Can you use a heating pad on your back after Breast Augmentation?

Question

I am 4 days post-op of submuscular silicone implants. I have had a great amount of upper back pain. I'm not sure if it is from the surgery itself, or from laying on my back. I am a normal tummy sleeper. I've had my mom gently rub between my shoulder blades which gives temporary relief but I'm curious if I could lay on a heating pad for the back pain? Or is there any other remedy I could try?

Richard H. Tholen, MD, FACS · Answer

This is a fairly common concern; I get asked this question almost weekly, but my partner and I do lots of breast surgery.Dr. Schlesinger has given a nice discussion of the muscular components of back pain after augmentation. But there is one other cause that helps to explain both upper and lower back pain after breast augmentation.Swelling occurs after surgery of the breasts, and chest and ribcage swelling is always evident after this surgery, to one degree or another, in every patient. Swelling is both due to (hopefully minor) surgical trauma, and also to "third-spacing," which is generalized tissue swelling secondary to adrenocortical hormone ("stress hormones") release with surgery and anesthetic medications. This third-spacing causes ALL of your tissues to swell a bit, reaching its peak 3-4 days after surgery. Add this to the actual surgical site swelling, and you have a few pounds of "extra" fluid in your tissues. (This is confirmed by standing on a scale right before surgery and again a day or two after surgery when the weight goes up by 4-8 pounds, and only 1 pound per implant (454g or cc) accounts for that increase of weight.)In the days that follow surgery, when you are standing the fluid gradually is pulled by gravity to your ribcage, abdomen, and eventually hips. You may already notice this in your pants fit. When you are sleeping, the swelling is pulled by gravity towards your back, and this is another cause of your back discomfort.Heating pads are NOT a good idea, since I have seen blisters and open wounds from falling asleep (and not moving because of pain medication blunting your normal roll and adjust responses). Same thing goes for ice--I have seen blistered frostbite from ice bags directly on skin.Take your muscle relaxants. If this does not settle fairly promptly over the next few days, you may wish to consider purchase of a TENS unit (Transcutaneous Electrical Nerve Stimulator) unit that can help diminish painful nerve impulses. But I doubt this will be necessary in a few more days. Your body will clear the excess fluid via your kidneys. Best wishes! Dr. Tholen

S. Larry Schlesinger, MD, FACS · Answer

Boy, this is a great question and I am really glad you asked it.The pain in the back you are feeling now is because the pectoralis muscles on the front of your chest and the muscles on your back work in unison, and because the pectoral muscles are temporarily not functioning normally, the back muscles overpull and go into spasm.A second theory why back muscles are spasming after subpectoral breast augmentation is because the pectoralis muscle is pushed forward by the implant and, in an attempt to compensate for this forward movement of the chest muscles, the back muscles overpull and go into spasm.  Unfortunately, laying on a heating pad can lead to a first degree burn because patients often fall asleep while the heating pad is still on.  A better, more effective, and safer treatment is a small patch of material called "Titanium" which is made by a company by the name of Phiten.  This has an amazing ability to block the transmission of the sensation of pain.  It's reasonable and easily purchased off the internet.

Larry S. Nichter, MD, MS, FACS · Answer

I generally don't recommend ice for breast patients as the implant is so far from the skin surface it does little good nor is it helpful after the point of maximum swelling, after the first 3 days.Discuss this with your surgeon and follow his directions!#iceaftersurgery#breastaugmentation#BA

Brian C. Reuben, MD · Answer

Thank you for your question.  There is no reason why you cannot use a heating pad.  As always, be careful and do not apply it directly on the skin as you don't want to get a burn.

Mathew A. Plant, MD, FRCSC · Answer

Yes, there should be no reason you can't. You can also probably take Tylenol extra strength or potentially a muscle relaxant like robaxacet but you should clear any drugs you take with your surgeon first.

Can you use a heating pad on your back after Breast Augmentation?

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