Pain After Breast Lift and Augmentation - Is This Normal?

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.

Chest muscle spasms are expected to occur for 3 to 4 weeks after the surgery. This is because your muscles are adjusting to the implants. This may cause a pulling and stretching feeling in your breasts. Pain and swelling should get better by week 4. Good luck with your healing process.

It is usual to have some pain and swelling after a breast uplift with an implant procedure. In such cases the implants are mostly placed behind the muscle and this may cause be responsible for more swelling and pain. This is mainly from muscle swelling and some bruising or damage to tiny nerve endings divided during the procedure. this may also make the nipple more sensitive or numb. The selling and pain starts to go down after two week and most swelling can be down by six weeks. In the initial period pain killers like codeine or paracetamol or combination may be needed. After a period of two to three weeks, ,the need for regular pain killer goes down.

It is very common to experience the searing and burning pain following a breast lift and augmentation. It can also differ between sides with one breast being more uncomfortable than the other, and also vary from day to day. This type of pain can come on suddenly and spontaneously and will become less over time.  If you are concerned or the pain persists follow up with your plastic surgeon. 
You should expect a great deal of swelling after surgery, however a significant amount of the initial swelling will resolve within the first 2 -3 weeks.  Typically, It takes 3 - 6 months for the breasts to completely soften and settle. 

Prolonged pain requiring narcotics for 2 weeks is unusual after breast augmentation.   You should see your surgeon and discuss where and when you are experiencing the pain.      Assuming there is nothing which obviously wrong, you will most likely need to just give it some time.      Discuss alternatives to narcotics, such as gabapentin (which often helps with nerve related pain), and/or a muscle relaxant.   

It would be best to set up an appointment with your surgeon, as the type of pain you are describing is not typical 2.5 weeks out from surgery and may have other indications.

I'm sorry to hear you're still having pain. Most patients undergoing breast surgery are able to transition from narcotics to over the counter pain medications within the first week. So it sounds like your pain is a little unusual. Also, burning pain is frequently associated with nerve pain. This can be related to inflammation, pinched or irritated nerve. Gabapentin or Lyrica can help with nerve pain. Contact your physician to have them evaluate you in person and make a decision about how to help improve your recovery. I hope this helps. 

You should go back and see the doctor who operated on you and ask him to review both your appearance and your pain medication.  The pain and swelling will go eventually, you just need some more time to heal.  It is unusual to be having this much pain at two weeks though so definitely get it checked out.  It is important that you are seen and assessed by your surgeon to ensure there are no other correctable causes for your discomfort.  The most obvious cause for concern would be either an infection of a haematoma, either of which could cause more pain on the affected side, but both of these tend to be fairly obvious.  Haematomas usually present with increased swelling on the more painful side, sometimes also with more bruising on that side.  Infections usually appear red and inflamed and you can also experience general symptoms of fevers and feeling unwell.  Some people do get nerve related pain following breast surgery.  This does tend to cause symptoms like burning and hypersensitivity and can result in the discomfort taking longer to settle.  You're quite right though that in most cases these discomforts tend to resolve on their own, do not represent anything sinister and do not reduce your chances of getting good a longterm result.  

Acute postoperative pain after breast lift and augmentation usually lasts just a couple of days. The pain usually evolves into a generalized soreness in the muscles after this period. Sharp intermittent searing pain or shooting burning pain two weeks out from surgery may represent pain from nerves that were stretched or otherwise injured during the surgery and are beginning to repair themselves. This type of pain can last several weeks in some patients and in my experience doesn't respond well to narcotic medications (vicodin). I recommend that you follow up with your surgeon to see if there is a medical reason for the continued pain. Your surgeon may prescribe a medicine like neurontin to help with the neurogenic pain until the damaged nerves repair themselves. Good luck.

Pain varies from patient to patient.  I have some patients who do not take any pain meds while others take all the prescribed pills.  I have found managing pain with a muscle relaxant, a narcotic and an anti-inflammatory such as Celebrex is quite helpful.  I allow patients to take NSAIDs such as advil or motrin after their first visit.  It is important to minimize your activity for several weeks after breast surgery (even though you will likely feel like you can do anything).  The shooting and burning pains you are having are likely from nerves getting used to their new environment.  It will all resolve.  Dr. Greenwald

Pain and swelling are expected in the weeks following a procedure. However, if you feel that the pain is not subsiding or getting worse, then you should schedule an in-person examination with your surgeon to be sure that you are healing properly. Based on the current state of your recovery, they will be able to suggest how to lessen the pain and swelling.