Nerve Pain Post Breast Augmentation: Nortriptyline Vs Gabapentin?

3 wks post op. In addition to ice and stretching, I have requested to be on gabapentin. It has worked well, but still some pain. I just titrated up to 600mg BID- Your thoughts on usage of gabapentin and nortriptyline. I know that Nor has quite a bit of SE, but I understand that it is used a lot for nerve pain and is the preferred medication for some Drs. Question: should I remain on gaga or switch? your experience on either medication and what is the preferred dose

Doctor Answers 4


I find that gabapentin (neurontin) is quite helpful for patients with neuralgias (nerve-related pain).  However, if the patient is still having a lot of pain, despite a good dose of the medication, I would certainly consider a referral to a pain management expert, for additional input.  That's what I would suggest for you.

Orlando Plastic Surgeon
4.9 out of 5 stars 79 reviews

Nerve pain

I have never used either gabapentin or nortriptyline for post operative pain management. I find the combination of muscle relaxants and narcotics to be very effective.

Norman Bakshandeh, MD, FACS
New York Plastic Surgeon
4.9 out of 5 stars 14 reviews


It is true that gabapentin is useful in nerve pain. Gabapentin doses are usually titrated until a desired effect is attained.  It is also true that the overwhelming majority of plastic surgeons have no expertise in its use, and your question would best be referred to your primary physician or a pain specialist. 

What puzzles me is why you need any pain medications at all three weeks after your surgery. Almost all patients are off everything by a week or so. Thanks for your question, best wishes for an uneventful recovery.

Jourdan Gottlieb, MD
Seattle Plastic Surgeon
4.6 out of 5 stars 45 reviews

Gabapentin at 3 Weeks Following Breast Augmentation

    Some degree of nerve pain can be anticipated at 3 weeks following breast augmentation.  If this pain is debilitating for some reason, Gabapentin is a reasonable choice.  Referral to a pain management specialist would probably be the best solution.  Kenneth Hughes, MD Hughesplasticsurgery Los Angeles, CA

Kenneth B. Hughes, MD
Los Angeles Plastic Surgeon
4.9 out of 5 stars 492 reviews

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