The painful truth about “painless breast augmentation”

I often have patients who ask me if I do “painless breast augmentation”.  The truth is that there is no such thing as painless breast augmentation.  There are a number of steps that can be taken to make the procedure less painful.

I have seen patients for breast augmentation revision who originally had a “painless” breast enhancment who reported to me that the experience was otherwise.

Much of the pain after breast augmentation is due to the stretch of the tissues around and above the breast implants.  Larger implants and placement of the implants beneath the pectoral muscles can increase this pain.

Its not all doom and gloom, however.  There are some excellent “tricks” to help reduce the pain significantly.

  • Gentle tissue handling without tearing
  • Creation of the implant pocket with minimal cautery (burning)
  • The use of local anesthetics at the end of the procedure (pain pump vs long-lasting anesthetics)
  • Avoiding hematoma (bleeding in the implant pocket)
  • Use of conservative breast implant sizes
  • Placement of the implants above the muscle

I would not recommend placing the implants above the muscle for most patients.  There are too many advantages (shape and feel) with placement beneath the muscle.

Generally, using these tricks the pain is minimal to moderate, lasting a couple of days to weeks.  The average patient takes pain medications for 3 days after surgery.  I certainly have patients who report they take no narcotic pain medications at all.  Unfortunately, the converse is also true and I have patients who still need pain medications for 2 weeks after surgery.

Here is my advice to the patient concerned about breast augmentation pain:

  1. Choose a board certified plastic surgeon.  (You just want to do this once)
  2. Go into it expecting pain (I have found that these patients generally do better)
  3. Do seek out a plastic surgeon who is experienced in breast augmentation
  4. Do find a surgeon who places an emphasis on limiting your pain and down-time as much as possible

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