The breast enlargement surgery itself should be painless, whether performed under sedation with local anesthetic, or general anesthesia. It is the postoperative period that some may find brings discomfort. Assuming the postoperative course is without complication, pain from breast augmentation surgery peaks the day after surgery, and diminishes over the course of the following three to four days to be tolerable enough without the use of narcotics. Of course, pain tolerance varies significantly from patient to patient. The 72-96 hrs time frame is a “ballpark” figure, and a reflection of personal experience. Several other important factors are crucial to consider in breast enlargement surgery. Pre-incisional administration of local or dilute local (called tumescent) anesthetic greatly diminishes postoperative breast enlargement surgery pain. Postoperative pain and tenderness can be further affected by breast implant placement position. Sub-muscular placement or “dual plane” placement may cause substantially more discomfort than sub-glandular placement because of muscle dissection. If a skin excision is necessary, pain may be more pronounced. The injection of local anesthetic at the conclusion of breast augmentation surgery greatly diminishes postoperative discomfort. In addition, a more effective multiple intercostal nerve block may be performed. Finally, a small catheter may be placed, within the breast implant pocket, for the purpose of delivering local anesthetic in the post breast enlargement surgery period. This has been shown in studies to help significantly with postoperative discomfort. In short, breast enlargement surgery is very well tolerated in most patients.
Having stated all of this, it is important to note that pain should get progressively better. Pain that is persistent, uncontrolled by pain medication, or increases in duration and/or intensity after breast augmentation may be a sign of post-operative complication and requires prompt attention.
