and on the amount and location of excess skin, as well as on the position of the nipples. It is in a minority of patients that the skin excess and nipple position is favorable enough to allow a good result with implant placement alone, without using an excessively large implant. For most women, it is best to accept the additional scars of a vertical (lollipop) or Wise pattern (anchor) mastopexy, in order to achieve a more satisfactory breast shape. A crescent mastopexy does little to nothing to change the shape of the breast. It removes very little skin and serves only to lift the nipple/areola position slightly. A periareolar (donut) mastopexy will reduce and tighten skin only in the central part of the breast. This technique tends to flatten the breast and reduce projection. Because of this effect and other potential complications, periareolar mastopexies have the highest rate of dissatisfaction and subsequent revisions. In my experience, having an aesthetically pleasing breast shape is much more important for patient satisfaction than having minimal scars. Unfortunately, for most women in your situation, they cannot have both.
Post-op issues like this should always be addressed with your treating surgeon. I agree with the other surgeons.
In addition, in my San Francisco practice, we typically do not recommend ibuprofen for post-op pain in the immediate post-op period as it can contribute to post-operative bleeding which can be a factor in post-op complications.
Bottom line - call your doctor. Today!
Steven Williams, MD
Pain expected after breast lift with submuscular implant, but check with your surgeon.
Your complaint is not uncommon after the operation you have had. Asymmetrical pain and healing is fairly common. Nevertheless, you should keep in touch with your surgeon to make sure there is no underlyiing problem (blood collection or infection) that is prolonging the suffering on your affected side.
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Breast Pain after Implants
This is highly variable and can depend on whether implants are placed under or over the muscle as well as the size of the implant relative to the breast.
Oftentimes the problem arised from the operation being performed on two sides leaving the patient to compare one side to the other. Sometimes pain can be confusing as well. Let me explain. Sometimes the side on which nerves are injured can be numb and this is interpreted as normal. Whereas the otherside with normal nerves that are intact is more painful.
Sometimes nerves "shutdown" after being stretched or compressed kind of like your leg falls asleep when you sit on it. But when it wakes up, it is painful and causes pain and needle sensations we call dysesthesias.
There are other nerves on the side of the breast that travel from between the ribs into the inner part of the upper arm. These can be stretched in a thin indivdual with a small chest and a relatively big implant that causes pain to radiate into the arm.
Most of these resolve with time as the nerves are stretched. Doing breast displacement (massage) exercises can help but I would leave this up to your surgeon. If this is the cause, the pain is generally worse at night when you are least active. Ask you surgeon about the exercises.
It should get better!
After Breast Augmentation with Mastopexy, particularly when the implants are placed behind the muscle, it is not unusual to have moderate pain which may be worse on one side than the other, even though the same operation was done to both breasts. What you perceive as severe pain might be perceived as less-painful (or excruciatingly painful) by a different patient, so there is no "normal" amount of pain. I prescribe very strong pain medications as well as muscle relaxants or Valium for my post-operative patients, and I allow them to adjust the doseage according to their pain threshold. The goal is to avoid pain as much as possible, while minimizing the side-effects of the pain medications.
Severe pain may indicate a problem like bleeding into the space around the implant, or possibly infection, and for this reason, you should see your surgeon to make sure that your healing is progressing as expected. By two weeks post-op, most of the serious pain shoud be resolved.
Need for narcotics unusual after 2 weeks
If you ask, "is my pain typical?" The answer is no, you sound like you have more pain than usual. If you ask, "what can I do to lessen the pain and swelling?," there may be several things.
First, your surgeon should confirm that these symptoms are not a sign of bleeding, infection, or other complication. Second, I agree with another surgeon's recommendation for muscle relaxants. Then, I talk with my patients to find other measures that may help. Some examples include: stretching or range-of-motion exercises, gentle breast massage, looser or firmer bra support, and ice packs. Some patients have noticed that anti-histamines like Benadryl have helped. You may have to try several things.
Hope you feel better soon.
I would advise you to follow up with your plastic surgeon to determine the cause of your pain
Pain following breast surgery is expected ranging from mild to severe. I would advise you to follow up with your plastic surgeon to determine the cause of your pain. There are many possible reasons and a thorough physical examination is required.
Thanks for your question.
Pain After Breast Lift and Augmentation
Pain after breast lift and sub-muscular augmentation
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.