Does Breast Enlargement with Implants Hurt?

Nobody likes to hurt, yet some level of what plastic surgeons euphemistically call “discomfort” does occur after all surgeries. Breast augmentation surgery in particular has in the past been associated with “a lot of pain.” My patients are always telling me of a friend of a friend who had the surgery and had so much pain that she could not go to work for a month. I tell my patients that they will be back at work on Monday if they have the surgery on Friday! 99.9% can do just that.

A large amount of how we perceive physical pain such as after a breast enlargement is based on our expectations, previous experiences, emotional state of the day, associated symptoms such as nausea or dizziness and a multitude of “higher” brain functions. In other words, part of it is in our heads. There is obviously pain coming from the site of the surgery also. This pain is either due to the pain of the skin nerves having been cut or to deeper structures such as muscles and fascia having been injured. In breast augmentation, where saline implants or silicone implants are placed under the muscles of the chest, the majority of the pain in due to muscle stretching. The actual incision for a saline implant is about one inch, and for a silicone implant 2-3 inches. These incisions have minimal pain associated with them. The muscle pain, on the other hand, is a cramping type of pain, which, like any muscle cramp, is not really helped by the narcotic pain medication that acts on our brains. Instead, what I have been prescribing for my patients with breast enlargement or even tummy tucks, where muscles are being pulled and stretched, is a muscle relaxant such as Valium.

My cosmetic surgery breast augmentation and tummy tuck patients get a combination of Valium and a pain medication such as Percocet for pain control, and this has been working wonderfully for them—and for me —for years. As soon as the incisional  pain is gone in a day or two, I tell my patients to switch to Tylenol. They can use the Valium here and there as necessary if they have a particular cramp in the muscle.

So some of the pain is in our heads, some of it in our skin and some in our muscles. Breast enlargement surgery with implants does hurt, but only a little and only for a couple of days.

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M.Tavallali,M.D. FACS

Cosmetic Plastic Surgeon serving DC,VA,MD