For photos of breast augmentation surgery, look here: Breast enlargement

Any surgery has some level of pain or discomfort associated with it. After all, your body is being cut, pulled, probed, pinched, injected as well as other unpleasant things, all for the greater good that will come afterwards when you look and feel great.

Breast augmentation pain

After a cosmetic breast augmentation surgery, there are two types of pain patients should be aware of.

Normal post-breast-enlargement pain

This type of pain is the pain associated with the placement of a saline or silicone implant under the skin and muscles of the chest, and it is common to all breast augmentation patients.

Pain and numbness from the breast implant stretching the skin

Whether your breast implant is placed above or under your muscle, the skin of the chest is stretched by it. The sensation is initially like getting a very strong pinch, and soon thereafter, in a day or so, the pain subsides as the skin stretches out.

The stretching of the skin does have another effect on the nerves that run through the skin. Specifically, the fourth inter-costal nerve leaves your spine and travels under your arm to supply sensation to the  nipple and medial parts of the breast. The implant stretches this nerve out, and patients typically get a little numbness of the nipple and the inner part of the breasts. Sensation usually goes back to normal in a few weeks.

Pain from the breast implant stretching the chest muscles

This type of pain pertains to patients who have breast enlargement with an implant placed under the muscle—the way I perform almost all of my breast augmentation surgeries. The implant will stretch the muscle and initially cause spasms and cramps that will lead to pain. I encourage my patients to take Valium and other muscle relaxants during the first couple of days to improve this pain. The sooner the patient is up and moving about, the sooner the pain will disappear as the muscles return to normal functioning. Placing the implant over the muscle does not cause this type of pain, but the implant can sometimes be felt under the skin.

Pain from infection

In rare cases, less than 2% of breast augmentation procedures, the breast implant can become infected. When this happens, the swollen, red, warm breast becomes painful like any other infection, and treatment requires removal of the implant, antibiotics and re-augmentation at another time.

Unusual pain after breast surgery

Nerve pain

Not uncommonly, patients will complain of a burning or shooting pain along the distribution of the nerve going to the nipple. The initial stretching at the time of surgery can take a little longer to heal, and this type of neuralgia, or nerve pain, can last for a few weeks. Typically, massage, icing and anti-inflammatory medications help the pain. Lidocaine patches, a form of local anesthetic, can also help.

Sharp pains years after surgery

Some patients have an uneventful recovery but experience a haphazard sharp pain in the breast. This usually occurs after exercise or some other activity. Pushing on the area of pain can pinpoint its location. The cause is almost always a muscle that has been pulled or a breast capsule that has been torn. Both are self-limiting effects and improve with time.

Dull pain and enlargement of the breast

In some patients, trauma to the lymphatics, either at the time of surgery or afterwards from some activity, can lead to a seroma formation. This accumulation of lymphatic fluid around the breast implant can lead to an enlarged and painful breast. The liquid may resolve itself spontaneously, but it often needs to be drained.

Should you have any pains after your surgery, make sure you speak to your cosmetic plastic surgeon so they can prescribe you relief. Both you and your plastic surgeon want your post-operative surgery to be as comfy as possible.

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