Breast Implants and Botox?

Im curious...why doesn't every PS use Botox injections to numb the pectoral muscle during submuscular implant surgery?

Doctor Answers 10

Breast Implants and Botox?

Dear PLAT,

Thank you for your post.  Botox is very expensive.  The amount of botox required to paralize a large muscle like the pectoralis major muscle would add a few thousand dollars to the procedure.  Also it is not necessary, and you will have much less strength in your arms for three months following the injections.

Best Wishes,

Pablo Prichard, MD


Phoenix Plastic Surgeon
4.9 out of 5 stars 42 reviews

Ways to Numb the Muscle during Augmentation and TT surgeries

First of all Botox does not numb muscles or anything else, rather it prevents spasms by temporarily paralysing it.
Exparel is a much better choice. Essentially Exparel is a very long-acting local anesthetic that has recently been released. It lasts approximately 3 or more days following injection. This is the same length of time that a pain pump lasts and will therefore take the place of a pain pump. This means patients can enjoy the same effect of a pain pump, but without any catheters and no pain pump to carry around.
Exparel will be available for those concerned about minimizing discomfort after surgeries such as tummy tuck and breast augmentation.
Exparel costs the same as a pain pump and produces the same result but with less hassle.

Breast augmentation and Botox use

I would not recommend the use of Botox for this purpose. I usually do intercostal nerve blocks with a long acting local anesthetic but not Botox.  Better to use valium as a muscle relaxant. 

Jeffrey Zwiren, MD
Atlanta Plastic Surgeon
4.5 out of 5 stars 16 reviews

Botox has no anesthetic effect.

Botox paralyzes muscle, it does not anesthetize it. It would be ineffectual for pain relief with sub muscular breast augmentation.

Vincent N. Zubowicz, MD
Atlanta Plastic Surgeon
4.9 out of 5 stars 32 reviews

Breast Implants and Botox?

Botox does not numb.  It paralyzes or weakens muscles.  If you want to numb the muscles, long acting local anesthetics can be used during surgery.  If you want to relax the muscles, muscle relaxants work very well and I use them on all my submuscular augmentations.

Rigo Mendoza, MD
Tampa Plastic Surgeon
4.3 out of 5 stars 34 reviews

Botox and Breast Augmentation

Botox works very well to weaken or paralyze muscles temporarily to reduce wrinkles. For "numbing" purposes in breast implant surgery long acting local anesthetic placed in surgery works very well. For relaxing of the pectoral muscle, muscle relaxing medicines work well during and even after surgery. Temporarily weakening pectoral muscles with botox for implants as it turns out does not actually have a role.

Botox and breast augmentation

Botox and breast augmentation inherently does not make sense to me.  This is because for Botox to work, it may take up to a week. The rationale to use it is to alleviate pectoralis muscle spasm after initial surgery and therefore some of the pain.  In general, most pain disappears within the first week. So it would defeat the purpose of using the Botox

Steven Wallach, MD
New York Plastic Surgeon
4.1 out of 5 stars 24 reviews

Botox for Breast Augmentation

I have thought about any role Botox could play in breast augmentation but I have not found a good indication for its use.  You should understand that Botox is not a numbing medication.  It works by interfering with a muscle's ability to contract.  In theory this might decrease discomfort with respect to muscle spasms but it typically takes at least several days to work and could not easily be injected several days before surgery.  By the time it would begin to work it would not be so necessary.  A better approach to decreasing discomfort after breast augmentation is to use a rapid recovery approach that uses some oral medications as well as a gentle surgical technique and postop arm exercises.  In addition, I have used a newer numbing medication called Exparel with dramatic reduction in postop discomfort.

Richard Kofkoff, MD, FACS
Saint Louis Plastic Surgeon
5.0 out of 5 stars 73 reviews

Breast Implants & Botox

I have never used Botox in the pectoralis muscle during breast augmentations.  I do not see the the need for this extra cost.

John Whitt, MD (retired)
Louisville Plastic Surgeon
5.0 out of 5 stars 2 reviews

Is Botox Needed for Breast Implant Placement?

Although one small study showed less discomfort when Botox was used for breast reconstruction with expanders under the chest muscle, similar studies have not been done for breast augmentation. As it takes a few days for Botox to relax the muscle, it is not likely to have a dramatic effect in this case, but may allow for the implant to end up in a lower position sooner. Also, there would be an additional cost to the procedure of about $1000. If you want to try this, ask your plastic surgeon. It will not be useful for implants placed over the muscle. 

Karol A. Gutowski, MD, FACS
Chicago Plastic Surgeon
4.9 out of 5 stars 65 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.